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Query: EC:2.7.10.2 (
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44,029
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As condylomata acuminata often persist in individuals infected with the human immunodeficiency virus (HIV), an immunohistological study of
warts
from infected men was undertaken to further knowledge about human papillomavirus persistence in this group. Using an indirect immunoperoxidase method and a panel of monoclonal antibodies, the phenotypes of cells were studied in cryostat sections of perianal or anal
warts
removed from 14 HIV-infected men (10 homosexual and 4 heterosexual) and from 16 non-infected men (10 homosexual and 6 heterosexual). Although the median numbers of CD1+, CD3+ and CD4+ cells per unit area were similar in each group of individuals, the number of CD8+ cells was significantly higher in HIV-infected homosexual men when compared with non-infected individuals and HIV-infected heterosexual men. The median CD4+ cell count in the peripheral blood was significantly higher in HIV-infected heterosexual men than in HIV-infected homosexual men (P less than 0.05). These findings may reflect differences in duration of HIV infection between the two groups. There was no significant difference in the proportion of cells expressing interleukin-2 receptors between HIV-infected and non-infected individuals. Natural killer (CD16+) cells were not identified in any of the condylomata.
Int J
STD
AIDS 1990 Jan
PMID:Immunological study of condylomata acuminata in men infected with the human immunodeficiency virus. 198 71
The case notes of 1080 men with genital warts were analysed retrospectively over a 30-month period. One hundred and forty patients were identified with intrameatal
warts
and an audit of their treatment is discussed. When electrocautery and cryotherapy were compared the former produced a more rapid resolution of the lesions. Cystourethroscopy was performed on 16 patients with intrameatal
warts
. No patient had involvement beyond the distal 3 cm of the urethra. Data on concurrent sexually transmitted diseases, population characteristics and pattern of referral are presented and compared to previously reported studies.
Int J
STD
AIDS 1990 Jul
PMID:Management of intrameatal warts in men. 210 89
Chlamydia trachomatis can be identified in up to 60% of cases of nongonococcal urethritis (NGU) and the aetiology of most of the remainder is obscure. This paper reports a role for other genitourinary (GU) infections such as candidiasis,
warts
and herpes simplex, in the causation of NGU. One hundred and ten men fulfilled the entry criteria which included the probability that their contacts would attend the department. Fifty-four of the 110 men had GU infections other than NGU; 56 had no other infections. NGU was detected in 31 (57%) of cases with other GU infections and 8 (26%) were chlamydiae-positive: in contrast NGU was found in only 10 (18%) of those with none of the other infections and 3 (30%) were chlamydiae-positive. Chlamydiae-negative NGU was, therefore, more common in those with other GU infections. Forty-five (86%) of 52 contacts of 41 patients with NGU had various GU infections such as candidosis and anaerobic vaginosis, in contrast with other GU infections in only 7 (23%) of 30 contacts of men with no other GU infections. Other GU infections in patients and their contacts appeared significantly related to the presence of chlamydiae-negative NGU.
