Periodic health examination, 1995 update: 1. Screening for human papillomavirus infection in asymptomatic women

Table 4: Trials of treatment of HPV infection

Study Type of study Intervention Subjects Results

Carmichael et al, Canada, 1989[12] Cohort study No treatment 235 women with mild to moderate dysplasia and HPV infection 2-yr follow-up; signs of progression in 10%, no change in 60% and regression in 30%

Ferenczy et al, Canada, 1985[62] Case series Carbon dioxide (CO2) laser therapy 20 patients with genital warts or CIN 6-mo follow-up; recurrence in 35% overall; recurrence in 67% with HPV infection and in 9% without HPV infection

Riva et al, United States, 1989[63] Case series CO2 laser therapy 16 women with vulvar papillomatosis Cure in 19%, relapse in 81%; mean time 4.6 mo.

Shafi et al, Britain, 1990[64] Case series CO2 laser therapy 25 women with HPV lesions High morbidity; persistent subclinical HPV infection in 88%

Eron et al, United States, 1986[65] Randomized controlled trial Intralesional alpha-2b interferon (IFN) therapy 296 patients with genital warts Reduced wart size in IFN at 13 wk; cure rate 13% with IFN and 17% with placebo; no long-term follow-up

Yliskoski et al, Finland, 1990[66] Randomized controlled trial IFN cream v. placebo for 1 yr 19 women with CIN and infection with HPV-16 No difference clinically: remission in 44% (4/9) of women given IFN and in 70% (7/10) of those given placebo; 33% 93/9) in IFN group and 70% (7/10) in placebo group remained HPV positive

Dunham et al, Britain,1990[67] Randomized controlled trial Perilesional injections of IFN v. no treatment 14 women with CIN Clinical improvement in 86% (6/7) of women given IFN and in 43 (3/7) of control subjects

Yliskoski et al, Finland, 1991[68] Cohort study Conization 116 women with HPV infection and grade 2 or 3 CIN HPV cured in 82.7% (mean follow-up 32 mo)

Ruge et al, Denmark 1991[69] Randomized controlled trial CO2 laser therapy v. standard therapy 50 women with HPV infection on Papanicolaou smear 6-mo follow-up: cure rate 100% in laser therapy group and in 72% in control group

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Table 4: Trials of treatment of HPV infection
Study	Type of study	Intervention	Subjects	Results
Carmichael et al, Canada, 1989[12]	Cohort study	No treatment	235 women with mild to moderate dysplasia and HPV infection	2-yr follow-up; signs of progression in 10%, no change in 60% and regression in 30%
Ferenczy et al, Canada, 1985[62]	Case series	Carbon dioxide (CO2) laser therapy	20 patients with genital warts or CIN	6-mo follow-up; recurrence in 35% overall; recurrence in 67% with HPV infection and in 9% without HPV infection
Riva et al, United States, 1989[63]	Case series	CO2 laser therapy	16 women with vulvar papillomatosis	Cure in 19%, relapse in 81%; mean time 4.6 mo.
Shafi et al, Britain, 1990[64]	Case series	CO2 laser therapy	25 women with HPV lesions	High morbidity; persistent subclinical HPV infection in 88%
Eron et al, United States, 1986[65]	Randomized controlled trial	Intralesional alpha-2b interferon (IFN) therapy	296 patients with genital warts	Reduced wart size in IFN at 13 wk; cure rate 13% with IFN and 17% with placebo; no long-term follow-up
Yliskoski et al, Finland, 1990[66]	Randomized controlled trial	IFN cream v. placebo for 1 yr	19 women with CIN and infection with HPV-16	No difference clinically: remission in 44% (4/9) of women given IFN and in 70% (7/10) of those given placebo; 33% 93/9) in IFN group and 70% (7/10) in placebo group remained HPV positive
Dunham et al, Britain,1990[67]	Randomized controlled trial	Perilesional injections of IFN v. no treatment	14 women with CIN	Clinical improvement in 86% (6/7) of women given IFN and in 43 (3/7) of control subjects
Yliskoski et al, Finland, 1991[68]	Cohort study	Conization	116 women with HPV infection and grade 2 or 3 CIN	HPV cured in 82.7% (mean follow-up 32 mo)
Ruge et al, Denmark 1991[69]	Randomized controlled trial	CO2 laser therapy v. standard therapy	50 women with HPV infection on Papanicolaou smear	6-mo follow-up: cure rate 100% in laser therapy group and in 72% in control group