الفهرس 
Virological aspects of HPVOnly 14 pages are availabe for public view
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Abstract
Warts are tumors or growths caused by infection by Human Papilloma virus (HPV). More than 100 HPV subtypes are known. They are common presenting disease in children and adolescents which spread by direct contact or autoinoculation.
The treatment of warts poses a therapeutic challenge for physicians. No single therapy had been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches include chemotherapy by (salicylic acid, TCA, formaldehyde, glutaraldehyde, formic acid, cantharidin, 5-fluorouracil, bleomycin, podophyllin, podophyllotoxin, silver nitrates and retinoids), cryotherapy mostly by liquid nitrogen, electrosurgery (curettage and cautary), laser therapy by (CO2 laser, Er: YAG laser, and Nd: YAG laser) and photodynamic therapy.
All these previous destructive modalities are variably effective, frequently painful and usually cause scarring. More over these modalities require individual treatment of each wart and do not prevent recurrence.
There are new trends towards the use of immunotherapy in treatment of warts, as the immune system seems to play an important role in the control of warts infection. Although the exact mechanisms are unclear but most evidences suggest that cell mediated rather than humoral immunity plays an important role in control of HPV infection as the incidence of warts increases in subjects with cell mediated immune defects e.g. (HIV infection patients, malignant diseases. etc…)Various methods have been used to stimulate the immunological response as oral levamisole, cimetidine, zinc sulfate, cidofovir, intralesional interferons, topical DNCB, DPCP, SADBE, imiquimod, intralesional immunotherapy with mumps, candida and trichophyton antigens, intradermal BCG vaccine, and intralesional Mw vaccine.
In this study, we investigated the efficacy of BCG antigen as immunotherapy in genital warts. Our study included 5 patients, 4 females and 1 males with an age ranging from 25-44 years old of different sizes of genital warts. All patients were subjected to full clinical evaluation, tuberculin testing, and intralesional BCG therapy.
The results showed that 1 (20%) patients had complete resolution, 1(20%) patient had partial resolution, 1(20%) patient had minimal resolution, and 2 (40%) patients had no response of the target wart. No serious side effects occurred in any of the patients included in this study. However systemic reaction in the form of fever, headache, myelgia and dysurea and local reaction at the site of injection in the form of redness, mild irritation and tenderness. All these reactions subsided 48 hours later after injection without any medications.
We found that BCG is a safe modality in treatment of warts. It is especially promising in countries where vaccination against tuberculosis is performed routinely.