Cidofovir, a new approach for the treatment of cervix intraepithelial neoplasia grade III (CIN III)

Cervix intraepithelial neoplasia grade III (CIN III) is an intraepithelial proliferative process with different levels of severity depending on both t he extension of the proliferation in the epithelium and the presence of cel lular atypia. Human papillomavirus (HPV) has been clearly associated with s uch lesions. The results of a preliminary study are described on the local application of cidofovir, an acyclic nucleoside phosphonate derivative with broad-spectrum anti-DNA virus activity for the treatment of CIN III. Cidof ovir 1% in gel was applied three times, every other day, on the cervix of e ach of 15 women with biopsy proven CIN III. Within 1 month after the start of treatment, the cervix was removed surgically. Histology and human papill omavirus polymerase chain reaction (HPV-PCR) were carried out. In 7 of the 15 patients the histology showed a complete response, whereas 5 patients ha d a partial response characterized by the persistence of CIN II-III lesions , 1 patient had a dysplasia of lower grade (CIN I), and 2 patients did not show differences in the histology. Complete response was confirmed by PCR i n 4 of the 7 patients, with complete response histologically. Cidofovir was not toxic to the normal epithelium. Cidofovir 1% gel was able to inhibit p artially or completely cervical dysplasia lesions after only three applicat ions (every other day). This effect was specific and tissue other than the dysplastic epithelium was not affected by the treatment. J. Med. Virol. 60: 205-209, 2000. (C) 2000 Wiley-Liss, Inc.