High-risk human papillomavirus infection in the prediction of poor treatment response and disease recurrence in patients with vulvovaginal condyloma

Int J Gynaecol Obstet. 2016 Jan;132(1):20-4. doi: 10.1016/j.ijgo.2015.06.049. Epub 2015 Oct 1.

Abstract

Objective: To determine the predictive factors for progression and recurrence of vulvovaginal condyloma (VVC), with a specific focus on high-risk HPV (HR-HPV) infections.

Methods: Retrospective data were collected from 48 patients who were diagnosed with VVC and treated with topical trichloroacetic acid application or laser therapy during 2003-2014 at a hospital in South Korea. The diagnoses were made based on the presence of exophytic condylomatous lesions as assessed by direct visual inspection regardless of whether a biopsy was performed.

Results: Overall, 18 patients (50.0% of those with a test result) were positive for HR-HPV. Three-quarters of the patients with a poor treatment response had abnormal cytologies, and abnormal cytology was a risk factor for a poor response (odds ratio, 4.33 [95% confidence interval, 1.05-17.84]). During a median follow-up of 24months, VVC recurred in seven (14.6%) patients. A high viral load (more than 50 relative light units) of HR-HPV was significantly associated with recurrence (odds ratio, 7.42, 95% confidence interval, 1.19-46.18).

Conclusion: A high HR-HPV load is a risk factor for recurrence, but is not related to treatment response. A poor treatment response is more related to abnormal cytology than it is to viral load.

Keywords: Condyloma; Genital wart; HPV infection.

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Caustics / administration & dosage
  • Condylomata Acuminata / pathology
  • Condylomata Acuminata / therapy
  • Condylomata Acuminata / virology*
  • Female
  • Humans
  • Laser Therapy
  • Middle Aged
  • Odds Ratio
  • Papillomaviridae
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / virology
  • Recurrence
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Treatment Failure
  • Trichloroacetic Acid / administration & dosage
  • Vaginal Diseases / pathology
  • Vaginal Diseases / therapy
  • Vaginal Diseases / virology*
  • Viral Load
  • Vulvar Diseases / pathology
  • Vulvar Diseases / therapy
  • Vulvar Diseases / virology*

Substances

  • Caustics
  • Trichloroacetic Acid