Human papilloma virus type and recurrence rate after surgical clearance of anal condylomata acuminata.
BACKGROUND
Anal condylomata acuminata (ACA) are caused by human papilloma virus (HPV) infection which is transmitted by close physical and sexual contact. The result of surgical treatment of ACA has an overall success rate of 71% to 93%, with a recurrence rate between 4% and 29%. The aim of this study was to assess a possible association between HPV type and ACA recurrence after surgical treatment.


METHODS
We performed a retrospective analysis of 140 consecutive patients who underwent surgery for ACA from January 1990 to December 2005 at our tertiary University Hospital. We confirmed ACA by histopathological analysis and determined the HPV typing using the polymerase chain reaction. Patients gave consent for HPV testing and completed a questionnaire. We looked at the association of ACA, HPV typing, and HIV disease. We used chi, the Monte Carlo simulation, and Wilcoxon tests for statistical analysis.


RESULTS
Among the 140 patients (123 M/17 F), HPV 6 and 11 were the most frequently encountered viruses (51% and 28%, respectively). Recurrence occurred in 35 (25%) patients. HPV 11 was present in 19 (41%) of these recurrences, which is statistically significant, when compared with other HPVs. There was no significant difference between recurrence rates in the 33 (24%) HIV-positive and the HIV-negative patients.


CONCLUSIONS
HPV 11 is associated with higher recurrence rate of ACA. This makes routine clinical HPV typing questionable. Follow-up is required to identify recurrence and to treat it early, especially if HPV 11 has been identified.
D'Ambrogio
Aris
A
Department of General Surgery, Hôpital du Jura bernois SA, Rue de Beausite 49, Moutier, Switzerland. aris.dambrogio@hjbe.ch
Yerly
Stéphane
S
Sahli
Roland
R
Bouzourene
Hanifa
H
Demartines
Nicolas
N
Cotton
Michael
M
Givel
Jean-Claude
JC
D000328:Adult; D001003:Anal Canal / Q000821:virology; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery* / Q000821:virology; D005260:Female; D005838:Genotype; D006785:Hospitals, University; D052140:Human papillomavirus 11 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009010:Monte Carlo Method; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery / Q000821:virology; D012008:Recurrence; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology