VPH (HPV) Treatment

[Guest guest]

Hello --Unfortunately the answer to your question whether you will have to fight HPV for ever is " yes "  It is a virus that never goes away, so we have to be vigilant because it can cause anal cancer in addition to condyloma.  You're right that people with HIV have more HPV disease, and it can be more severe (i.e. cancerous) and recur more often.  

If you have severe condyloma that freezing with nitrogen can't remove, I'd suggest finding a good colorectal surgeon who can perform electrocautery (burning with an electrode)  There is recent research suggesting that this is most effective, with fewer recurrences than other treatments.  If it's available, laser surgery is also very effective, and has less scarring and a faster healing time.  

If you have condyloma & HIV, you are at very high risk of anal cancer.  If your provider is unable to perform an anal PAP smear, I would suggest finding a colorectal dr who could do an anoscopy.  Basically he/she would use a colposcope (like gynecologists would use for a cervical exam) to examine the rectal mucosa after first applying acetic acid (vinegar)  The vinegar makes any areas with dysplasia (abnormal tissues) appear white, so the dr can then take biopsies to see if they are precancerous or cancerous.  Any high grade lesions (AIN 2 or 3) should be aggressively treated using nitrogen, podophyllin, TCA (trichloroacetic acid), laser, infrared coagulation--anything to kill & remove the dysplastic cells so they can't turn into cancer.  Here's a good website with more information:  http://id.medicine.ucsf.edu/analcancerinfo/

If none of this is available where you are (it's only very recently that HIV doctors started doing this in the US--it's still not standard of care) I would try to find a good gynecologist who's willing to do this for HIV patients.  HIV+ women are at high risk of HPV cervical cancer AND anal cancer, so a doctor who treats many HIV+ women may be a good ally.  In the meantime, if you aren't able to do any of the above, I'd suggest having your doctor (or you) apply a weak podophyllin solution to the entire perianal area periodically to gently burn off the top layer of the rectal mucosa that may have dysplastic cells.  You brush or swab it on, leave for 3-4 hrs, and then wash off completely.  A weak solution should cause only minor irritation.  I had anal cancer and recurrent condyloma, but when my colorectal doc used podophyllin this way (after two major surgeries with electrocautery & laser) I had no more recurrences, and 15 yrs later am cancer- and condyloma-free.

Feel free to contact me offline if you have more questions or need more info.  I know how frustrating (and potentially life-threatening) this can be, so  happy to help any way I can.

Jeff in Palm SpringsVPH treatment

Posted by: " Virgo Arcangel "  virgoarcangel@...   virgoarcangel

Thu Jan 5, 2012 8:12 am (PST)

Dear Friends;I have a small question for you. I have VPH and presence of condiloms at my anus. I went to the doctor several times and he gave me some medicines in order to reduce/eliminate this condilomas.

But the problem still persists and I really need your help. I have tried with podofiline, imiquimod and nitrogen but the problemn still persists. That men I should fight this disease (VPH) for ever. I'm HIV+ too and I now that is a problem cause my inmune system is weak.

Regards from Peru (32 years old).