A. Treatment
The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. Sexual partners should be treated at the same time, and sexual intercourse should not be performed before cure.
1. Podophyllotoxin (podophyllotoxin) is also known as podophyllotoxin tincture. The actual topical use is the first line of medication recommended by the World Health Organization in 1990 for the treatment of condyloma acuminata, and recommended by the State Ministry of Health in 1994 as the first choice of topical medication for the treatment of condyloma acuminata. from June 1994 to February 1995 in the nationwide phase III clinical observation of this drug, such as the six hospitals in the north, led by Peking Union Medical College Hospital, completed 300 cases of observation, cured 270 cases ( 90%). 90%), apparent effect 24 cases (8%), effective 5 cases (1.7%), ineffective 1 case (0.3%), healing rate 90%, efficiency (healing rate + apparent efficiency) 98%, the country completed 1839 cases, the efficacy is similar. The recurrence rate is about l0%. Before the drug must be applied to the affected area with 3% to 5% acetic acid to detect the subclinical state of the condyloma acuminatum that is not easily seen, together with the drug to reduce the recurrence rate. Ghost toxin is the drug of choice for topical application and is effective in the treatment of condyloma acuminata. The pharmacological effect is mainly to inhibit the mitosis of HPV infected cells, so that the genital warts necrosis, fall off, to achieve the purpose of cure.
2, 10% to 25% of the foot leaf grass ester (podophyllin) which is a compound benzoin tincture preparation, topical use should avoid its systemic absorption and prevent toxicity. Suitable for warts range less than 10cm, each course of treatment dosage of no more than 0.5ml, with the drug l to 4 hours after a thorough wash away. If not healed, 1 week after the drug can be repeated, if the drug is not healed 6 times, should be changed to other therapies.
3, 80% to 90% trichloroacetic acid treatment warts, and carbonic acid medicine. After 6 times the warts still exist should be changed to other therapies.
4, liquid nitrogen cryotherapy relatively cheap, no anesthesia, cure rate of 63% to 88%, but easy to recur.
5, carbon dioxide laser treatment requires the use of local anesthesia, easy to recur.
6.Electric drying method and electrocautery treatment The efficiency is about 94%, the recurrence rate is 22%, local anesthesia is required, and there is moderate discomfort.
7, anti-viral therapy Interferon (interferon, IFN) is a biological cell in the infection of the virus or in the role of certain inducers produced a class of glycoprotein, there are anti-viral effect, anti-proliferative effect and immunomodulatory effect, so the treatment of condyloma acuminata can be applied in conjunction with other methods, or other methods to remove the warts and then use interferon, in order to achieve adjuvant treatment or reduce recurrence. It is possible to use intra-dermal injection, 1 million U each time, 3 times a week, 9 times in total. For example, Wang Jia Bi et al. (1991) of Peking Union Medical College Hospital applied purified human leukocyte interferon for the treatment of condyloma acuminata. The treatment group of 51 cases of localized condyloma acuminata, q interferon injection in the lesions, healed 15 cases (29%), 16 cases (31%), the efficiency of 60%; control group placebo intramuscular injection healed 1 case (2%), 5 cases (10%), the efficiency of 12%, there is a significant difference between the two, it can be seen that interferon treatment of condyloma acuminata has some efficacy. Wang Jia Bi et al. (1997) used alpha-2a interferon to treat condyloma acuminata, injected in the skin lesions (treatment group) and muscle (control group), 26 cases in the treatment group and 20 cases in the control group. In the treatment group, 9 cases were cured (34.6%), 7 cases were effective (26.9%), 8 cases were effective (30.8%), and 2 cases were ineffective (7.7%); in the control group, 4 cases were cured (20%), 1 case was effective (5%), 6 cases were effective (30%), and 9 cases were ineffective (45%). The healing rate of the treatment group was 34.6% and the effective rate was 61.5%, while the healing rate of the control group was 20% and the effective rate was 25%. There was a statistically significant difference in the efficiency of the two groups, and thus the intradermal injection method was superior to intramuscular injection. Adverse effects of β-IFN have been reported to be less severe than those of other interferons for the treatment of condyloma acuminatum. But condyloma acuminata skin lesion injection treatment is still too troublesome, there is a topical interferon gel, there is a certain efficacy.
8, interleukin (IL) is a biological cells (including keratinocytes) after damage to a class of media, is the performance of antibody defense function. The treatment of warts with IL-2, is produced by activated T lymphocytes glycoprotein (molecular weight 1500), to reduce recurrence has a certain adjuvant effect.
