Efficacy and tolerability of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected persons.
BACKGROUND
Treatment options for anogenital warts in patients with HIV-1 are unsatisfactory because they fail to eradicate latent human papillomavirus.


OBJECTIVE
To determine tolerability and efficacy of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected patients.


METHODS
A randomized, placebo-controlled, single-blind, crossover pilot study of either 1% cidofovir cream or placebo applied once daily 5 days a week for 2 weeks followed by 2 weeks of observation was performed.


RESULTS
Six patients were randomized to 1% cidofovir cream and six to placebo. The latter patients eventually received 1% cidofovir cream. Thus, 12 treatment rounds of cidofovir were compared with six rounds of placebo. A reduction of more than 50% in the total wart area achieved by seven cidofovir treatments (58%), as compared with no placebo regimen (P = 0.02). Local reactions occurred in 10 of the 12 patients treated with cidofovir, as compared with 0 of the 6 subjects in the placebo group (P < 0.001).


CONCLUSIONS
For the initial clearance of anogenital warts in HIV-infected patients, 1% cidofovir cream is significantly more effective than vehicle cream. Local mucosal erosion is a common side effect.
Matteelli
A
A
Clinic of Infectious and Tropical Diseases, University of Brescia, Italy. forleo@master.cci.unibs.it
Beltrame
A
A
Graifemberghi
S
S
Forleo
M A
MA
Gulletta
M
M
Ciravolo
G
G
Tedoldi
S
S
Casalini
C
C
Carosi
G
G
D000279:Administration, Cutaneous; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001004:Anus Diseases / Q000150:complications / Q000188:drug therapy*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D005260:Female; D052776:Female Urogenital Diseases / Q000150:complications / Q000188:drug therapy*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D017060:Patient Satisfaction; D010865:Pilot Projects; D016037:Single-Blind Method; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000150:complications / Q000188:drug therapy*; D014860:Warts / Q000150:complications / Q000188:drug therapy*
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D003596:Cytosine; D000077404:Cidofovir