Condylomata Acuminata

The genital tract infection by human papilloma virus (HPV) is one of the most common viral STD.
Genital warts (venereal warts, genital warts, warts-fig) are known for a long time, but until recently were considered trivial and sexual transmission was even questioned by some. It is now known that the genital warts is only the most obvious manifestation of HPV infections in the anogenital region.
There is much evidence supporting the concept that subclinical HPV infections are much more common than previously thought. In addition, diagnosis and treatment of HPV infections must take into account that some types are often associated with squamous atypia and less often with invasive anogenital region.
HPV is a DNA virus of 55 nm, papovavirus family. Infects the skin and mucous membranes, replicating in the nucleus of infected epithelial cells.
The final expression of the viral gene, synthesis of the capsid protein, viral DNA replication and virion assembly occurs almost exclusively on epithelial cells at the terminal stage of differentiation.
Currently the group has 70 distinct types HPV, 34 are associated with anogenital lesions. A subgroup of the anogenital types of HPV is detected more frequently in genital lesions.
HPV can not be grown in tissue culture. The inoculation experiments in vidada century and electron microscopy data over 30 years showed the first evidence of reproducible viral etiology of warts.
Currently, the location of HPV DNA in situ hybridization and molecular hybridization techniques have been used to confirm the presence of viruses in tissues.
Treatment
Treatment of genital warts can be frustrating because it often requires many con-consultations and relapse is common.
HPV is recovered on the banks of apparently healthy warts surgically resected, being responsible for some talbez recurrent lesions.
Recurrence results from a failure in the total eradication of epithelial cells containing HPV or reinfection from sexual partners infected.
Local treatment is done with application of caustic agents or antimetabolites (podophyllin, trichloroacetic acid, fluorouracil), cryotherapy, and electrodissection surgical resection. Patients with internal warts should be referred to specialist services.
All women with warts should undergo Pap smear to exclude coexisting CIN.
Although often used in laser surgery is not yet established efficacy in comparison with other treatment methods.
A severe restriction of laser therapy is the destruction of the lesion without histological evaluation to exclude malignancy.
Large lesions, confluent, necrotic and rapidly increasing in elderly or immunocompromised should be biopsied before treatment with laser or other destructive means local. The patient should also be followed carefully.
The intramuscular or intralesional injection of interferon has limited efficacy and severe side reactions. Not yet been established the need for treatment in subjects with subclinical infection.
Prevention
There is no way to prevent 100% safe, since HPV can be transmitted even through a towel or other object.
It is estimated that the use of condoms can spread between 70% and 80% of the transmissions, and its effectiveness is not greater because the virus can be hosted elsewhere, not necessarily to speak, but also on the skin of the pubic area, perineum and anus.
The novelty is the arrival, in 2006, the first vaccine to prevent infection by the two most common types of HPV, 6 and 11, accounting for 90% of the warts, and also the two most dangerous types, 16 and 18 responsible for 70% of cases of cervical cancer. Still under discussion values ​​for dose (3 doses) for the Brazilian private market.
Most of the time men do not manifest the disease. Yet are transmitters of the virus.
For women, it is important that they make the examination of preventing cancer of the cervix, known as "Pap" or preventive regularly.
Control
The epidemic nature of sexually transmitted diseases makes them difficult to control. Some public health officials attribute the increase in the number of cases of these diseases to increased sexual activity.
Another factor that contributes significantly is the replacement of condom use (condom) - which offers some protection - for pills and diaphragms with contraceptive methods. The patterns of sexually transmitted diseases are quite variable.
While syphilis and gonorrhea were both epidemic, intensive use of penicillin caused the frequency of syphilis fell to a level reasonably controlled, attention then turned to the control of gonorrhea, was when the frequency of syphilis increased again. Cases of genital herpes and chlamydia also increased during the 70's and during the early 80s.
Treatment of sexually transmitted diseases is basically done with antibiotics.
Penicillin has been a drug effective against syphilis and gonorrhea, but many of the organisms that cause gonorrhea are now resistant to penicillin, is used in these cases ceftriaxone or spectinomicine.
Tetracycline is used to treat lymphogranuloma venereum, granuloma inguinale and chlamydial uterite.
There are specific treatments for most sexually transmitted diseases, with the exception of molluscum contagiosum. The antivirus drug acyclovir has proven useful in the treatment of herpes.
The only way to prevent the spread of sexually transmitted diseases is through the location of individuals who have had sexual contact with infected people and determine whether they also need treatment. Find everyone, however, is quite difficult, especially because not all cases are reported.
AIDS (AIDS) and hepatitis B is transmitted through sexual contact, but these diseases can also be transmitted in other ways.