9, epinephrine gel The main components are fluorouracil (300mg/ml), epinephrine (0.1mg/m1), purified bovine collagen and inactive excipients. Treatment consisted of one injection per lesion per week for 6 weeks. Fluorouracil-epinephrine gel has a 77% recovery rate for acromegaly, with a mean time to lesion resolution of 56 days, and most patients tolerate this drug well.
11, 5% Imiquimod cream (Imiquimod cream) non-nucleoside isocyclic amines, is a new type of topical immunomodulator, there are anti-viral effect, by inducing the body to produce IFN-α, β, γ, IL-8, IL-12, TNF-a and other cytokines to play a role, but also to stimulate HPV-specific T lymphocyte immunity, kill the cells that have been infected with HPV. It makes the warts smaller and eventually clears the infection. The average time to cure warts with 5% Imiquimod cream is 7-10 weeks, with the shortest course of treatment being 4 weeks. 5% Imiquimod cream can reduce the HPV DNA level in patients with warts to 3% of the original level. This can prevent the recurrence of condyloma acuminatum by reducing the level of HPV DNA to 3-14% of the original level.
12, HPV vaccine research in the past 10 years, HPV vaccine research has made significant progress, has entered clinical trials. hpv vaccine is divided into preventive vaccine and therapeutic vaccine. In the former, when L1 or L1+L2 of HPV is overexpressed in mammalian, insect, yeast or bacterial cells, it can spontaneously assemble and form recombinant virus like particle (VLP) without oncogenic genome, and VLP can make the body produce specific antibodies against HPV virus capsid, which has the effect of neutralizing the virus. VLP has entered phase I/II clinical trials. Prophylactic vaccines are very beneficial for people at high risk of HPV exposure, preventing infection and reinfection. Therapeutic vaccines elicit specific cellular immunity, whereby the progression of lesions is stopped and lesions and even malignancies are cleared. It can be used as an adjuvant therapy to conventional treatment (targeting oncoproteins of HPV, especially E6 and E7) in the early stages of infection. There are many types of therapeutic vaccines, including live vector vaccines, peptide vaccines, protein vaccines, DNA vaccines (naked DNA has the advantages of high purity, easy preparation, good stability, and low price for rapid mass production), etc.
Laryngeal papillomas are also found in infants delivered by cesarean section, and thus the role of performing cesarean section to prevent acromegaly is not certain. The actual fact is that it is not advisable to perform a cesarean section in order to prevent HPV infection in newborns, but a cesarean section should be performed if the warts do obstruct the birth canal or if the vaginal delivery is likely to result in hemorrhage.
14, sexual partner management Most sexual partners may have HPV subclinical infection, although they do not have obvious warts, but also regular review, can use 5% acetic acid auxiliary examination.
Two, prevention
Thus, to prevent recurrence of condyloma acuminata, the patient’s immune function should be improved. The reason for the recurrence may also be related to the presence of other sexually transmitted infections in the patient, so a thorough screening for sexually transmitted infections should be done when treating warts. The actual fact is that you will be able to find out if you’ve got any kind of gonorrhea or non-gonorrheal urethritis. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The HPV latent infection causes new clinical and subclinical lesions to develop in the non-lesioned area, and after local wart removal treatments such as carbon dioxide laser or freezing, new lesions can develop in the original lesion through the process of repairing the ulcerated epithelium by HPV-infected cells around the ulcer. The actual fact that 60% of the HPV latent infection in the urethra of patients with condyloma acuminata become dangerous foci of HPV stock, which can cause HPV transmission between sexual partners, and can cause recurrence of condyloma acuminata through self-infection. Because of the widespread presence of latent HPV infection in the non-lesioned areas of the genitalia and urethra of condyloma acuminatum, topical therapies alone are sometimes inadequate and the search for more effective modulation of host immune function will be the way forward in the treatment of condyloma acuminatum. Vaccines for condyloma acuminatum are under investigation.
Kataja equals 528 women treated for cervical HPV infection from 1982 to 1992 with a total follow-up of 60.3 months, with a follow-up every 6 months, and 480/528 cases with complete data at each follow-up. Of the 480 cases with HPV infection, 58.3% regressed spontaneously and 14.8% had clinical progression. Factors associated with progression of cervical HPV infection such as cervical epithelial tumor The degree of infection, HPV type, cervical epithelial neoplasia II, and HPVl6 were the most relevant factors for the progression of cervical HPV infection. Cervical biopsy should be performed regardless of the degree of cervical epithelial tumor, and this lesion should be treated when HPV-DNAl6 is detected, and if it is found to be cervical epithelioma II it should be treated immediately, regardless of whether HPV DNA is detected.
In order to prevent infection or reinfection of condyloma acuminata, the fundamental measure is to prevent sexual promiscuity, to be clean, in addition, to prevent indirect infection, advocate the use of common towels, bath towels, not in a shared bath tub.