Single application treatment of human papillomavirus infection of the cervix and vagina with trichloroacetic acid: a randomized trial

Article Abstract:

Using DNA hybridization techniques, a close association has been established between human papillomavirus (HPV) and cervical neoplasia (new or abnormal tissues in the cervix of the uterus). Subclinical HPV infections should be treated in order to prevent the development of cervical carcinoma. Sixteen patients received active treatment and 18 received placebo. Treatment of the infections consisted of application of a solution of trichloroacetic acid into the lower genital tract. The results from the first 15 patients in each group were analyzed and no differences were noted. There was only an 18 percent response rate to treatment and the study was considered a failure. Cytologic and histologic examinations confirmed that HPV was still present in the majority of patients; at 4- and 16-week evaluations, only one of 16 patients in the treatment group and three of 18 in the placebo group were free of HPV infection. The concentration of trichloroacetic acid, a 50 percent solution, was lower than that used in previous studies, which was 85 percent. A weaker solution was used in this study since the investigators found that higher concentrations were too caustic and associated with low patient compliance. The treatment with trichloroacetic acid accomplished the desired effect of chemically denuding the epithelium of the vagina and cervix; however, its efficacy in treating subclinical HPV infections needs to be examined further. All patients with HPV should have cervical and vaginal cells evaluated every four to six months and undergo an annual colposcopic evaluation, using a specialized instrument to examine the lower genital tract. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Infection, Vagina

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Human papillomavirus DNA in invasive carcinoma of the vagina

Article Abstract:

Cancer of the vagina is rare, accounting for only 1 to 2 percent of all cancers of the female reproductive system. The survival rate for cancer of the vagina of between 42 and 56 percent. Although the association between cervical cancer and human papillomavirus (HPV) infection is well known, the low prevalence of vaginal carcinoma has made it difficult to evaluate the relationship between this disease and HPV infection. To learn more about this, tissue specimens from 18 patients (median age, 78) with invasive cancer of the vagina were analyzed to determine whether they contained HPV DNA (viral genetic material) and if so, which type, since there are many types of HPV. The location and extent of differentiation of the tumors are described. Results showed that HPV DNA was present in tumor tissue from 10 of these patients, with 6 specimens containing HPV-16 DNA (a particular viral sequence). Follow-up at a median of 13 months revealed that five of the nine HPV-positive women survived without recurrence of their disease, while four died of the disease. In addition, all seven women who had been HPV-negative died of vaginal carcinoma. A discussion is provided regarding HPV types in this disease. The results suggest that HPV infection may play a major role in the development of cancer of the vagina. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Risk factors, Cancer, Vaginal cancer

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