Int J
STD
AIDS 1990 Nov
PMID:Aetiology of non-gonococcal urethritis: a possible relation to other infections. 204 9
Whilst some viruses of the Papilloma family cause
warts
on the skin, others infect mucosal cells. The types called 6 and 11 produce benign papillomas, called condylomata acuminata, visible to the naked eye, not only on the vulva, vagina, penis (cockscomb), but also in the anus, and occasionally the larynx, mouth (tongue) and oesophagus. Types 16 and 18 cause cervical cancer (generally called in situ) and especially very small flat lesions that can only be seen through the colposcope in women and a lens in men. These flat micro-lesions can also be found on the vulva, vaginal walls and on the glans and, balano-preputial area and shaft in males, the distal urethra, anus, larynx (especially the vocal cords), the mouth and oesophagus. These flat micro-lesions are either early cancers (here the deoxyribonucleic acid (DNA) of the virus 16 and/or 18 is integrated into the cell genome), or precancerous lesion in which case the viral DNA is not integrated. Their malignant transformation is much more frequent at the junction of the glandular and squamous parts of the cervix, than in the vulva or vagina. Co-carcinogenic factors appear to have an important role in the malignant transformation;--as for instance sexually transmissible infections including chlamydiae, bacteria that produce carcinogens such as nitrosamines, herpes virus which is known to cause mutations predisposing to the integration of the Papova viruses, chemical substances applied to the genitalia. The role of low hygiene standards in male sexual partners is the major cause (such men can carry simultaneously several sexually transmissible diseases (
STD
], who are never examined in search for flat lesions, who do not seek medical advice and have multiple sexual contacts with many women among whom some are more dangerous than prostitutes, especially since the wide use of hormone contraceptives and abortion that has multiplied the incidence of cervical cancer by 3 among the 20 year-old females, by 4 among the 25 year-old ones and by 2.5 among the 30 year-old ones, between 1961-65 and 1982-83. These changes in contraception have now made intra-vaginal ejaculation the rule (this not only carries viruses and other micro-organisms into the female genital tract, but also deposits sperm that contains some thirty factors that suppress local immunity). This with the rise of multiple partners, early sexual activity in particular in girls (hardly post-puberty) explains the increase of the frequency of cervical cancer in younger and younger women.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[Prevention of genito-anal and bucco-laryngo-esophageal cancers caused by sexually transmitted viruses]. 300 11
The study was conducted at three urban adolescent clinics administered by the Denver Department of Health and Hospitals.The population was derived predominantly from inner city, low-income adolescents 12-18 years old during the period of May 1989 to January 1990. A questionnaire regarding sexual and
STD
history, contraceptive use, and substance use was administered to each patient. Specimens for laboratory studies included collection of vaginal fluid swabs for pH determination and wet mount microscopy; sequential cervical swabs for testing for Neisseria gonorrhea, Chlamydia trachomatis, and HPV DNA; and endocervical swabs and ectocervical scrapes for cytology. A total of 634 were included. The population was ethnically mixed: 167 (26%) were Black, 287 (45%) were Hispanic, 174 (28%) were White, 1 (0.2%) was Asian, and 3 (10.5%) were of other ethnic groups. The mean age was 16.8 years, with a range of 12-18 years. Cervical HPV infection was the most prevalent
STD
in the population, detected in 99 (15.6%) subjects, followed by infection with C. trachomatis in 69 (11.0%), N. gonorrhea in 45 (7.1%), and T. vaginalis in 34 (5.3%). Overall, 188 (30.3%) subjects had any of the 4 STDs detected. The most prevalent, higher-risk HPV types were 16/18, either as single or mixed infections, which were detected in 46 (7.2%) patients. Infection with HPV types 31/33/35 or 6/11 occurred in an additional 31 (4.9%) and 23 (3.6%) subjects, respectively. Overall, 152 (24%) patients had any manifestation of genital HPV infection, 23 (15%) with clinically apparent infection (external genital warts), an additional 54 (36%) with cytologically apparent infection (low-grade squamous intraepithelial lesions or LSIL) without
warts
, and 69 (49%) with subclinical cervical infection (with neither
warts
nor LSIL). The relative risk of cervical HPV DNA for those with 2 or more partners was 2.7 (p 0.001). By multivariate analysis, the independent predictors of cervical HPV DNA included the number of lifetime sexual partners (2 or more partners: OR, 1.9) and current genital warts (OR, 5.1).
...
PMID:Spectrum of genital human papillomavirus infection in a female adolescent population. 748 7
Sixty women with genital warts were randomly allocated to treatment with either weekly application of 20% podophyllin solution or self-treatment with 0.5% podophyllotoxin cream twice daily for three days in weekly intervals. After a maximum of 4 treatment cycles a final assessment was carried out after 3 months. Primary clearance after termination of treatment was 82% for podophyllotoxin and 59% for podophyllin solution. After excluding relapses at the 3-month follow-up, final clearance for podophyllotoxin (71%) was significantly better (P < 0.05) than that for podophyllin solution (48%). The total frequency of
warts
eradicated was 94% with podophyllotoxin and 74% with podophyllin solution (P < 0.001). Local adverse effects were generally mild or moderate. Podophyllotoxin cream provides a mode of easy application for women with external genital warts and had in this study a significantly better effect than podophyllin solution.
