Table 2 - uploaded by Claudia S Estcourt
Content may be subject to copyright.
Source publication
To characterise risk factors for the acquisition of genital warts and specifically to determine whether condoms confer protection from infection.
A retrospective case-control study comparing demographic, behavioural, and sexual factors in men and women with and without newly diagnosed genital warts, who attended Sydney Sexual Health Centre (SSHC),...
Context in source publication
Context 1
... diVerence in age distribution between those with and without genital warts remained significant for both men and women, and the odds ratio showed a very strong negative trend with age (table 2). In men, the eVect of smok- ing and number of lifetime partners was mini- mally aVected by adjustment for other vari- ables. ...
Citations
... For example, a retrospective case-control study in Australia showed that people who smoked 11 or more cigarettes per day had a higher risk (OR = 1.9, CI 95 %: 1.00-2.30) of developing genital warts than people who smoked 1-10 cigarettes per day (OR = 1.3, CI 95 %: 1.00-1.80) (Wen et al., 1999). Furthermore, a case-control study in the Czech Republic reported a 0.5 higher risk in men and 3.0 in women who smoked more than 10 cigarettes per day than those who smoked 2-10 cigarettes per day (Petráš and Adámková, Jul. ...
Background
Limited research exists regarding the association between smoking and anal warts. In this study, we evaluated this association among a clinic-based Hispanic population in Puerto Rico.
Methods
Cross-sectional study among eligible patients seen at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (2016–2023) (n = 920). Sociodemographic and clinical variables were collected from medical records. Patients underwent a high-resolution anoscopy (HRA) during the clinical visit; physicians assessed anal condylomas on HRA. Poisson regression models with robust standard errors were used to evaluate the association between smoking and anal warts. Demographic and clinical factors were also assessed.
Results
The mean age of participants was 45.8 ± 13.1 years, 66.4 % were men, and 21.6 % were current smokers. While 10.8 % self-reported a history of anogenital condylomas, 18.9 % had anal condylomas on clinical evaluation. A higher prevalence of anal condylomas was observed among current smokers (PR = 1.28, 95 % CI: 0.94–1.75) in comparison to non-smokers in adjusted analysis, but this was not statistically significant. However, a higher prevalence of anal condylomas was observed among younger individuals (PR = 0.96, 95 % CI: 0.96–0.98) and individuals with anal high-grade squamous intraepithelial lesions (HSIL) as compared to those with benign histology (PR = 1.74. 95 % CI: 1.09–2.77).
Conclusions
Although current smoking seemed to be positively associated with anal condylomas in this high-risk Hispanic population, this finding was not statistically significant as the power to detect an association was limited. However, younger age and HSIL diagnosis were associated with a higher prevalence of anal condylomas.
... In our study, total number of patients were 150, male 81 (74%) and female 69(26%) with male to female ratio of 1.17: 1, we noted that the highest prevalence of GW was among the age group (28-37) which is 44.7% and second the second peak was noted at age group (18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Concerning the educational status of our study sample, the highest prevalence of GW was observed in illiterate group (33.3%), followed by primary school graduates (31.3%) and the least was among higher education graduates (2%). ...
... like some remote and distant (considering our location) eastern European (236) and north American countries (223). 18 These diversities can be attributed to a number of reasons, such as: a different age range of the study population sample vs. larger age ranges in other studies, a different background of the study population (patients visiting a community centers in our study vs. general population or privately-diagnosed and treated in other [19][20] We noted that the vast majority of our study samples (about 92%) did not use condom, this could be related or linked to their occupation and/or educational level as follow; 33.3% of the samples were illiterate or merely an elementary school graduates (31.3%) going furhter19 % of the male samples were taxi and heavy machinery drivers, 33.7% of them were soldiers & military personals, it is probably due to lack of condom advantages and not accepting it. ...
