genital warts
Pattern of sexually transmitted diseases among commercial sex workers (CSWs) in Ibadan, Nigeria.

Bakare RA, Oni AA, Umar US, Adewole IF, Shokunbi WA, Fayemiwo SA, Fasina NA.

Special Treatment Clinic, University College Hospital, Ibadan, Nigeria. rabakare yahoo.com

The purpose of this study was to determine the pattern of STDs among commercial sex workers (CSWs) in Ibadan, Nigeria. The subjects were 169 CSWs randomly selected from 18 brothels, majority of who were examined and investigated in their rooms. Another 136 women without symptoms who visited the special treatment clinic, University College Hospital, Ibadan were selected as a normal control group. Vaginal candidiasis was the most common STD diagnosed in both CSWs and the control group. The other STDs in their order of frequency were HIV infection 34.3%, non-specific vaginosis 24.9%, trichomoniasis 21.9% and gonorrhoea and "genital ulcers" had an incidence of 16.6% each. Other important conditions were tinea cruris 18.9%, scabies 7.7% genital warts 6.5% and 4.1% of them had syphilis sero-positivity. All the 13 CSWs that had scabies, the 4 (36.4%) with genital warts and the 19 (67.9%) with "genital ulcers" had HIV infection. While there was no significant difference between the CSWs with vaginal candidiasis, gonorrhoea, trichomoniasis and the control group, the HIV positivity was significantly higher (P < 0.001) in CSWs than in the control subjects. These findings suggest that women who exchange sexual services for money can no longer be ignored, and should therefore be identified and made to participate in STD prevention and control programmes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12751565&dopt=Abstract genital wart


genital warts
An audit of patients who have received imiquimod cream 5% for the treatment of anogenital warts.

Maitland JE, Maw R.

Department of Genitourinary Medicine, Royal Victoria Hospital, Belfast, UK.

With the licensing of the new drug Imiquimod cream 5% (Aldara 3M Health Care) for the treatment of anogenital warts and its inclusion into clinic guidelines, a case note review audit was performed of its use. The treatment of 52 patients was audited. Results showed that clinic guidelines were being followed and that patient outcomes in terms of clearance were at least as good as the quoted rates in the literature. Significant issues included firstly patient education-especially for those who had previously received ablative therapy. Secondly the length of time that therapy would be continued before a patient was deemed to be a non-responder to Imiquimod cream 5%, and if this was the case should the frequency of application be amended from the manufacturer's recommended regime of 3 times a week.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10772094&dopt=Abstract genital wart


genital warts
The health and economic burden of genital warts in a set of private health plans in the United States.

Insinga RP, Dasbach EJ, Myers ER.

Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA. rpinsinga students.wisc.edu

We estimated the prevalence of and costs associated with genital warts among privately insured individuals from the perspective of a private health plan in the United States. Health care claims data were derived from a sample of 3,664,686 privately insured individuals. The database was limited to cases of disease for which an insurance claim was generated, with costs reflecting inpatient, outpatient, and pharmacy payments from all sources. We identified 5095 cases of genital warts (1.7 cases per 1000 person-years) billed through the health plans during 2000. The prevalences of and health plan costs associated with genital warts were highest among women aged 20-24 years (6.2 cases and $1692 in costs per 1000 person-years) and men aged 25-29 years (5.0 cases and $1717 in costs per 1000 person-years). On average, individual episodes of care for genital warts involved 3.1 physician visits and incurred costs of $436. These are the first age- and sex-specific estimates of the prevalence and cost of genital warts for a US health plan.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12766834&dopt=Abstract genital wart


genital warts
Anogenital warts contributing to the risk of squamous intraepithelial lesions among HIV-positive women of Sao Paulo, Brazil.

Goncalves MA, Burattini MN, Donadi EA, Massad E.

Division of Clinical Immunology, Department of Medicine, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil. epigin uol.com.br

Unsafe sexual practices may expose HIV-positive women to high-grade squamous intraepithelial lesions (SIL) and to infection with oncogenic human papillomavirus (HPV) types. A cross sectional study of 141 HIV-positive women was designed to evaluate risk factors for the development of cervico-vaginal SIL and HPV-DNA detection/typing. Uni- and multivariate forward stepwise analysis was used to determine the relationship between risk variables and HPV infection and between risk behaviour, HPV and HIV infection with development of SIL. Univariate analysis showed that HPV-DNA infection was related to previous and recurrent anogenital warts, male genital warts and cytological alteration. For final multivariate analysis, both HPV type (undetermined- and high-risk, OR=29.3 and 112.0, respectively) were statistically associated (P=0.019) with high-grade cervico-vaginal SIL. The presence of anogenital warts as well as high- and undetermined-risk HPV infection may alert to cyto/histopathological alterations. These results point out the importance of the use of barrier methods and routine early genitoscopy/treatment for HIV-infected partners.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12803937&dopt=Abstract genital wart


genital warts
[Identification and assessment of multiple human papillomavirus types in condyloma acuminata lesions from patients with genital warts in Beijing area]

[Article in Chinese]

Hong SL, Wang JB, Liu YH, Si JY, Xu XM, Guo XC, Zeng Y.

Department of Dermatology, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.

OBJECTIVE: To identify and assess multiple human papillomavirus types in condyloma acuminatum lesions from patients with genital warts in Beijing area, and compare different features between otherwise healthy and immunosuppressed patients. METHODS: PCR, RFLP and nucleotide sequencing analysis were used to determine HPV types from individual lesions. RESULTS: The predominant type from other healthy patients was HPV6, secondly HPV11. The mean age of patients infected by HPV6 was lower than that of HPV11 and HPV6 + 11. While lesions from immunosuppressed patients were often contained HPV11 or mixed with HPV6. Besides, HPV types 16 and 53 were detected from infected lesions than other HPV types. CONCLUSIONS: HPV6 was the major pathogen of condyloma acuminatum, but infected patients were at lower ages. While HPV11 was most often detected from immunosuppressed patients. As a low risk virus in normal genital tract, HPV53 also could be a pathogen in genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12905662&dopt=Abstract genital wart