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Gynacology and Health

Human Papilloma Virus

A New Treatment For Genital Warts

By Dr. W. Gifford Jones

January 20, 2002

What's the best way to make love these days? I tell patients of all ages to make love like the porcupine, very, very carefully. If they don't, they may join the millions of people who contact what's called the "Human Papilloma Virus" (HPV), which causes genital warts. Now there's a new treatment to eradicate these troublesome warts.

There are over a 100 viral types that can infect the human body. For instance, HPV type 1 causes the common hand warts. Type 6 and 11 cause genital warts. And type 16 is associated with cervical cancer.

Genital HPV is spread almost exclusively by sexual contact. But most people infected with HPV do not know it's present, as there are no symptoms.

The first sign that the virus is present is the discovery of genital warts in either women or men. It's believed that 80 to 90 percent of patients who carry the HPV virus will eventually develop genital warts. This happens within 8 to 12 weeks following exposure.

Dr Alex Ferenczy, Professor of Pathology and Obstetrics and Gynecology at McGill University, says, "Until recently, none of the treatments were anti-viral; rather they simply focused on removing warts".

For instance, some patients were treated by chemical or electrosurgical burning. Others by laser or freezing the warts with liquid nitrogen. These treatments can be painful and require repeated visits to the family physician, gynecologist or dermatologist. And unfortunately recurrence rates can be higher than 50 percent.

Dr. Daniel N Sauder, Chief of Dermatology at the University of Toronto, reports that about 10 to 30 percent of people with genital warts experience spontaneous regression."

This suggests that patients with a strong immune system can beat the virus without any treatment. But for others with external warts there's now a new cream they can apply themselves at home. It helps boost their immune system.

Dr. Spotswood Spruance is Professor of Medicine, University of Utah School of Medicine, Salt Lake City. He reported a study using Aldara (5 percent Imiquimod cream). This cream increases the patient's resistance to warts by stimulating natural killer cells and the production of interferon-alpha.

Dr Spruance reported on the results of 311 adults treated with Aldara. The cream was applied to the warts three times a week. 50 percent of the warts were eliminated within eight weeks and 71 percent after 16 weeks. And it was equally effective in both circumcised and uncircumcised males.

Final results revealed that Aldara cream cured 77 percent of females and 40 percent of males. In women, warts occur on thin mucous membranes allowing greater penetration of the drug.

Dr Spruance described another distinct advantage to Aldara. Genital warts are less likely to recur following its use. In this study only 13 percent recurred within 12 weeks of treatment.

Aldara cream is well tolerated with mild to moderate inflammatory skin reactions in 66 percent of patients. These patients complained of burning, itching and redness of the skin.

Genital warts are not life-threatening, but cervical cancer still kills too many women. Since HPV-16 and 18 do not cause symptoms the best defence against cancer of the cervix is still the Pap smear.

Cells of the normal cervical lining appear as if they were lined up for military inspection. But as the virus invades the cervix this orderly arrangement breaks down. Cells gradually enlarge and the nucleus, the central part of the cell becomes irregular and eventually as black as coal tar.

Luckily, cervical cancer may take from 10 to 15 years to develop. This provides ample time for the annual Pap smear to detect early precancerous changes.

Women who have abnormal Pap smears must have a colposcopy examination. In this procedure the cervix is inspected by a high-powered microscope. The cervix is painted with a vinegar-like solution which causes virus-infected tissue to turn white. These areas are then biopsied to determine the nature of the lesion.

What follows depends on the severity of the finding. Some patients require cryosurgery. Others have a part of the cervix removed by laser treatment.

Unfortunately, at the moment, there's no 100 percent sure way to prevent contacting HPV if you're sexually active. The condom is the best defence against gonorrhoea, chlamydia and AIDS. But HPV is transmitted more easily from person to person as the virus lives on the outside of the skin as well as in the vagina. This makes the condom less effective in preventing HPV.

Until a vaccine becomes available, condoms remain the most effective barrier to HPV. And never, never forget the technique of the porcupine.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod