Topical treatment of anogenital human papillomavirus infection in male patients

Donna P. Ankerst, Helmut Diepolder, Sophia Horster

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Human papillomavirus (HPV) -associated anogenital warts have a prevalence of up to 78% in sexually active men. Some HPV subtypes bear a considerable oncogenic potential. Materials & methods: Original papers on the treatment of external anogenital warts were included in a meta-analysis to assess the most effective topical treatment. Results: Clearance rates were 0-6.5% for placebo treatment, 76.6% for podophyllotoxin 0.15% cream administered for 4 weeks, 61.5% for podophyllotoxin 0.5% solution (2-6 weeks) and 53.7% for imiquimod 5% cream (12-16 weeks). For male patients, the intent-to-treat analysis demonstrated statistically significant superiority of podophyllotoxin preparations versus imiquimod (p < 0.0001 and p < 0.005, respectively). Clearance rates of locally ablative treatments, such as surgery, cryotherapy, electrocautery and carbon dioxide laser, differed widely without clear superiority of a specific ablative technique. In HIV-positive patients, all treatment options yielded lower clearance rates and higher recurrence rates. Conclusion: While preventive vaccines might reduce HPV-associated morbidity for future generations, those with active HPV disease still need to be treated with customary treatment options. In male patients, podophyllotoxin preparations yielded higher response rates than imiquimod.

Original languageEnglish (US)
Pages (from-to)531-541
Number of pages11
JournalFuture Virology
Issue number6
StatePublished - Dec 1 2009


  • Anogenital warts
  • HIV
  • HPV
  • Imiquimod
  • Male patients
  • Podophyllotoxin

ASJC Scopus subject areas

  • Virology

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