title: The combination treatment using CO₂ laser and photodynamic therapy for HIV seropositive men with intraanal warts.
abstract: BACKGROUND
  We evaluate the effectiveness of combination treatment using photodynamic therapy after carbon dioxide laser in preventing the recurrence of condylomata acuminata for intraanal warts in HIV positive homosexual men. A retrospective survey of 41 patients referred to the STD clinic of the Fourth People's Hospital of Shenzhen for the treatment of intraanal warts among HIV positive homosexual men between Janurary 2009 and September 2011.
  
  
  METHODS
  The patients who accepted CO₂ laser monotherapy for the same diagnosis were used as the comparison group. After the confirmation of the diagnosis of HIV infection and intraanal warts, the patients were treated with the combination treatment using PDT with 5-ALA thermal gel immediately after CO₂ laser ablation of the warts. PDT was performed with irradiation of 100 J/cm² at an irradiance of 100-150 mW/cm² with a semiconductor laser, wavelength 635 nm. PDT therapy was repeated twice with 2 weekly intervals. Follow up examinations including an anoscopy every 4 weeks after the latest PDT.
  
  
  RESULTS
  After 3 cycles of PDT treatments, 39 cases of anoscopy examination showed no new or recurrent lesions. At the end of the sixth months, recurrence occurred in 12(29%) cases. HPV 11 was present in 6 (50%) of these recurrences. HPV 6/11 or 16/18 remains positive in 19 cases (46.3%) and HPV negative in 22 cases.
  
  
  CONCLUSIONS
  The combination treatment with CO₂ laser and PDT is much more effective in reducing the treatment cycles and the time intervals of the whole treatment for intraanal warts in HIV infected people.
authors.affiliation: Institute of Dermatology for Immune Disease and STD, Guangdong Medical College, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xu
authors.forename: Li
authors.initials: L
authors.lastname: Xiang
authors.forename: Jiayuan
authors.initials: J
authors.lastname: Chen
authors.forename: Qin
authors.initials: Q
authors.lastname: He
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001004:Anus Diseases / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D006679:HIV Seropositivity / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014860:Warts / Q000628:therapy*; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid