Efficacy and safety of intralesional quadrivalent human papillomavirus vaccine as immunotherapy in management of recalcitrant genital warts in a tertiary health care center of North India

Abstract

Background: Warts are common epidermal outgrowths caused by various strains of Human Papilloma Virus (HPV) and are spread by direct or indirect contact. Although they undergo spontaneous remission in 60–70% of cases over a period of few years, the cosmetic disfigurement, tendency to spread, and associated poor quality of life warrants intervention. Aim and Objectives: The purpose of this case study was to explore the efficacy of Intralesional quadrivalent HPV Vaccine as immunotherapy in management of genital warts. Materials and Methods: Twelve subjects of genital warts were enrolled from outpatient department of dermatology. Intralesional HPV vaccine was administered at 3 weekly intervals till three sittings or till the resolution of the lesions occurs, whichever was earlier. Results were measured in the terms of reduction in the number of the lesions, size of lesions or appearance of the new lesions. Follow-up was done at 3 weeks, 6 weeks, 9 weeks, 6 months, and 1 year. Any side effects seen during the study were recorded. Results: Eleven out of 12 patients showed complete resolution. Side effect observed was only pain and that too during the injection. Only one patient had recurrence. Conclusion: Immunotherapy is a simple, cost effective, and non-ablative mode of treatment for genital warts with better efficacy, tolerability, and less recurrence rate.