Background and objectives: External genital warts are currently the most common form of viral sexually transmitted disease found in the general population which occur as a direct result of infection with the human papilloma virus. Our aim was to study the clinical features of genital warts among populations of Erbil governorate. Methods: A cross-sectional survey was conducted for 6 month’s period from (September 2017 to March 2018) on 150 patients at the Erbil Dermatology Teaching Center; Erbil governorate. Participants were interviewed and examined individually, and diagnosis of the genital warts confirmed clinically. Results: female to male ratio is 1: 2.9. Our data showed the highest prevalence (44.7% of our main sample size of external genital wart) was among age groups ranging from (28-37 years) of both genders. The second peak was noted at age groups (18-27years) which was about 26.7%. The range declines to less than 1.3% for the age group of 75 years and above. We found a slightly higher prevalence of external genital wart among males (54%) versus females (46 %). Higher prevalence of the disease was found among the married samples of both genders (74.7 %) versus singles (25.3%). No female patient; whether married or single, admitted having multiple partners while some male’s patients were having multiple partners. Conclusions: This study showed that genital warts are more common in male with multiple sex partner and who are married and it’s also more common in lower educational levels of population.
... In previous analyses, we identified an association between a recent history of anal lump and a higher burden of HSIL, which we hypothesized may be because of coinfection with multiple HPV types and concomitant anal warts. 33 A history of anogenital warts is associated with subsequent development of anal cancer, 12,34 which may be explained by shared risk factors for the acquisition of low and high-risk HPV types, 27,34-37 smoking, 12,36 or differences in cellmediated immunity. 38 However, in our analysis, the association between intra-anal warts and HSIL remained significant after adjustment for the number of RAI partners and smoking. ...
Human papillomavirus (HPV) causes anal warts and anal squamous cell carcinoma (SCC). A higher incidence of anal cancer has been found among individuals previously diagnosed with anogenital warts. We aimed to investigate the association between anal warts and the presumed anal SCC precursor high-grade squamous intraepithelial lesion (HSIL), among participants in the Study of the Prevention of Anal Cancer (SPANC). SPANC was a longitudinal study of anal HPV infections and related lesions among gay and bisexual men (GBM) age 35 years and older, in Sydney, Australia. Anal cytology and high-resolution anoscopy were performed. Logistic regression was used to investigate the association between clinically diagnosed anal warts and intra-anal composite-HSIL (cytology and/or histology) at the baseline visit. The prevalence of HSIL within biopsies from intra-anal warts was calculated. Laser capture microdissection (LCM) and HPV-genotyping was performed on HSIL lesions. Among 616 participants at study entry, 165 (26.8%) and 51 (8.3%) had intra-anal and perianal warts, respectively. Warts were associated with composite-HSIL, even after adjustment for HIV status, age, lifetime receptive anal intercourse partner number, and smoking (perianal: aOR 2.13, 95% CI 1.17-3.87, p = 0.013; intra-anal: aOR 1.69, 95% CI 1.16-2.46, p = 0.006). HSIL was detected in 24 (14.5%) of 165 biopsies from intra-anal warts. Of 17 HSIL lesions, 16 (94.1%) had high-risk HPV detected by LCM. Anal warts were common. Prevalent anal warts were associated with composite-HSIL. HSIL may be detected within biopsies of intra-anal warts. Anal warts may be a useful addition to risk stratification for HSIL among GBM.
... • Condoms have been shown to at least partially protect against the acquisition of anogenital warts. 98,99 Whether condoms protect against HPV transmission per se is less clear 99 but some data suggest that male condom use may protect female partners against HPV acquisition. 9,100 The prevalence of HPV DNA has also been shown to be lower in men who consistently use condoms. ...
This guideline is an update of the 2011 European Guideline for the Management of Anogenital Warts. It is intended to support best practice in the care of patients with anogenital warts by including evidence‐based recommendations on diagnosis, treatment, follow‐up and advice to patients. It is intended for use by healthcare professionals in sexual healthcare or dermato‐venereology clinics in Europe but may be adapted for use in other settings where the management of anogenital warts is undertaken. As a European guideline, recommendations should be adapted according to national circumstances and healthcare systems. Despite the availability of vaccine to prevent HPV types 6 and 11, the cause of >95% anogenital warts, they remain an important and frequent health problem. The previous systematic review of randomized controlled trials for anogenital warts was updated. The changes in the present guideline include the following: Updated background information on the prevalence, natural history and transmission of human papillomavirus (HPV) infection and anogenital warts. Key recommendations for diagnosis and treatment have been graded according to the strength of the recommendation and the quality of supporting evidence. 5‐fluorouracil, local interferon and photodynamic therapy have been evaluated and included as potential second‐line treatment options. Evidence of the impact of HPV vaccination on the incidence of anogenital warts has been updated.
