Effective treatment of hpv: A Synthesis of Findings from 16 Studies

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Original Abstract of the Article

Major Research Findings

Human papillomavirus (HPV)-related diseases are a significant health problem worldwide, particularly in developing countries. 5 notes that surgical excision has been the standard treatment for these diseases. However, the authors question why surgery is the standard treatment for other clinically evident, virally mediated diseases. They review prevention, chemoprevention, and vaccine trials for the prevention and treatment of HPV-related diseases of the genital tract. The review highlights significant advancements in the last decade, suggesting promising non-surgical options for patients with cervical dysplasia and other HPV-associated diseases.

15 investigates the effectiveness of topical cidofovir and imiquimod in treating vulvar intraepithelial neoplasia (VIN). The study found that these treatments are effective in approximately 55% of patients, reducing the need for surgery. Furthermore, HPV E2 gene methylation has been identified as a predictor of response to treatment, though methylation measurements are only obtainable in about 50% of patients.

14 presents a randomized clinical trial (ORATOR2) comparing radiotherapy (RT) and transoral surgery (TOS) for HPV-related oropharyngeal squamous cell carcinoma (OPSCC). The trial found that TOS had an unacceptably high risk of grade 5 toxic effects, leading to the discontinuation of accrual. While both treatment arms achieved good swallowing outcomes at 1 year, long-term follow-up is necessary to assess overall survival (OS) and progression-free survival (PFS) outcomes.

10 explores the use of the bivalent HPV vaccine for recalcitrant common warts, comparing intramuscular and intralesional injection methods. The study found that intralesional injection led to complete clearance of warts in 81.8% of patients, compared to 63.3% in the intramuscular group, although the difference was not statistically significant. Both methods were well-tolerated, with no reported recurrences.

4 examines the efficacy and safety of low-dose oral isotretinoin for recalcitrant condylomata acuminata (RCA) of the cervix. A randomized, placebo-controlled trial found that isotretinoin was significantly more effective than placebo in treating RCA, with a low recurrence rate and manageable side effects.

11 presents a meta-analysis investigating the prophylactic effect of HPV vaccination following conization for high-grade cervical intraepithelial neoplasia (CIN 3). The analysis showed that HPV vaccination significantly reduced the risk of developing recurrent CIN 2+ after surgical excision, regardless of HPV type. The number needed to vaccinate (NNV) to prevent one case of recurrent CIN 2+ was estimated to be 45.5.

2 examines the predictive factors for successful treatment of genital HPV lesions with systemic interferon alpha-2b. The study found that detectable diagnostic phase levels of serum antibodies to HPV16 open reading frame (ORF) E2 derived peptide were associated with a 10-fold difference in the risk of recurrence of HPV infection following adjuvant interferon alpha-2b therapy, suggesting that evaluating E2 antibody responses may help identify patients who would respond to systemic interferon treatment.

7 reviews the potential of HPV vaccination as an adjuvant treatment for individuals with HPV-related clinical disease. The review suggests that vaccination could be a valuable addition to traditional therapies.

1 compares carbon dioxide laser treatment with and without adjuvant interferon alpha-2b for genital HPV infection. While complete response was similar in both groups, the study found that interferon alpha-2b treatment was more effective in reducing recurrence among patients infected with HPV 16/18.

9 reviews the use of HPV vaccines for treating HPV-related dysplastic and neoplastic conditions. The review found that the commercially available quadrivalent HPV vaccine is a potential therapeutic option for cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas. Non-commercially available HPV vaccines have shown promise in treating anogenital warts, cervical intraepithelial neoplasia, anal intraepithelial neoplasia, and vulvar intraepithelial neoplasia. The review highlights the need for further research on the efficacy of HPV vaccines as adjunctive therapy for HPV-associated cutaneous and/or mucosal disease.

6 reports on a Phase I clinical trial evaluating the safety and immunogenicity of GTL001, a therapeutic vaccine for women infected with HPV16 or 18 with normal cervical cytology. The trial demonstrated the tolerability and immunogenicity of GTL001, offering hope for preventing high-grade lesions in HPV-infected women.

12 analyzes the impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment. While HPV prophylactic vaccines are acknowledged to be effective in HPV-naive individuals, the study suggests that HPV vaccination may also benefit individuals who have undergone surgery for cervical disease.

3 reviews the efficacy of treatments for subclinical cervical HPV infection without intraepithelial neoplasia. The review found that none of the clinical trials evaluated demonstrated significant differences between the experimental and control groups, suggesting that effective treatments for subclinical HPV infection without intraepithelial neoplasia are currently lacking.

