CARBON-DIOXIDE (CO2)-LASER THERAPY CURES MACROSCOPIC LESIONS, BUT VIRAL GENOME IS NOT ERADICATED IN MEN WITH THERAPY-RESISTANT HPV INFECTION

Background and Objectives: We have evaluated the efficacy of CO2-laser in eradicating human papillomavirus (HPV) DNA from genitoanal skin le sions. Study Design: Biopsies of 38 male patients with histologically confirmed HPV-infection after an average of 2 years of follow-up were analyzed. Post-treatment biopsies were obtained from all residual or r ecurrent HPV-suspect (acetowhite) lesions in 23 patients. Results: Aft er an average of three separate CO2-laser treatments, 15 of 38 patient s were devoid of any clinical or acetowhite lesions. By in situ hybrid ization (ISH), the frequency of HPV-types 6/11 decreased from 52% to 2 6%, and HPV-types 16/18 decreased from 48% to 17%,respectively, in 23 patients biopsied twice. When ISH-negative biopsies were further analy zed with polymerase chain reaction (PCR) and southern blotting (SB) fo r HPV-16, HPV-types 16/18 were detected in a total of 65% of biopsies before CO2-laser therapy, and in 61% after the therapy. The cure rate achieved with CO2-laser was 39% (15/38) according to clinical, 61% (14 /23) according to histopathological, and 26% (6/23) according to molec ular biological criteria. The frequency of Bowenoid papulosis was redu ced from 57% (13/23) to 17% (4/23), Conclusions: Although CO2-laser is ineffective in eradicating HPV genome from therapy-resistant penile w arts, the treatment reduces the recurrence of atypical changes and vis ible warts.