... The age distribution of our patients is comparable to that reported in previous articles of populations with AGW [18,27,28] and the proportion of females is approximately as low as that reported by Ünal et al. [18], presumably because women with AGW tend to be treated by gynecologists rather than dermatologists. The percentage of MSM (7.1 %) in our population reflects the proportion of MSM among Swiss men [29]. ...
Background and objectives
Anogenital warts (AGWs) are most commonly caused by low‐risk human papillomavirus (HPV) types, and although they are the most frequent viral sexually transmitted infections (STIs), little is known about STI coinfections in affected patients. We therefore sought to assess STI coinfection rates in patients with AGW, specify STI coinfections and calculate the number needed to screen (NNS) for each STI.
Methods
A retrospective cross‐sectional study analyzing data sets from AGW patients treated in our clinic between 2008–2016.
Results
142/196 (72 %) patients had been variably screened for infections with HIV, HBV and HCV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and HSV. The STI coinfection rate in all tested patients was 24.6 %, yielding an NNS of 4.1 to detect any STI. Of note, the coinfection rate did not differ significantly between heterosexual men, homosexual men and women, respectively. The NNS for syphilis was 8.4, for HIV 14.0, for HCV 28.5 and for HBV 39.0. The NNS for asymptomatic patients tested for HSV, Chlamydia trachomatis and Mycoplasma genitalium were 1.4, 5.3 and 12.0, respectively.
Conclusion
Due to the high prevalence of STI coinfections, AGW patients should be screened for other STIs.
... The risk factors for GW in both sexes, include HIV coinfection (Neme et al. 2015), more lifetime sexual part-ners, failure to use condoms, greater cigarette smoking and alcohol consumption (Wen et al. 1999). In women, history of STIs also increased the risk of developing GW. ...
This study aimed to determine the prevalence of HPV genotypes in genital warts among women in Harare, Zimbabwe. Women aged 18–45 years attending gynaecology and genitourinary clinics with a clinical diagnosis of genital-warts were recruited. HPV-DNA was extracted from tissue biopsies. HPV-DNA testing and typing was done by Southern Dot Blot Hybridisation. A hundred samples from 100 women were analysed. Median age of participants was 30.3 years (range 18–45 years). Seventy-eight percent of participants were HIV infected. HPV prevalence was 98%. Low risk genotypes predominated at 86% prevalence. The most prevalent genotypes were 11 (47%), 6 (42%) and 16 (14%). This is the first study on HPV genotype distribution among women with genital warts in Zimbabwe. The high prevalence of HR-HPV 16 in clinically benign lesions shows that warts should have histological analysis to exclude pre-malignancy and malignancy.
• Impact statement
• What is already known on this subject? Genital warts (GWs), also known as condylomata acuminata (EAC), are a clinical manifestation of persistent infection with ‘low risk’ or non-oncogenic HPV genotypes. HPV 6 and 11 are examples of low risk genotypes, and both are associated with 90% of GWs. Data on HPV genotypes causing genital warts in the population under study are scarce.
• What do the results of this study add? A high prevalence (98%) of HPV DNA in genital warts, confirms that the biopsied lesions were HPV related. Over and above the high prevalence of low risk HPV 11 (47%) and HPV 6 (42%), the women had 14% prevalence of HPV 16, an oncogenic genotype, in genital warts. Seventy-eight percent of the participants were HIV infected. The HIV infected women had a 33.3% prevalence of HR-HPV as compared to the 15.8% prevalence in the HIV uninfected women.
