Efficacy of topical imiquimod in HIV-positive patients with recurrent anal condylomata acuminata

introduction: imiquimod is a topical chemotherapic and immunostimulant agent with antitumoral and antiviral activities, used for anal condylomata acuminata treatment, mainly in recurrences. objective: evaluate the imiquimod efficiency in chronic and recurrent anal condylomata acuminata in hiv-infected persons. method: a prospective study that analyzed 61 patients with recurrent anal condylomata treated with topic 5% imiquimod, for at least 8 weeks. these patients had already been submitted to other topical and surgical treatments for anal warts. we evaluated the efficiency of this agent, through wart remission, with clinical examination and high-resolution anoscopy, cd4+ t lymphocyte count and side effects. the patients were 55 males and 6 females, from 22 to 63 years old. results: remission was seen in 90%, being 46% complete remission and 44% partial remission. other 10% did not respond to the treatment with imiquimod within the 16th week. recurrences were observed in 11% of patients in 24-week follow-up. statistics showed no differences in cd4+ t cell scores when groups with and without complete remission were compared. adverse effects were reported by 45% of patients. they were mild to moderate burning (25%), intense burning (7%), ulcerative dermatitis (8%) and systemic symptoms (5%). conclusion: imiquimod was effective in controlling recurrent anal condylomata acuminata in hiv-positive patients, regardless of cd4+ t cell count.