COMBINED ANTIRECURRENT THERAPY FOR POINTED CONDYLOMAS OF THE EXTERNAL FEMALE GENITALS


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Abstract

Objective. To optimize approaches to preventing recurrent pointed condylomas (PC) of the external female genitals after destructive therapy. Subjects and methods. A bicentric randomized open-label controlled comparative study was conducted in 3 parallel groups. It included 93 patients with PC of the external genitals, who were, after CO 2 laser destruction of PC, divided into three groups. A study group (n = 31) received combined therapy with interferon-α 2 (IFN-α) as rectal suppositories for 10 days in combination with oral indole-3-carbinol (I3C) capsules for 6 months. For the prevention of recurrent PC, a comparison group (n = 31) had only standard immunomodulatory therapy with IFN-α as rectal suppositories. A control group (n = 31) did not use pharmacotherapy. The investigators carried out PC photofixation and qualitative tests for human papillomavirus (HPV) by a PCR assay. Results. Six months after destruction, the frequency of PC recurrences was 6.5% in the study group, 25.8% in the comparison group, and 32.3% in the control group (p = 0.010). None of the groups were found to have recurrent PC 12 months following treatment initiation. According to the data of HPV diagnosis (a common qualitative test), the posttreatment viral elimination rates during a 12-month follow-up were 85.7%, 66.66, and 54.54% in the study, comparison, and control groups, respectively. After 12 months of treatment initiation, the HPV types 6 and 11 elimination rates were 87.5, 85.7, and 75.0%, respectively. In these groups, HPV types 31 and 33 were eliminated in 83.3, 80, and 100% of cases, respectively. The high-risk HPV types 16 and 18 elimination rates were 100, 83.3, and 0%, respectively. Conclusion. Thus, there was a statistically significant reduction in the rate of recurrent PC of the external female genitals, as well as HPV elimination and reduced reinfection especially with high-risk HPV types 16 and 18 during combined therapy with I3C and IFN-α. A combination of I3C and IFN-α showed a higher efficacy than the routine use of the latter.

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About the authors

Inna Anatolyevna Apolikhina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University; Professor of the Department of Obstetrics, Gynecology and Perinatology

Email: i_apolikhina@oparina4.ru
PhD, MD, Professor, Head of gynecological rehabilitation department and one-day clinic 117997, Ac. Oparina str. 4, Russia; Moscow 119991, Bolshaya Pirogovskaya str. 2 bld. 4, Russia

Elena Alekseyevna Gorbunova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: el_gorbunova@oparina4.ru
doctor obstetrician-gynecologist 117997, Ac. Oparina str. 4, Russia

Elena Vladymirovna Shybaeva

Nizhny Novgorod Branch, State Research Center for Dermatovenereology and Cosmetology, Ministry of Health of Russian

Email: shelly_v@mail.ru
PhD, doctor dermato-venerologyst, Consulting and Diagnostic Center

Gulnar Fazilevna Gasanova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: g_gasanova@oparina4.ru
graduate student

Yulia Valeryevna Saleh

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: amam898@yandex.ru
graduate student 117997, Ac. Oparina str. 4, Russia

Kristina Ovikovna Aslanyan

I.M. Sechenov First Moscow State Medical University

Email: k_aslanyan@inbox.ru
assistant of the Department of obstetrics, gynecology and perinatology Moscow 119991, Bolshaya Pirogovskaya str. 2 bld. 4, Russia

Tatyana Alexandrovna Teterina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: palpebra@inbox.ru
graduate student 117997, Ac. Oparina str. 4, Russia

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