Kamalakannan, K K (2010) A study on the prevalence of HPV infection in HIV infected and HIV non infected individuals and to analyse the different treatment modalities on Anogenital Wart. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Anogenital warts have been recognized as a disease entity for many centuries. They were recognized by early Greek and Roman physicians such as Hippocrates and Galen. The term Condyloma was derived from ancient Greek word meaning “a round swelling adjacent to the anus”. The addition of the suffix acuminate is a relatively new feature, appearing towards the end of the 19th century. The viral etiology for development of human skin warts were proposed in the early 20th century1 and viral particles were seen on electron microscopy of wart samples in the late 1960s2. Gissman and Zur Hausen3, isolated HPV 6 from genital wart in 1980. Cautery was used as a treatment from 6th century onwards. Genital wart as a manifestation of HPV infection represents the tip of the iceberg when considering the total spectrum of infection. Within the spectrum of sub clinical infection there are several distinct entities. True prevalence of HPV anogenital infection in the community is not known. Current evidence suggests that over 50% of sexually active adults have been infected with one or more HPV types. Progress in HPV research was hampered by the inability to culture the virus in vitro and absence of satisfactory animal models. Major advances in molecular, biological techniques such as DNA amplification and splicing, have in part overcome the problem in detection of Human Papilloma Virus infection. Many patients do not seek medical help.Although most anogenital wart in immunocompetent patient eventually undergoes spontaneous regression, treatment is offered to the majority of affected individuals to reduce the risk of secondary infection and to alleviate anxiety . Immunocompromised state alters the natural course of HPV infection. And increased incidence of genital wart and persistence of HPV infection is seen. Certain HPV types have been implicated in the causation of benign and malignant cancerous anogenital disease as well as benign and malignant head and neck lesions. Bearing in mind that carcinomas are considered and recorded as a sexually transmitted disease, according to the World Health Organization, its determination and the application of the respective therapeutic concepts according to the location and dimensions of the lesions is of paramount importance for the patient's prognosis. Papilloma viruses are difficult to reproduce under in vitro conditions, so generation of a "normal” vaccine is impossible. Hence virus-like particles (VLP), which are recombinant versions, are used as vaccine presently. AIM OF STUDY : To study the prevalence of HPV infection in HIV infected and NON HIV infected individuals and to analyse the different treatment modalities. OBJECTIVES * To study the prevalence of HIV infection among STD male OPD attendees * To study the prevalence of genital wart among STD male OPD attendees * To study the prevalence of genital wart among HIV Non infected individuals attending STD male OPD. * To study the prevalence of genital wart among HIV infected individuals attending STD male OPD. * To analyse the different treatment modalities and responses on exophytic anogenital wart those attending STD male OPD. * To compare the different treatment modalities and responses on exophytic anogenital wart among HIV Non infected individuals and HIV infected individuals those attending STD male OPD * To find out the difficulties in managing the patients with genital wart. CONCLUSION : This study was conducted for a period of 2 years from June 2007 to May 2009 in those patients who attended STD male OPD in Institute of Venereology, Madras Medical College, Chennai. This study showed the prevalence of genital warts among the STD male OPD attendees to be 1.91%. The prevalence of HIV infection among STD male OPD attendees was 2.69%. The prevalence of genital warts was 8.2 times higher among HIV infected patients than HIV non infected patients. Among all study groups, study group V and study group II shows more efficacy than other treatment modalities i.e electrocautery therapy and liquid nitrogen therapy respectively. But while compared to liquid nitrogen, electrocautery showed low recurrence rate with minimum number of applications to obtain maximum response with acceptable level of side effects. When compared to treatment response at the end of treatment among HIV Non infected and HIV infected individuals shows there is no statistical significance between these two for all study groups. Similarly treatment response after 3 months showed statistically insignificant difference except for study group V(electrocautery). Most of the patients developed local acceptable side effect during the course of treatment but it resolved on its own.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | prevalence of HPV infection in HIV ; treatment modalities ; Anogenital Wart. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Subramani R |
| Date Deposited: | 05 Jul 2017 04:38 |
| Last Modified: | 05 Jul 2017 09:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/975 |
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