16 explores the efficacy of HPV vaccination on HPV infection and the recurrence of HPV-related diseases after local surgical treatment through a systematic review and meta-analysis. The analysis suggested that HPV vaccination might reduce the risk of CIN recurrence, especially for HPV16 or 18-related cases, in women treated with local excision. However, the quality of evidence was inconclusive, and large-scale randomized controlled trials are needed to confirm the effectiveness and cost-effectiveness of HPV vaccination in women undergoing treatment for HPV-related diseases.

13 reviews the potential of HPV vaccination as a therapeutic approach for ano-genital warts, drawing on previous case reports. The study suggests that HPV vaccination could be a promising therapeutic option for managing these lesions. However, randomized prospective trials are needed to evaluate the efficacy, safety profile, and effects of HPV vaccination for treating ano-genital warts, and formal approval and an off-label indication for this use are needed.

Treatment Summary

Research has explored various treatments for HPV-related diseases, including topical cidofovir and imiquimod for VIN, radiotherapy and transoral surgery for OPSCC, bivalent HPV vaccine injection (intramuscular and intralesional) for recalcitrant common warts, oral isotretinoin for RCA of the cervix, systemic interferon alpha-2b therapy with laser ablation, and prophylactic HPV vaccination after conization.

Benefits and Risks

Benefits Summary

Research shows potential benefits of non-surgical treatment options for HPV-related diseases, including reduced need for surgery, improved quality of life, and fewer risks associated with surgery.

Risks Summary

While non-surgical treatment options offer potential benefits, they also have potential risks, including side effects and varying individual responses to treatments. It's crucial to consult a healthcare professional to determine the most appropriate treatment plan for individual circumstances.

Comparison of Studies

Similarities

Many studies demonstrate the potential of non-surgical treatment options for HPV-related diseases.

Differences

The studies reviewed examined different types of HPV-related diseases, used various treatment methods, and employed different assessment methods. Therefore, careful interpretation of the findings is essential.

Consistency and Contradictions

The effectiveness of non-surgical treatment options for HPV-related diseases varies across studies. Further research is needed to clarify the findings and identify the most effective treatment approaches.

Implications for Real-World Application

It's crucial to remember that the most appropriate treatment for HPV-related diseases depends on individual circumstances. Consulting a healthcare professional to determine the best treatment plan is essential.

Limitations of Current Research

Current research on non-surgical treatment options for HPV-related diseases is still evolving. Further large-scale research is necessary to comprehensively evaluate the efficacy and safety of these treatment options.

Future Research Directions

Future research should focus on identifying the most effective treatment approaches for different types of HPV-related diseases, optimizing existing treatments, and developing new treatment options. Further investigation of the safety and efficacy of HPV vaccination as a therapeutic approach for different HPV-related diseases is warranted.

Conclusion

Non-surgical treatment options for HPV-related diseases are gaining significant attention. Research suggests that non-surgical approaches can be effective and safe, offering alternatives to surgery. However, further research is needed to optimize these treatments and develop new options. If you are concerned about HPV-related diseases, it's important to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan.

Treatment List

  • Topical cidofovir and imiquimod for VIN
  • Radiotherapy for OPSCC
  • Transoral surgery for OPSCC
  • Bivalent HPV vaccine (intramuscular and intralesional) for recalcitrant common warts
  • Oral isotretinoin for RCA of the cervix
  • Systemic interferon alpha-2b with laser ablation for genital HPV lesions
  • Prophylactic HPV vaccination after conization for cervical intraepithelial neoplasia
Literature analysis of 16 papers
Positive Content
14
Neutral Content
1
Negative Content
1
Article Type
10
2
6
4
15
1.

Treatment of genital HPV infection with carbon dioxide laser and systemic interferon alpha-2b.

Author: NieminenP, AhoM, LehtinenM, VesterinenE, VaheriA, PaavonenJ

Reduced recurrence

Adjuvant systemic interferon alpha-2b treatment following carbon dioxide laser ablation of genital HPV lesions was beneficial only for patients infected with HPV DNA 16/18.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Diagnostic phase antibody response to the human papillomavirus type 16 E2 protein is associated with successful treatment of genital HPV lesions with systemic interferon alpha-2b.

