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Genital Human Papilloma Virus Infection Classification and Transmission Staging. (Arani Papilloma Staging, APS Proposal for Condyloma Acuminata, Anogenital warts)

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  • Dr. Arani Medical Center

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Human Papillomavirus (HPV) is the most common sexually transmitted infection in the world. Vaccination has helped decrease the number of HPV infections worldwide, yet effective external genitoanal epithelial infection as genital and anal warts treatment continues to be an obstacle for clinicians and patients. Dr. Siavash Arani’s expertise and experience in treating thousands of patients infected with human papilloma virus (HPV) has led him to propose a new classification and staging of genital and anal warts. This classification and recommendation is made to further observe and control the spreading of HPV infection in the patient. In general, the higher stage of genital HPV infection, the more aggressive the treatment method and follow up required. While Stage I might benefit from conservative treatment, patients with Stage IV necessitate more invasive treatment and follow up. Patients with higher HPV stages have a greater chance to develop anal warts so that annual anal pap smears to screen for possible malignant or precancerous transformation is recommended.
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Genital Human Papilloma Virus infection classification and transmission staging
Human Papillomavirus (HPV) is the most common sexually transmitted infection in the world.
Vaccination has helped decrease the number of HPV infections worldwide, yet effective external
genitoanal epithelial infection as genital and anal warts treatment continues to be an obstacle
for clinicians and patients.
Dr. Siavash Arani’s expertise and experience in treating thousands of patients infected with
human papilloma virus (HPV) has led him to propose a new classification and staging of genital
and anal warts. This new staging would assist clinicians to further observe infected individual
and select treatment approach.
Stage I: Single wart or group of warts (primary or mother wart) in close proximity of 2 cm from
each other at pubic, inguinal area, genital, scrotum or perineum. Usually found at original site of
infection when the entry of virus occurs during sexual contact. Primary growth or mother wart is
typically larger than secondary growths.
Stage II: Secondary growths which are mainly offspring of primary wart appears at symmetrical
area of same anatomical area, i.e., bilateral side of penile or labia majora. HPV infection usually
spreads with autoinoculation from primary site or as two or more primary sites of infection
simultaneously appear. This may progress to viral infection in multiple areas at the same time
which has occurred during original or subsequent sexual encounters.
Stage III: Genital warts spread to different anatomical location than Stage I and II, i.e., from
pubic to penile or to perineum area or from labia majora to vaginal fourchette.
Stage IV: Virus spread to perinanal area.
According to Dr. Arani, infected HPV patients that have not responded to conservative treatment
such as topical application, acid, and cryotherapy, should not repetitively follow the same
treatment pathway which might further mask the disease and contribute to spreading of the
infection to self and partner. Failure to successfully remove genital warts could cause the
formation of anal warts which could lead to anal squamous cell carcinoma and further morbidity
as well as long term health care management.
This classification and recommendation is made to further observe and control the spreading of
HPV infection in the patient. In general, the higher stage of genital HPV infection, the more
aggressive the treatment method and follow up required. While Stage I might benefit from
conservative treatment, patients with Stage IV necessitate more invasive treatment and follow
up. Patients with higher HPV stages have a greater chance to develop anal warts so that
annual anal pap smears to screen for possible malignant or precancerous transformation is
recommended.
Dr. Arani’s basal cell removal (BCR) method to treat HPV related growth was introduced in
2007 as 3 step microsurgical destruction technical procedure approach and has helped
thousands of patients with persistent and complicated genital and anal warts to live without HPV
related growth today. Dr. Arani is author of “HPV, the Silent Intruder”.
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