Effect of imiquimod in anogenital warts from HIV-positive men.
BACKGROUND
HIV-positive patients have unpredictable local immune responses even with severe systemic immunosuppression and data reported to date is insufficient to predict the effect of imiquimod in HIV-positive patients.


OBJECTIVE
To evaluate the efficacy of 5% topical imiquimod in HIV-positive male patients with anogenital warts (AGW) and to elucidate its effect on recurrence.


METHODS
Open-label clinical trial.


RESULTS
Of the 43 patients enrolled, 86% completed treatment. Patients' mean age was 34 years (range: 19-50). Thirty-one patients were receiving highly active antiretroviral therapy (HAART) therapy. At week 16, 10 patients completely cleared lesions and 21 patients had a wart size reduction > or =50%. At 20 weeks of therapy, 17 patients achieved total clearance whereas 14 patients had a >50% wart reduction. Clearance was not influenced by CD4-counts, HIV-viral load, previous therapy, or wart localization. Of the patients who experienced a complete clearance, five (29%) had a recurrence. Mean time of recurrence was 14.4 weeks. Erythema, pruritus, and burning sensation were the most frequent local skin reactions.


CONCLUSIONS
Topical 5% imiquimod is safe and may benefit HIV-positive patients with anogenital warts particularly when it is used for up to 20 weeks. It is also useful to decrease wart recurrence.
Herrera
Silvia
S
GRID, Dermatology Section, Department of Internal Medicine, University of Antioquia, Medellín, Colombia.
Correa
Luis A
LA
Wolff
Juan Carlos
JC
Gaviria
Angela
A
Tyring
Stephen K
SK
Sanclemente
Gloria
G
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000821:virology; D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000287:Administration, Topical; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001004:Anus Diseases / Q000188:drug therapy* / Q000821:virology; D003218:Condylomata Acuminata / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D005832:Genital Diseases, Male / Q000188:drug therapy* / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D000077271:Imiquimod; D007369:Interferon Inducers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D007369:Interferon Inducers; D000077271:Imiquimod