genital warts
Screening for cervical abnormalities in women with anogenital warts in an STD clinic: an inappropriate use of colposcopy.

Coker R, Desmond N, Tomlinson D, Bretherton K, Byrne M.

Department of Genitourinary Medicine, Patrick Clements Clinic, Central Middlesex Hospital, London, UK.

An audit of the use of colposcopy in women with anogenital warts was performed. Fifty women attending a clinic for sexually transmitted diseases in a District General Hospital with anogenital warts were examined by cervical cytology and colposcopy for cervical infection by human papillomavirus (HPV) or epithelial abnormality indicating cervical intraepithelial neoplasia (CIN) or both. Collated results showed a high prevalence of both conditions in these 50 women; 20 (40%) had evidence of cervical infection by HPV and 11 (22%) epithelial abnormalities consistent with CIN 1 or 2. However, neither CIN 3 nor invasive disease was detected. Colposcopy in this setting was shown to be a specific but insensitive tool and its role in the routine management of women with anogenital warts at our institution is not warranted.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7849124&dopt=Abstract genital wart


genital warts
Significance of anogenital warts in children.

Bingham EA.

Royal Victoria Hospital, Belfast.

Abuse or non-abuse, that is the question? The possibility of sexual abuse must be considered in every child with anogenital warts. However, innocent transmission of infection is recognised. This article sets out the evidence and indicates the points that should be addressed in order to identify the significance of anogenital warts in each child.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7874362&dopt=Abstract genital wart


genital warts
Ano-genital warts in consecutive male heterosexual patients referred to a CO2-laser clinic in Copenhagen.

Sand Petersen C, Menne T.

Department of Dermatology, University of Copenhagen, Gentofte Hospital, Denmark.

The relation between sexual practices and location of anogenital warts is discussed. Results were derived from clinical examination and interview of 56 consecutive male patients referred to CO2-laser treatment of therapy-resistant genital warts, at a clinic at the Department of Dermatovenereology, Gentofte Hospital, located in the northern area of Copenhagen. Twenty (100%) patients with anal warts and 36 (100%) patients with penile warts all claimed to be strictly heterosexuals. None of the patients interviewed had had anoreceptive coitus or been engaged in sexual practices with oro-anal contact. The study population otherwise had a heterosexual profile with approximately one fifth of the patients having had other sexually transmitted diseases, mainly chlamydia. The group of patients with anal warts had significantly fewer known sex partners with genital warts (25% versus 58%, p < 0.05) compared to the patients with penile warts. All patients received one or more CO2-laser treatments using local anesthesia, resulting in cure rates of 80% (16/20) and 89% (32/36) in men with anal warts and penile warts, respectively. Anal warts seem to be much more common in a heterosexual male population. There is a need to elucidate the nature and epidemiology of anal human papillomavirus infection in heterosexual males.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7906466&dopt=Abstract genital wart


genital warts
A pharmacokinetic evaluation of 14C-labeled afovirsen sodium in patients with genital warts.

Crooke ST, Grillone LR, Tendolkar A, Garrett A, Fratkin MJ, Leeds J, Barr WH.

Isis Pharmaceuticals, Carlsbad Research Center, CA 92008.

Afovirsen sodium is a 20-mer phosphorothioate oligonucleotide designed to be complementary to the messenger ribonucleic acid sequence for the translation initiation codon of the E2 protein vital to replication of human papillomaviruses types 6 and 11. 14C-Labeled afovirsen was given as a single-dose intradermal injection in each of four warts of five patients to determine the time-dependent changes in concentration of intact afovirsen in genital warts and to determine the systemic absorption and elimination of radiolabeled compound. Intact afovirsen in genital warts was determined by high pressure liquid chromatography analysis of protease K digested extracts. Intact afovirsen was present in wart tissue for at least 72 hours at concentrations several times in excess of the estimated minimal inhibitory concentration of 1 mumol/L. Absorption of radiolabeled afovirsen from the injection site was rapid, with a peak plasma concentration achieved within 1 hour. Clearance of afovirsen was primarily attributable to slow metabolism, with about 30% of the radiolabel eliminated as 14C-CO2 in expired air over a 6-day period after dosing. Radioactivity eliminated in urine represented metabolites of afovirsen. From the clinical pharmacokinetic data presented here and from previously published pharmacokinetic data in rats, the disposition of afovirsen in humans appears to be relatively similar to that in rats. These data suggest that once or twice weekly dosing regimen in the clinic may be appropriate.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7995006&dopt=Abstract genital wart


genital warts
Surveillance report: disease trends at New Zealand sexually transmitted disease clinics 1977-1993.

Lyttle PH.

New Zealand Venereological Society--Surveillance Unit, Christchurch Sexual Health Centre, Christchurch Hospital.

AIM--To document trends in sexually transmitted diseases (STDs) recorded by New Zealand STD Clinics from 1977-1993. METHODS--Clinic disease figures have been recorded since clinics commenced in the 1920s and were recorded in a comprehensive format from the 1970s. The New Zealand Venereological Society has collated these data since 1986. RESULTS--The most common STDs in New Zealand clinics are genital warts, non-specific genital infections, chlamydia and genital herpes. Genital Wart infection has been the commonest STD diagnosed in clinics since 1988 and occurred in 17.9% of new patients in 1993. Non Specific Genital Infections were the commonest diagnosis from 1977 to 1988 affecting 17.5% of new patients in 1993. Chlamydia has shown a fall since the mid 1980s diagnosed in 5.4% of new patients in 1993 compared with 14.6% in 1986. Gonorrhoea incidence has fallen steadily since 1975 affecting only 1.1% new patients in 1993. Genital Herpes numbers tripled from 1977 to 1993 and 54% are primary cases. HIV Disease has increased clinic workload greatly with screening and counselling conducted in 25% of new patients in 1993. HIV disease was diagnosed or managed in 0.2% new clinic patients (49 cases). Syphilis has remained at a low incidence in New Zealand diagnosed in 0.3% new patients in 1993. CONCLUSION--Attendance for the viral diseases, HIV disease, genital warts and genital herpes is increasing while for the bacterial diseases, gonorrhoea and chlamydia is decreasing. The rise in disease numbers since 1990 may be due to meeting service needs rather than a true rise in disease incidence. STD surveillance in New Zealand is improving with new reporting systems being developed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8001945&dopt=Abstract genital wart