• What are the implications of these findings for clinical practice and/or further research? The population under study will benefit more if an HPV vaccine that includes anti-HPV 6 and 11 is used. The high prevalence of the HR-HPV in apparently benign lesions shows that warts should have histological analysis to exclude vulvar cancer and vulvar intraepithelial neoplasia. All women presenting with genital warts should be offered an HIV test.
... In other studies, 26.40% and 66.24% used condoms. 22,23 In our study, there was no significant relationship between education and condom use. In addition, in a study conducted by Malakouti et al., 19 there was no significant relationship between education and decrease in the risk of genital warts, because methods for preventing STDs are not taught at higher education centers in our country. ...
Introduction: Genital infection with papilloma virus is the most common sexually-transmitted disease (STD). It is recommended that individuals who have a sexual risk factor, should be screened for syphilis, human immunodeficiency virus (HIV), and hepatitis B and C. However, this strategy is often not carried out in Iran. In the present study, patients with genital warts were screened for syphilis, HIV, and hepatitis B and C. Methods: We evaluated 311 patients with anogenital warts visiting dermatology clinics from June 2016 to June 2017. In addition, demographic data were collected using a pre-designed questionnaire. Patients who presented to Sina Hospital, Tabriz, Iran, were examined for HIV, syphilis, hepatitis B and C, urethral and vaginal discharge, and history of painful genital lesions, while patients presenting to Bahar Behavioral Disease Counseling Center of Tabriz were examined only for HIV. Data were analyzed using chi-square and Fisher’s exact tests via SPSS software. Results: Out of 263 cases with genital warts presenting to Sina Hospital, 1, 1, and 2 cases were positive for HIV, syphilis, and hepatitis B, respectively. At the same time, one of the patients presenting to Bahar Center showed HIV infection. Conclusion: We found two HIV-positive, two hepatitis B virus (HBV)-positive, and one syphilis cases in 311 patients with genital warts, so it is recommended to assess these tests routinely in high-risk individuals with genital warts, including multi-partner and addicted patients.
... In our sample, routine condom use conferred a significant reduction in the risk of developing GWs in both genders. This finding is consistent with a retrospective case-control study on men and women attending the Sydney Sexual Health Centre, with and without newlydiagnosed GWs [24]. As for the use of hormonal contraceptives, our analysis revealed no additional risk of GWs among women using oral contraceptives. ...
... The influence of smoking on the risk of acquiring GWs is controversial. It is hard to say whether smoking is a confounder or a genuine risk factor for GWs: some authors found no correlation [26,27], while our data would seem to support other reports of a positive link between smoking and the burden of GWs among males [20,22,13,24,28]. ...
Background
Genital warts are one of the most common forms of sexually-transmitted disease, but their epidemiology has yet to be thoroughly elucidated. The present study was designed to shed light on the prevalence of clinically-confirmed, self-reported genital warts (GWs) in a representative sample of the university population. Methods
In 2015, a cross-sectional survey was conducted on 11,096 individuals approached at the Students Information Bureau where they came to enroll for a university degree course. Participants completed an anonymous, self-administered questionnaire providing information on their sociodemographic characteristics, sexual behavior, and any history of clinically-diagnosed genital warts. Multivariate logistic regression was then used to identify any factors associated with the disease. ResultsOur analysis was conducted on 9259 questionnaires (83.4%). Participants were a mean 21.8 ± 4.8 years of age, and 59.6% were female. Overall, 124 individuals (1.3%, 95%CI: 1.0–1.6) reported having been diagnosed with genital warts: 48 men (1.3%, 95%CI: 0.9–1.6), and 76 women (1.4% 95%CI: 1.1–1.7). Overall, 22.5% of the sample were vaccinated (1.3% of the males and 36.8% of the females). The group of respondents aged 30 years or more had the highest incidence of genital warts (males: 5.6%, 95%CI: 2.5–8.6; females: 6.9%, 95%CI: 3.4–10.4). The independent risk factors associated with a history of disease were (for both genders) a history of other sexually-transmitted diseases, and ≥2 sex partners in the previous 24 months. A protective role emerged for routine condom use. Additional risk factors associated with genital warts in males concerned men who have sex with men, bisexuality vis-à-vis heterosexuality, and smoking. Conclusions
The findings emerging from our study help to further clarify the epidemiology of genital warts in young people, and may be useful to public health decision-makers. This study showed that genital warts occur in men as well as women, and suggests that both genders should be monitored for this disease to ascertain the effects of the free HPV vaccination offered to all girls in the Veneto in their 12th year of life since 2008, and to all boys of the same age since 2015.
