Lack of efficacy in treating condyloma acuminata and preventing recurrences with the recombinant quadrivalent human papilloniavirus vaccine in a case series of immunoconipetent patients

摘要

To the Editor: With great interest we read the article by Lee et al published in the journal in June 2011. The authors report on a 46-year-old man with extensive perianal condylomata acuminata that showed a dramatic improvement after a single injection of the recombinant quadrivalent human papillomavirus (HPV) vaccine (against the HPV types 6, 11, 16, and 18). In contrast, our experiences with the prophylactic HPV vaccine for treating condylomata acuminata are less promising. Six immunocompetent patients (1 female and 5 male) with anogenital warts who had received the prophylactic HPV vaccine presented at our institution between 2009 and 2011. The mean age of the patients was 26 years (range, 12-42 years). Patients' clinical characteristics are shown in Table I. In all of them, HPV vaccination (3 doses of Gardasil [Sanofi Pasteur MSD, Leimen, Germany] within 6 months) was initiated after the first clinical visit at our department, where ablation of the warts was performed with electrocautery. All patients experienced recurrences (mean number of recurrences: 4.8; range, 1-11) of at least 1 condyloma after electrocautery and HPV vaccination. HPV typing of the condyloma performed at first presentation and at time of recurrence showed that the respective HPV types had probably persisted in the patients (Table I).