genital warts
Quercetin and kaempherol: an argument against the use of podophyllin?

Petersen CS, Weismann K.

Department of Dermatology, Gentofte Hospital, Hellerup, Denmark.

INTRODUCTION--Topical application of podophyllin is a routine procedure in patients with ano-genital warts. Podophyllin is a crude plant extract and is therefore not a well-defined product. It may contain variable amounts of the active lignan podophyllotoxin and the majority of the dry weight of podophyllin is made up of substances never identified. OBJECTIVE--The purpose of the study was to estimate in podophyllin 20% the amounts of two mutagenic substances, quercetin and kaempherol. METHODS--Using high-pressure liquid chromatography the amounts of quercetin and kaempherol were determined in 3 batches of podophyllin 20%. RESULTS--Quercetin and kaempherol constitutes 2.5-3.8% and 6.0-6.4% of podophyllin dry substance, respectively. Podophyllotoxin constitutes in comparison 12.7-13.8% of podophyllin dry substance. CONCLUSION--As approximately 10% of the amount of dry substance in podophyllin 20% is composed of two mutagenic flavonoids, quercetin and kaempherol, efforts should be focused on the production of a well-defined purified podophyllotoxin preparation that may replace podophyllin for clinic use in patients with genital warts. Self-medication with purified podophyllotoxin 0.5% may be considered as first-line treatment in well-instructed patients with external genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7744421&dopt=Abstract genital wart


genital warts
Use of human papillomavirus type 6 capsids to detect antibodies in people with genital warts.

Carter JJ, Wipf GC, Hagensee ME, McKnight B, Habel LA, Lee SK, Kuypers J, Kiviat N, Daling JR, Koutsky LA, et al.

Fred Hutchinson Cancer Research Center, University of Washington, Seattle, USA.

Human papillomavirus (HPV) type 6 capsids were produced by recombinant vaccinia viruses and used in a capture ELISA to screen 901 human sera from three studies of genital HPVs. The highest seroprevalence was observed among subjects with recurrent genital warts. In a population-based case-control study of genital warts, 26 (58%) of 45 women with recurrent genital warts were seropositive compared with 19 (19%) of 101 control women with no history of genital warts (odds ratio, 6.5; 95% confidence interval, 3.0, 14.1). Among a cohort of pregnant women, 7 (88%) of 8 with recurrent warts were seropositive compared with 24 (30%) of 79 pregnant women with no such history. A significant association between seropositivity to HPV-6 capsids and the detection of HPV-6/11 DNA from genital specimens by polymerase chain reaction was also observed. Men with genital warts were less likely to be seropositive than were women with genital warts, and a positive association between the number of sex partners and seropositivity was observed among only the female university students.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7797899&dopt=Abstract genital wart


genital warts
HIV, sexually transmitted diseases and gynaecologic disorders in women: increased risk for genital herpes and warts among HIV-infected prostitutes in Amsterdam.

Fennema JS, van Ameijden EJ, Coutinho RA, van den Hoek AA.

Department of Public Health and Environment, Municipal Health Service, Amsterdam, The Netherlands.

OBJECTIVES: To determine the incidence of sexually transmitted diseases (STD; gonorrhoea, early syphilis, Chlamydia trachomatis infection, trichomoniasis and primary genital herpes) and gynaecologic disorders (vaginal candidiasis, anaerobic vaginosis, genital ulcerations of unknown cause, pelvic inflammatory disease, recurrent genital herpes, recurrent genital warts) in a cohort of HIV-infected and non-infected drug-using prostitutes in Amsterdam between 1986 and 1992. DESIGN: A subgroup of 212 female drug users with a history of prostitution, who made at least one visit to a special STD clinic for drug-using prostitutes was selected from an ongoing cohort study of drug users in Amsterdam. METHODS: Using Poisson regression, the relative risk (RR) for each outcome was calculated for HIV-positive women compared with HIV-negative women. To determine potential causal relations with immune suppression, associations between disease incidence and immunologic markers (CD4 cell count and anti-CD3 response) were assessed in HIV-positive women. RESULTS: Adjusted for number of clients and frequency of condom use, HIV-positive women were at strong and significantly increased risk for primary genital herpes (RR, 7.64), recurrent herpes (RR, 8.33) and recurrent genital warts (RR, 15.93); moderately (significantly) increased risks were found for gonorrhoea (RR, 1.43), trichomoniasis (RR, 1.39), vaginal candidiasis (RR, 2.11) and genital ulcers of unknown aetiology (RR, 2.60). Of these HIV-related outcomes, the risk for recurrent genital herpes and genital warts were strongly associated with decreased CD4 cell counts. CONCLUSIONS: HIV-infected women experience an excess morbidity of STD and gynaecologic disorders. The strongly increased risk for genital herpes and warts in HIV-seropositive women indicates a causal relation with HIV. This study emphasizes the need for accessible medical care for drug-using prostitutes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8527081&dopt=Abstract genital wart


genital warts
[The pediatrician, sexual abuse and anogenital warts in prepuberty]

[Article in Spanish]

Martinez-Roig A, Sanchez X.

Department of Pediatrics, Hospital Universitari del Mar. Barcelona, Spain.

The increase of incidence in human papillomavirus infection in population has favored the more frequent appearance of anogenital warts in children. Types 6 and 11 are the most frequently associated to this pathology. Though sexual transmission is common, with a very lengthy incubation period, it is not the only way. Sexual abuse is always a possible source of infection and should be excluded in all cases. An actuation protocol has to be established for the pediatrician depending on the clinical, epidemiological and the social characteristics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8640426&dopt=Abstract genital wart


genital warts
Genital warts: a study of patient anxiety and information needs.

Chandler MG.

Infection with genital warts is one of the most commonly seen infections in genitourinary medicine (GUM) clinics. A study of 50 women with a first-time diagnosis of genital warts was undertaken to determine the patients' levels of knowledge and anxiety in relation to their diagnosis. The findings revealed that 42 (84%) of these women were aware of their possible diagnosis before attending the clinic. Just over a half of them received this information from their GPs. Eight (35%) patients lacked and fundamental knowledge about the mode of transmission of genital warts and the need for prophylactic use of condoms. Seventeen (74%) of the women did not know or were unsure about the methods of treatment. High levels of anxiety were reported by the patients on their first clinic attendance. To increase knowledge and lessen anxiety in this client group, the author recommends reciprocal liaison between GPs, their practice nurses and GUM clinics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8696129&dopt=Abstract genital wart