Zusammenfassung
Condylomata acuminata sind die häufigste Ausdrucksform genitoanaler Infektionen mit humanen Papillomaviren (HPV). Zugleich stellt diese Infektion die häufigste sexuell übertragbare Erkrankung dar. Unter den derzeit mehr als 100 bekannten Subtypen finden sich so genannte Low-risk-Typen (vornehmlich HPV 6 und 11), die externe genitoanale Warzen hervorrufen und onkogene High-risk-Typen (insbesondere HPV 13, 16, 18, 31, 33 und 35), die in bis zu 100 % aller Fälle mit prämalignen und invasiven Läsionen des Genitoanalbereiches assoziiert sind. Die aktuellen diagnostischen Verfahren wie auch die derzeitig verfügbaren Therapiemodalitäten werden dargestellt. Die meisten Verfahren führen zu einer lokalen Gewebezerstörung, entweder durch zytotoxische Wirkung oder physikalisch-ablativ. Interferone besitzen antivirale, antiproliferative und immunmodulatorische Eigenschaften, doch führen diese bisher nicht zu effektiven Heilungsraten. Allen gängigen Therapieverfahren eigen sind zudem hohe Rezidivraten gemeinsam. Einen Ausblick stellen innovative immuntherapeutische Ansätze sowie die Darstellung der Vakzinierungsstrategien dieser weltweit an Bedeutung zunehmenden Infektionen dar.
Abstract
Condylomata acuminata are the most prevalent expression of genito-anal infections caused by human papillomavirus (HPV), the most common sexually transmitted disease. To date more than 100 subtypes are classified among which the high-risk-types (HPV 6 and 11) are mostly associated with genital warts. Oncogenic high-risk HPV (13, 16, 18, 31, 33 and 35) are found in premalign and malign genito-anal lesions. Although many treatments are available for genital warts, none are uniformly successful in the treatment of this disease. Most current treatment options work by destroying affected tissue, either by a cytotoxic or a physically ablative mode of action. Interferons have antiviral, antiproliferative, and immunomodulatory activities, but these have not translated into a high level of cure rates against warts. With all current treatments, recurrent warts are common. New treatment modalities focus on activating the host's immune system and perhaps the most effective means for managing HPV disease would be a vaccine that prevents the occurrence of genital warts.
Schlüsselwörter
Genitalwarzen - Condylomata acuminata - Diagnose - Therapie - humane Papillomaviren
Key words
Genital warts - condylomata acuminata - diagnosis - therapy - human papillomavirus
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