Int J
STD
AIDS
PMID:Self-treatment of female external genital warts with 0.5% podophyllotoxin cream (Condyline) vs weekly applications of 20% podophyllin solution. 754 88
A cross-sectional study is undertaken to determine the prevalence of male intrameatal and distal urethral
warts
, using meatoscopy. A group of 169 patients presenting for anogenital
warts
and a group of 74 unselected patients attending the Department for a variety of reasons during the study period, were examined. Twenty-one patients (13.5%) out of 155 patients with anogenital or related
warts
had external
warts
at the meatus. Of these 21 cases, 12 (57.1%) had further extension of their
warts
into the distal urethra. Fifteen other cases of intrameatal and distal urethral
warts
were detected in the absence of external
warts
at the meatus. Twenty-three cases out of 107 males with genital warts (21.5%) were found to have intrameatal or distal urethral
warts
, thus reflecting the common occurrence of these lesions. A highly significant association between the presence of intrameatal/distal urethral
warts
and the presence of male genital warts was found (P = 0.003). One hundred and fifty-three repeat meatoscopic examinations were carried out, 6 weeks after their first examination. Three new cases of intrameatal/distal urethral
warts
were found. Intrameatal and distal urethral
warts
occurred from a depth of 5 mm to 25 mm. One hundred and eighty-three female partners of the study patients were examined. An association between the presence of intrameatal/distal urethral
warts
and female anogenital
warts
was found (P = 0.028). No corroborating association between the presence of male and female anogenital
warts
was found (P = 0.47). This observation may have a bearing on disease transmission and control. The detection of intrameatal/distal urethral
warts
will be important in achieving successful treatment of male anogenital
warts
.
Int J
STD
AIDS
PMID:A study of the prevalence of male intrameatal warts using meatoscopy in a genitourinary medicine department. 764 21
212 females attending a genitourinary medicine (GUM) clinic with first episode anogenital
warts
were screened by cervical cytology and colposcopy/histology for the presence of cervical epithelial abnormalities in keeping with infection by the human papillomavirus (HPV infection) and/or cervical intraepithelial neoplasia (CIN). The prevalence of cervical epithelial abnormalities detected by cervical cytology alone was 32%, rising to 56% after colposcopic examination. However, the majority of cervical lesions detected by colposcopy alone were of low grade (HPV infection and/or CIN I). Histologically-confirmed high grade cervical lesions (CIN II or CIN III) were detected more frequently in those females in whom cervical cytological examination indicated dyskaryosis in keeping with any grade of CIN, compared to females without dyskaryotic changes on cervical smear (P < 0.05, chi-squared test with Yates' correction). Early colposcopy is indicated for females with anogenital
warts
in the presence of a cervical smear showing dyskaryosis in keeping with any grade of CIN, because of the statistically significant increased risk of detecting a potentially progressive high grade cervical lesion. In females without dyskaryotic changes on cervical smear, the value of early colposcopy is uncertain and warrants larger more long-term trials.
Int J
STD
AIDS
PMID:The role of early colposcopy in the management of females with first episode anogenital warts. 781 52
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.
Int J
STD
AIDS
PMID:Screening for cervical abnormalities in women with anogenital warts in an STD clinic: an inappropriate use of colposcopy. 784 24
The cost effectiveness of 25% podophyllin resin and 0.5% podophyllotoxin solution in the treatment of genital warts in Genitourinary Medicine Clinic attenders was studied. Although the average treatment cost for a course of podophyllotoxin was more than that for podophyllin resin (20.75 pounds v. 14.95 pounds respectively) the overall cure rate with podophyllotoxin was 66% as opposed to 34.6% with podophyllin. When the costing of secondary treatment options was considered the cost per patient cured of
warts
with podophyllin resin was 27.15 pounds compared with 25.73 pounds for podophyllotoxin solution (not significant).
Int J
STD
AIDS
PMID:The cost effectiveness of treatment of genital warts with podophyllotoxin. 764 32
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