Document Detail

Topical imiquimod treatment for human papillomavirus infection in patients with and without cervical/vaginal intraepithelial neoplasia.
MedLine Citation:
PMID:  23276555     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To evaluate the efficacy and toxicity of topical imiquimod for the treatment of persistent human papillomavirus (HPV) infection in patients with or without cervical/vaginal intraepithelial neoplasia (CIN/VAIN).
METHODS: Patients with persistent HPV infection (≥1 year) after a history of treatment for cervical or vaginal neoplasm but normal histology and cytology, abnormal Papanicolaou (Pap) smears without abnormal histology, and untreated histology-documented CIN/VAIN Grade 1/2/3 with HPV-positive testing were recruited. Patients were instructed to apply 250 mg of 5% imiquimod cream intravaginally on consecutive days or at least twice weekly on an outpatient basis for a minimum of 12 doses. A group of age- and previous diagnosis-matched, imiquimod-untreated historical controls (n = 20) were selected. The main outcome measures included HPV DNA detection, cytology, and colposcopy/histology at 6 months after treatment.
RESULTS: A total of 72 patients were eligible for analysis. At a median follow-up of 33.6 months, 37 patients (51.4%) had cytological/histological regression and tested HPV-negative. Six patients (8.3%) had progressive cytology/histology with persistent HPV infections. Of the 72 treated patients, 26 patients who had a normal Pap test but were persistently HPV-positive for at least 1 year had a complete regression rate of 65.4%, which was significantly different from the rate (30%) observed in the untreated historical control (p = 0.036). Six patients with histologically proven CIN2/3 or VAIN2/3 had a complete regression rate of 66.6% (4/6).
CONCLUSIONS: The tolerability of intravaginal self-administered imiquimod is confirmed. Its efficacy in the treatment of women with persistent HPV infection and normal cytology warrants further randomized, controlled trials to determine appropriate dosages and scheduling.
Cheng-Tao Lin; Jian-Tai Qiu; Chin-Jung Wang; Shuenn-Dyh Chang; Yun-Hsin Tang; Pei-Ju Wu; Shih-Ming Jung; Chu-Chun Huang; Hung-Hsueh Chou; Mei-Shan Jao; Chyong-Huey Lai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Taiwanese journal of obstetrics & gynecology     Volume:  51     ISSN:  1875-6263     ISO Abbreviation:  Taiwan J Obstet Gynecol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-01-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213819     Medline TA:  Taiwan J Obstet Gynecol     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  533-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
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