... Tamer et al. [13] reported that no significant differences between the use of condom and development of GWs among the patient and control groups. Wen et al. [20] showed that condom use serves as a barrier by preventing direct contact and the risk of HPV transmission can be reduced by regular condom use. ...
Objectives: This study aimed to evaluate the demographic features, clinical presentations, sexual aspects, and possible risk factors of genital warts (GWs) among patients treated at Outpatient Clinics of the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Sohag University, Egypt. Patients and Methods: In a
prospective cross‑sectional clinical study, it conducted on 85 patients with clinically evident GWs. All patients were
subjected to clinical assessments included a detailed medical history and full general and local examinations. All
patients were investigated to exclude other sexually transmitted diseases (STDs). Results: This study included
85 patients with clinically evident GWs; 65 (76.5%) were male and 20 (23.5%) were female. Of male patients,
44.5% were university graduate, 73.8% were urban, 90.8% were smoker, 64.6% had a single sexual partner, 75.4%
preferred intravaginal sex, 100% were circumcised, 80% had occasional history of condom use, and 95.4% had
a history of illegal sexual relation. Of female patients, 40% were university graduate, 55% were suburban, 100%
were nonsmoker, 45% had a single sexual partner, 65% preferred intravaginal sex, 100% were circumcised, 50%
had an occasional history of partner use of condom, and 35% had a history of illegal sexual relation. All patients
had neither other STDs nor warts in other body sites. Conclusion: Like all STDs , GWs have important effects on the health of society and quality of life. So, awareness of clinical presentations, sexual aspects, and possible risk factors of GWs leads to the use of effective protection measures and decrease the cost of treatment.
... As we observed in the 2 patients: lower age at first intercourse, multiple sexual partners and failure to use condom have been described as risk factors of genital warts; more over smokers were concerned in account of the immunosuppressive effects of nicotine [22,23]. Data on natural history of cervical cancer show that contamination in early adolescence increases the risk of early onset of cervical cancer [24]. ...
Introduction: Genital wart is a public health issue in developed countries. In sub Saharan Africa
environment, more particular in Cameroon, it should be a preoccupation because of the risk of recurrence
whatever the treatment modalities. Moreover it is a sexually transmitted disease (STD) due to some
known types of Human Papilloma virus (HPV) of which serotypes 16 and 18 could be responsible of
cervical, vulvar, and anal cancers. We present two cases of genital warts.
Case 1: A 16 years primiparous adolescent sexually active female who presented with vulvo-vaginal wart
at 37 weeks gestation. Gynecological examination revealed an obstructive vulvar wart extending to almost
all of the vaginal mucosa. At the 38 weeks 5 days gestation, she delivered through an elective cesarean
section a life foetus. At the 4th month post-partum, the vulvar wart was treated by surgical excision and
electrocautery. Histology confirmed squamous papilloma. A cervical smear done 6 months after delivery
was normal and her recovery was uneventful.
Case 2: A 26 years old, single, nulligravid HIV positive sexually active female referred by her physician
for a giant peri-anal and vulvar wart. Surgical excision of the wart was performed. Histology confirmed
squamous papilloma; a cervical smear done 2 months after the discharge from the hospital was normal
and her recovery uneventful.
Conclusion: The authors hence advocate the extension of current strategies to the whole country
(prevention of STD, vaccination against cervical cancer, cervical smear and HPV’ DNA screening, visual
inspection with acetic acid and lugol, treatment of precancerous lesions) and involvement of
paediatricians in sensitizing parents to vaccinate adolescent girls and the fight against early sex.
Keywords: Genital Warts, Cervical Cancer, Vaccination, Youth.
