lives, these drugs do not reduce the risk of transmitting the disease to someone else.
Many new HIV drugs are under investigation. The U.S. Food and Drug Administration is expected to approve a CCR5 receptor antagonist, called maraviroc (Celsentri®), and an integrase inhibitor, called raltegravir (Isentress®), in late 2007.
human papilloma virus (hpv)
Overview: The human papilloma virus (HPV) is a viral infection that sometimes causes genital warts (also called venereal warts). There are more than 100 different types of HPV, but only a few cause genital warts.
HPV is highly contagious. The infection may be transmitted through direct contact with the virus during oral, anal, or vaginal sex. It may also be transmitted after touching objects (e.g. towels, bed linens, or clothing) that have come into contact with an infected person.
There is currently no cure for HPV. Although treatment can help manage symptoms, females with HPV have a much greater risk of developing cervical cancer than females who are not infected with HPV. It has also been associated with other types of genital cancers,
including cancer of the penis, anus, vulva, and vagina.
In June 2006, the U.S. Food and Drug Administration (FDA) approved the first HPV vaccine called Gardasil®. The vaccine is expected to prevent most cases of cervical cancer due to HPV types included in the vaccine. However, patients will not be protected if they
have been infected with the HPV type(s) prior to vaccination, and the drug does not protect against less common types of HPV.
Symptoms: Most patients develop symptoms within three months of exposure to HPV. However, some patients may not develop symptoms for several years, and others may not experience any symptoms at all.
Common symptoms include small swellings in the genital area, multiple warts that form cauliflower-shaped clusters, itching or discomfort in the genital area, and bleeding during intercourse. Warts may spread to other areas of the body. Symptoms may worsen during pregnancy.
Complications: HPV has been shown to cause cervical cancer in females. In addition, certain types of HPV have also been associated with cancer of the anus, vagina, vulva, and penis. Regular pelvic exams and Pap tests are recommended to diagnose and treat infections quickly.
Genital warts may also lead to complications during pregnancy. In some patients, the warts may enlarge, making it difficult to urinate. Also, warts on the vaginal wall may reduce flexibility of the vaginal tissues during childbirth. In rare cases, a baby born to a mother with genital warts may develop warts in the throat. In such cases, surgery may be required to remove the warts and prevent airway obstruction.
Diagnosis: An acetic acid solution may be applied to the patient's genitals. This solution helps the healthcare provider detect warts because it turns warts a white color. Then, a specialized microscope, called a colposcope, is used to view the warts. If they are characteristic of HPV, a positive diagnosis is made.
It is especially important for women to undergo routine pelvic exams and Pap tests because HPV increases a female's risk of developing cervical cancer. Patients diagnosed with HPV may need to have a Pap test every three to six months. Patients should talk to their healthcare providers to determine how often they should be screened.
Treatment: There is currently no cure for HPV. However, many treatments are available to manage symptoms. Even if genital warts are no longer present, the virus is never eliminated from the body. This means warts may come back in the future.
Patients should not use over-the-counter wart removers for genital warts. These products are not designed for genital warts and they may cause serious side effects. Patients should consult their healthcare providers to determine the safest and most effective way to remove warts.
Many creams and ointments, such as imiquimod (Aldara®) and podofilox (Condylox®), may be applied directly to the skin to remove warts. Healthcare providers may also apply a chemical called trichloroacetic acid (TC