HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial

Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based o...

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Veröffentlicht in:Journal of clinical virology 2013-07, Vol.57 (3), p.227-232
Hauptverfasser: Bruggink, Sjoerd C, Gussekloo, Jacobijn, de Koning, Maurits N.C, Feltkamp, Mariet C.W, Bavinck, Jan Nico Bouwes, Quint, Wim G.V, Assendelft, Willem J.J, Eekhof, Just A.H
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container_end_page 232
container_issue 3
container_start_page 227
container_title Journal of clinical virology
container_volume 57
creator Bruggink, Sjoerd C
Gussekloo, Jacobijn
de Koning, Maurits N.C
Feltkamp, Mariet C.W
Bavinck, Jan Nico Bouwes
Quint, Wim G.V
Assendelft, Willem J.J
Eekhof, Just A.H
description Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care.
doi_str_mv 10.1016/j.jcv.2013.02.021
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Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. 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Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. 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Gussekloo, Jacobijn ; de Koning, Maurits N.C ; Feltkamp, Mariet C.W ; Bavinck, Jan Nico Bouwes ; Quint, Wim G.V ; Assendelft, Willem J.J ; Eekhof, Just A.H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-572ecfe1cc3239567d457283d2bb6c1c6ed1912b342bfd2aff43371908c9a9e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Allergy and Immunology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cryotherapy - methods</topic><topic>Cutaneous warts</topic><topic>DNA, Viral - genetics</topic><topic>Drug Therapy - methods</topic><topic>Female</topic><topic>Foot Diseases - therapy</topic><topic>Foot Diseases - virology</topic><topic>Genotype</topic><topic>Human papillomavirus (HPV)</topic><topic>Humans</topic><topic>Infectious Disease</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands</topic><topic>Papillomaviridae - classification</topic><topic>Papillomaviridae - genetics</topic><topic>Papillomaviridae - isolation &amp; purification</topic><topic>Papillomavirus Infections - therapy</topic><topic>Papillomavirus Infections - virology</topic><topic>Salicylic Acid - administration &amp; dosage</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><topic>Warts - therapy</topic><topic>Warts - virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bruggink, Sjoerd C</creatorcontrib><creatorcontrib>Gussekloo, Jacobijn</creatorcontrib><creatorcontrib>de Koning, Maurits N.C</creatorcontrib><creatorcontrib>Feltkamp, Mariet C.W</creatorcontrib><creatorcontrib>Bavinck, Jan Nico Bouwes</creatorcontrib><creatorcontrib>Quint, Wim G.V</creatorcontrib><creatorcontrib>Assendelft, Willem J.J</creatorcontrib><creatorcontrib>Eekhof, Just A.H</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bruggink, Sjoerd C</au><au>Gussekloo, Jacobijn</au><au>de Koning, Maurits N.C</au><au>Feltkamp, Mariet C.W</au><au>Bavinck, Jan Nico Bouwes</au><au>Quint, Wim G.V</au><au>Assendelft, Willem J.J</au><au>Eekhof, Just A.H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial</atitle><jtitle>Journal of clinical virology</jtitle><addtitle>J Clin Virol</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>57</volume><issue>3</issue><spage>227</spage><epage>232</epage><pages>227-232</pages><issn>1386-6532</issn><eissn>1873-5967</eissn><abstract>Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>23518443</pmid><doi>10.1016/j.jcv.2013.02.021</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Allergy and Immunology
Child
Child, Preschool
Cryotherapy - methods
Cutaneous warts
DNA, Viral - genetics
Drug Therapy - methods
Female
Foot Diseases - therapy
Foot Diseases - virology
Genotype
Human papillomavirus (HPV)
Humans
Infectious Disease
Male
Middle Aged
Netherlands
Papillomaviridae - classification
Papillomaviridae - genetics
Papillomaviridae - isolation & purification
Papillomavirus Infections - therapy
Papillomavirus Infections - virology
Salicylic Acid - administration & dosage
Treatment
Treatment Outcome
Warts - therapy
Warts - virology
Young Adult
title HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial
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