title: High-risk human papillomavirus infection in the prediction of poor treatment response and disease recurrence in patients with vulvovaginal condyloma.
abstract: OBJECTIVE
  To determine the predictive factors for progression and recurrence of vulvovaginal condyloma (VVC), with a specific focus on high-risk HPV (HR-HPV) infections.
  
  
  METHODS
  Retrospective data were collected from 48 patients who were diagnosed with VVC and treated with topical trichloroacetic acid application or laser therapy during 2003-2014 at a hospital in South Korea. The diagnoses were made based on the presence of exophytic condylomatous lesions as assessed by direct visual inspection regardless of whether a biopsy was performed.
  
  
  RESULTS
  Overall, 18 patients (50.0% of those with a test result) were positive for HR-HPV. Three-quarters of the patients with a poor treatment response had abnormal cytologies, and abnormal cytology was a risk factor for a poor response (odds ratio, 4.33 [95% confidence interval, 1.05-17.84]). During a median follow-up of 24months, VVC recurred in seven (14.6%) patients. A high viral load (more than 50 relative light units) of HR-HPV was significantly associated with recurrence (odds ratio, 7.42, 95% confidence interval, 1.19-46.18).
  
  
  CONCLUSIONS
  A high HR-HPV load is a risk factor for recurrence, but is not related to treatment response. A poor treatment response is more related to abnormal cytology than it is to viral load.
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Koo
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea.
authors.forename: Yeon-Sun
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea.
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Min
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea.
authors.forename: Jin-Hwa
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea. Electronic address: jklee38@gmail.com.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Lee
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002424:Caustics / Q000008:administration & dosage; D003218:Condylomata Acuminata / Q000473:pathology / Q000628:therapy / Q000821:virology*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D014238:Trichloroacetic Acid / Q000008:administration & dosage; D014623:Vaginal Diseases / Q000473:pathology / Q000628:therapy / Q000821:virology*; D019562:Viral Load; D014845:Vulvar Diseases / Q000473:pathology / Q000628:therapy / Q000821:virology*
chemical_list: D002424:Caustics; D014238:Trichloroacetic Acid
keywords: Condyloma; Genital wart; HPV infection