Skip to main content Skip to main navigation menu Skip to site footer

Condyloma acuminatum in a 62-year-old patient with HIV infection

Abstract

Introduction: Condyloma acuminatum is caused by infection from Human Papilloma Virus (HPV), mostly found in the perineum and genital area. Therefore HPV infection is the most common sexually transmitted infection in the world. Infection often occurs in patients with a decreased immune system, such as Human Immunodeficiency Virus (HIV) infection.

Case: A 62-year-old man was diagnosed with condyloma acuminatum in the penis and accompanied by stage IV HIV infection. CD4 + count is 23 cells/μL. Patients were given electric surgical therapy and 80% TCA. After receiving 8 treatments in 3 months, there was no significant improvement.

Discussion: There are several therapeutic modalities in the management of condyloma acuminatum. Some considerations in the selection of condyloma acuminatum therapy include size, number, anatomic location of the lesion, patient comfort, side effects and the experience of the doctor in charge. The immune system plays an important role in the successful treatment of HPV infections. The risk of persistence, recurrence, and malignant transformation can increase with the decrease in the immune system by HIV infection as measured by CD4 + counts. In this case, more aggressive treatment will be needed and immunomodulators can be given to increase the success of the therapy.

Conclusion: Host immune status has a significant impact on the course of HPV disease and response to treatment. HIV patients have an increased risk of HPV infection, with an increase in the duration and persistence of the disease and thus require aggressive therapy.

References

  1. Morineau G, Nugrahini N, Riono P, Nurhayati, Girault P, Mustikawati DE, Magnan R. Risk Taking, STI and HIV Prevalence among men Who Have Sex with Men in six Indonesian Cities. AIDS Behav. 2009;6:1-12.
  2. Sparling PF, Swartz MN, Musher DM, Healy BP. Clinical Manifestations of Syphilis. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, Cohen M, Watts DH. Sexually Transmitted Diseases. Fourth edition. New York: McGraw-Hill; 2008. p.661-84.
  3. Mayer KH, and Carballo-Dieguez A. Homosexual and Bisexual Behavior in Men in Relation to STDs and HIV Infection. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, Cohen MS, Watts DH. Sexually Transmitted Diseases. Fourth edition. New York: McGraw-Hill; 2008. p. 203-18.
  4. Xioling Z, Hongxiao C. Decrease recurrence rate of condylomata acuminata ny photodynamic therapy combined with C02 laser in mainland china : A Meta-Analysis. Dermatology. 2012;225:364-370.
  5. Daili FS, Makes BIN, Zubier F, Judanarso J, editors. Sexual Transmitted Disease, 3rd ed. Jakarta: Publishing Service FKUI; 2005.p.126-31.
  6. Kenshiro B, Crowell TA, Nowak RG, Adebajo S, Peel S, Gaydos CA. High prevalence of HIV, chlamydia and gonorrhea among men who have sex with men and transgender women attending trusted community centers in Abuja and Lagos, Nigeria. J Int AIDS Soc. 2016; 19(1): 212-20.
  7. Wiraguna A, Andriani P, Adiguna M. Comparison of Plasma Zinc Levels Among HIV+ and HIV- Subjects Infected with Condyloma Acuminata. Asian Pacific Journal of Cancer Prevention. 2019;20(3):943-949.
  8. Anna LW. The Interaction between Human Immunodeficiency Virus and Human Pappilomaviruses in Heterosexuals in Africa. J Clin Med. 2015;4(4):579-92.
  9. Winer RL, Koutsky LA. Genital Human Papillomavirus Infection. In: Holmes.KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, Cohen MS, Watts DH, editors. Sexually Transmitted Diseases, 4th ed. New York:.McGraw Hill; 2008.p.490-501.
  10. Pattman R, Sankar KN, Elawad B et al. Oxford Handbook of Genitourinary Medicine, HIV and sexual Health. 2nd ed. New York: Oxford University Press; 2010.
  11. Yanofsky VR, patel RV, Goldenberg G. Genital Wartt. Comprehensive review. J Clin Aesthet Dermatol. 2012;5(6):25-36.
  12. Doorbar J, Egawa N, Griffin H, Murakami I. Human papillomavirus molecular biology and disease association. Rev Med Virol. 2016;25:2-23.
  13. Rowen D, Fox P, Goon P. Anogenital Human Papillomavirus Infection: Natural.History, Epidemiology, and Vaccination. In: Gupta S, Kumar B, editors..Sexually Transmitted Infections, 2nd ed. New Delhi: Elsevier; 2012. p.360-65.
  14. Fernandes JV, Fernandes TAA. Human Papillomavirus: Biology and Pathogenesis. In: Broeck DV, editors. Human Papillomavirus and Related Diseases-From Bench to Bedside-A Clinical Perspective. InTech; 2012. p.3-41.
  15. Gomley RH, Kovarik Cl. Human papiloma virus-related genital disease in the immunocompromised host: part I. J Am Acad Dermatol. 2012;66(6): 867.el-e17.
  16. CDC. Guidelines of Department of Health and Human Services Centers for Disease Control and Prevention. MMWR. 2010;59:26-36.
  17. Clifford GM, de Vuyst H, Tenet V, Plummer M. Effect of HIV infection on human papillomavirus types causing invasive cervical cancer in Africa. JAIDS. 2016;22:1-12.
  18. Wifanto SJ, Bobby S, Aria K. Perianal condyloma acuminate : Factors that contribute to recurrence.New ropanasuri journal of surgery.2018;3:31-33.
  19. Ji Hyun S, Eun Jung A, Heung K.O. Association of immune status with recurrent anal condyloma in human immunodeficiency virus-positive patients. J Korean Soc Coloproctol.2012.28(6):294-298.

How to Cite

Wiraguna, A. A. G. P., & Puspawati, N. M. D. (2020). Condyloma acuminatum in a 62-year-old patient with HIV infection. Bali Medical Journal, 9(1), 91–94. https://doi.org/10.15562/bmj.v9i1.1652

HTML
1

Total
3

Share

Search Panel

Anak Agung Gde Putra Wiraguna
Google Scholar
Pubmed
BMJ Journal


Ni Made Dwi Puspawati
Google Scholar
Pubmed
BMJ Journal