[The diagnosis and therapy of HPV-associated genital lesions: the role of systemic beta-interferon treatment].
OBJECTIVE
To evaluate the effective role of HPV DNA typing by commercial probes and of i.m. interferon therapy in the management of HPV-related female genital lesions.


METHODS
Perspective study in a second-level colposcopy service (Istituto Ostetrico-Ginecologico "L. Mangiagalli"--II Clinica Ostetrica-Ginecologica). 110 patients, age range 15-45 years, with cytologic and/or histologic diagnosis of HPV-related genital lesions: HPV DNA typing (commercial probes) of genital specimens was performed. Excluding CIN III or VIN III cases, patients were treated with i.m. interferon-beta therapy for 4 weeks and, in case of persistence, for other 4 weeks. A colposcopic, cytologic and histologic follow-up for 6 months after therapy was performed. HPV DNA typing was repeated only in case of positive hybridization before therapy.


RESULTS
In 81 cases, diagnosis of low-grade intraepithelial genital lesion (LSIL) was done, while 29 were high-grade intraepithelial genital lesions (HSIL). 73 patients completed the study. 3 months after interferon-beta i.m. administration, we observed complete remission in 72.97% of LSILs and in 47.36% of HSILs, while, 6 months after, remissions were observed in 81.25% of LSILs and in 73.33% of HSILs. Anyhow, treatment was well tolerated. HPV DNA typing confirmed the clinical course of lesions.


CONCLUSIONS
Because of difficulties to standardize techniques, we believe that HPV DNA typing cannot assume a clinical or prognostic value, but only an experimental one. Interferon-beta i.m. administration could be considered a valid alternative or support to physical therapy as treatment of HPV-related genital lesions.
Mojana
G
G
II Clinica Ostetrico-Ginecologica, Università degli Studi di Milano.
Carinelli
S
S
Borroni
R
R
Buonaguidi
A
A
Luzzu
A
A
Milesi
M
M
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017403:In Situ Hybridization; D016899:Interferon-beta / Q000627:therapeutic use*; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000628:therapy*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000628:therapy; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000628:therapy
D004279:DNA, Viral; D016899:Interferon-beta
Diagnostica e terapia delle lesioni genitali associate ad HPV: ruolo del trattamento sistemico con beta-interferone.