Author: StellatoG, PaavonenJ, NieminenP, HibmaM, ViljaP, LehtinenM

Predicts response to treatment

Detectable diagnostic phase levels of serum antibodies to HPV16 ORF E2 derived peptide predicted a 10-fold difference in the risk of recurrence of HPV infection following adjuvant interferon alpha-2b therapy compared with placebo. This trend was statistically significant in the whole study population and in patients with high viral load.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Efficacy in treatment of subclinical cervical HPV infection without intraepithelial neoplasia: systematic review.

Author: RussomanoF, ReisA, de CamargoM J, DutraM V, FonsecaS C, AndersonJ

Unsatisfactory evidence

There is unsatisfactory evidence for the efficacy of any therapy for subclinical HPV infection of the cervix without intraepithelial neoplasia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Oral isotretinoin in the treatment of recalcitrant condylomata acuminata of the cervix: a randomised placebo controlled trial.

Author: GeorgalaS, KatoulisA C, GeorgalaC, BoziE, MortakisA

Condylomata acuminata treatment
Low recurrence rate
Mild side effects

This study evaluated the effectiveness of low-dose oral isotretinoin for the treatment of recalcitrant condylomata acuminata (RCA) of the cervix. The study found that low-dose isotretinoin was significantly more effective than placebo in treating RCA, with minimal side effects and a low recurrence rate.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Chemoprevention and vaccines: a review of the nonsurgical options for the treatment of cervical dysplasia.

Author: BellM C, AlvarezR D

HPV prevention
Nonsurgical treatment options

This review examines prevention, chemoprevention, and vaccine trials for human papillomavirus (HPV)-related disease, highlighting the potential for effective nonsurgical options for treating cervical dysplasia and other HPV-associated conditions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

GTL001, A Therapeutic Vaccine for Women Infected with Human Papillomavirus 16 or 18 and Normal Cervical Cytology: Results of a Phase I Clinical Trial.

Author: Van DammePierre, Bouillette-MarussigMyriam, HensAnnick, De CosterIlse, DepuydtChristophe, GoubierAnne, Van TendelooViggo, CoolsNathalie, GoossensHerman, HercendThierry, TimmermanBenedikt, BisseryMarie-Christine

HPV infection treatment

This study examined the tolerability and immunogenicity of GTL001, a therapeutic vaccine, in women infected with HPV16 or HPV18 with normal cytology.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Adjuvant Human Papillomavirus Vaccination for Secondary Prevention: A Systematic Review.

Author: DionGregory R, TengStephanie, BoydLeslie R, NorthamAntonia, Mason-AppsCharlotte, VieiraDorice, AminMilan R, BranskiRyan C

HPV vaccination

While HPV vaccination is recommended for children and young adults, older adults and those who have already been exposed to HPV remain at risk. New research suggests that vaccination might be helpful as an additional treatment for people with HPV-related diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Effect of Human Papillomavirus Vaccine to Interrupt Recurrence of Vulvar and Anal Neoplasia (VIVA): A Trial Protocol.

Author: Stankiewicz KaritaHelen C, HaugeKirsten, MagaretAmalia, MaoConstance, SchoutenJeffrey, GriecoVerena, XiLong Fu, GallowayDenise A, MadeleineMargaret M, WaldAnna

Reduced HSIL recurrence

Human papillomavirus (HPV), particularly type 16, is a common cause of precancerous lesions in the anus and vulva. Over 30% of people treated for these lesions experience recurrence, with even higher rates among people with HIV and men who have sex with men. These recurrences can cause significant health problems and costs. Research suggests that the HPV vaccine may be beneficial in reducing the recurrence of these lesions in people who have been previously infected.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

The human papillomavirus vaccine as a treatment for human papillomavirus-related dysplastic and neoplastic conditions: A literature review.

Author: PhamChristine T, JuhaszMargit, SungCalvin T, MesinkovskaNatasha Atanaskova

Basal cell carcinoma treatment
Respiratory papillomatosis treatment
Squamous cell carcinoma treatment
Warts treatment

The commercially available three-dose, quadrivalent HPV vaccine is a potential therapeutic option for the treatment of cutaneous warts, recurrent respiratory papillomatosis, and squamous and basal cell carcinomas.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Intralesional versus intramuscular bivalent human papillomavirus vaccine in the treatment of recalcitrant common warts.

Author: NofalAhmad, MareiAyman, IbrahimAl-Shimaa M, NofalEman, NabilManal

Wart clearance
Adverse effects

Intralesional injection of bivalent HPV vaccine was more effective than intramuscular injection in treating multiple recalcitrant common warts.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Prophylactic HPV vaccination after conization: A systematic review and meta-analysis.

