Herrera Silvia, Correa Luis A, Wolff Juan Carlos, Gaviria Angela, Tyring Stephen K, Sanclemente Gloria
GRID, Dermatology Section, Department of Internal Medicine, University of Antioquia, Medellín, Colombia.
J Clin Virol. 2007 Jul;39(3):210-4. doi: 10.1016/j.jcv.2007.04.001. Epub 2007 May 21.
HIV-positive patients have unpredictable local immune responses even with severe systemic immunosuppression and data reported to date is insufficient to predict the effect of imiquimod in HIV-positive patients.
To evaluate the efficacy of 5% topical imiquimod in HIV-positive male patients with anogenital warts (AGW) and to elucidate its effect on recurrence.
Open-label clinical trial.
Of the 43 patients enrolled, 86% completed treatment. Patients' mean age was 34 years (range: 19-50). Thirty-one patients were receiving highly active antiretroviral therapy (HAART) therapy. At week 16, 10 patients completely cleared lesions and 21 patients had a wart size reduction > or =50%. At 20 weeks of therapy, 17 patients achieved total clearance whereas 14 patients had a >50% wart reduction. Clearance was not influenced by CD4-counts, HIV-viral load, previous therapy, or wart localization. Of the patients who experienced a complete clearance, five (29%) had a recurrence. Mean time of recurrence was 14.4 weeks. Erythema, pruritus, and burning sensation were the most frequent local skin reactions.
Topical 5% imiquimod is safe and may benefit HIV-positive patients with anogenital warts particularly when it is used for up to 20 weeks. It is also useful to decrease wart recurrence.
即使处于严重的全身免疫抑制状态，HIV阳性患者的局部免疫反应仍不可预测，且迄今为止报道的数据不足以预测咪喹莫特在HIV阳性患者中的疗效。
评估5%外用咪喹莫特对患有肛门生殖器疣（AGW）的HIV阳性男性患者的疗效，并阐明其对复发的影响。
开放标签临床试验。
43名入组患者中，86%完成了治疗。患者的平均年龄为34岁（范围：19 - 50岁）。31名患者正在接受高效抗逆转录病毒疗法（HAART）治疗。在第16周时，10名患者的疣体完全清除，21名患者的疣体大小缩小≥50%。在治疗20周时，17名患者实现了完全清除，而14名患者的疣体缩小超过50%。清除情况不受CD4细胞计数、HIV病毒载量、先前治疗或疣体部位的影响。在实现完全清除的患者中，5名（29%）出现了复发。复发的平均时间为14.4周。红斑、瘙痒和烧灼感是最常见的局部皮肤反应。
外用5%咪喹莫特是安全的，可能使患有肛门生殖器疣的HIV阳性患者受益，尤其是在使用长达20周时。它对减少疣体复发也有帮助。