Author: JentschkeM, KampersJ, BeckerJ, SibbertsenP, HillemannsP

HPV recurrence reduction

This study found that HPV vaccination significantly reduces the risk of developing recurrent cervical intraepithelial neoplasia (CIN) after surgical excision, compared to surgical excision only.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: post-hoc analysis from a randomized controlled trial.

Author: ZhaoShuang, HuShangying, XuXiaoqian, ZhangXun, PanQinjing, ChenFeng, ZhaoFanghui

HPV vaccine prevention
Uncertainty for post-surgery patients

This review examines the potential benefits of HPV vaccination for individuals who have undergone surgery for cervical disease, given the well-established preventive benefits of the vaccine.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Could the human papillomavirus recombinant vaccine be a new valid approach in the management of ano-genital warts?

Author: SarroA, AiroldiC, PediciniA, Di TullioE, PecereA

HPV vaccine effectiveness

This study suggests that the HPV vaccine, which is used to prevent genital warts, might also be effective in treating existing warts. While previous reports have shown promise, more research is needed, particularly large studies, to confirm its effectiveness as a treatment and to determine the best way to use it for this purpose.

LetterA written message for communication and exchange of information between individuals.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

14.

Assessment of Toxic Effects and Survival in Treatment Deescalation With Radiotherapy vs Transoral Surgery for HPV-Associated Oropharyngeal Squamous Cell Carcinoma: The ORATOR2 Phase 2 Randomized Clinical Trial.

Author: PalmaDavid A, PrismanEitan, BertheletEric, TranEric, HamiltonSarah, WuJonn, EskanderAntoine, HigginsKevin, KaramIrene, PoonIan, HusainZain, EnepekidesDanny, HierMichael, SultanemKhalil, RichardsonKeith, MlynarekAlex, Johnson-ObasekiStephanie, OdellMichael, BayleyAndrew, DowthwaiteSamuel, JacksonJames E, DzienisMarcin, O'NeilJohn, ChandaranaShamir, BanerjeeRobyn, HartRobert, ChungJeffson, TenenholtzTodd, KrishnanSuren, LeHien, YooJohn, MendezAdrian, WinquistEric, KuruvillaSara, StewartPaul, WarnerAndrew, MitchellSylvia, ChenJeff, ParkerChristina, WehrliBret, KwanKeith, TheurerJulie, SathyaJinka, HammondJ Alex, ReadNancy, VenkatesanVaragur, MacNeilS Danielle, FungKevin, NicholsAnthony C

Good swallowing outcomes
Grade 5 toxic effects

A randomized clinical trial of 61 patients with HPV-related oropharyngeal squamous cell carcinomas (OPSCCs) found that primary transoral surgery was associated with an unacceptable risk of grade 5 toxic effects. The study was halted due to these complications.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Combined HPV 16 E2 and L1 methylation predict response to treatment with cidofovir and imiquimod in patients with vulval intraepithelial neoplasia.

Author: HurtChristopher Nicholas, NedjaiBelinda, Alvarez-MendozaCarlos, PowellNed, TristramAmanda, JonesSadie

VIN treatment

Topical cidofovir and imiquimod are effective treatments for vulval intraepithelial neoplasia (VIN) in approximately 55% of patients, avoiding the need for surgery. Human papillomavirus (HPV) E⁢2 gene methylation can predict response to treatment, but it can only be measured in approximately 50% of patients.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: systematic review and meta-analysis.

Author: KechagiasKonstantinos S, KallialaIlkka, BowdenSarah J, AthanasiouAntonios, ParaskevaidiMaria, ParaskevaidisEvangelos, DillnerJoakim, NieminenPekka, StranderBjorn, SasieniPeter, VeronikiAreti Angeliki, KyrgiouMaria

Disease recurrence
HPV infection risk
CIN2+
Local surgical treatment

HPV vaccination might reduce the risk of cervical intraepithelial neoplasia (CIN) recurrence, especially when related to HPV16 or HPV18, in women treated with local excision. The risk of CIN2+ recurrence was reduced by 57% in vaccinated women compared to unvaccinated women (risk ratio 0.43, 95% confidence interval 0.30 to 0.60). However, large-scale, high-quality randomized controlled trials are needed to confirm this finding and establish the effectiveness and cost of HPV vaccination in women undergoing treatment for HPV-related diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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