Genital Warts caused by HPV – treatment, recurrence, research 2018

What should you know about genital warts caused by HPV?

Anogenital warts typically develop approximately 2–3 months after HPV infection (almost all caused by types 6 or 11); however, not all persons infected with HPV types 6 and 11 develop genital warts. Anogenital warts should be assessed by a clinician and can be treated, although many warts (20–30%) regress spontaneously. Recurrence of anogenital warts within 3 months is common (approximately 30%), whether clearance occurs spontaneously or following treatment.

Read the whole manual about HPV and genital warts:

What is the most effective treatment against genital warts?

The most effective treatment (with the lowest recurrences) is called Photodynamic Therapy. Unfortunately this treatment is not available in the Western world. I mean: it is possible to get Photodynamic Therapy against i.e. ACNE on face, but it’s not possible to get it against genital warts. Why? I have no idea. Maybe it is a some kind of conspiracy? Anyway the fact is one: HPV virus hides in the skin, and it is possible to eradicate it during a few ALA-PDT treatments.

There were many clinical trials about Photodynamic therapy, but usually in China. You can check this PDF file:

What is the biggest problem with genital warts?

The biggest problem with genital warts is that they can come back, especially in the first months after their show up. All available methods (Cryotherapy, Podophyllotoxin, Aldara, Veregen…) have high recurrence rates.

What can you do to lower genital warts recurrence rate?

You can take medicinal mushrooms to boost your immune system (for example:  Coriolus versicolor and Reishi had 88% clearance rate after 2 months, during one clinical trial).

You can try food supplements like Ellagic Acid and Annona Muricata extract.  In one clinical trial EA+AM gave 74% HPV clearance rate after 6 months.

You can try use Panavir gel topically. Panavir is an antiviral medicine created in Russia. It works antiviral and immunostimulating. There are many russian clinical trials about its effectiveness.

You can try hypethermia (44-45 celsius degree) on your genitals, but it might be hard to get this treatment in any clinic.

You can combine removing warts with taking Inosine Pranobex (3g daily for 4 weeks).

If you have strong recurrences – you should check your glucose level in blood. If you have diabetes, then you should know that there is correlation between the strength of HPV/number of recurrences and diabetes.

So what can you do?

Option A:

You can go to China and try to get Photodynamic Therapy (ALA-PDT) against genital warts. That’s the most expensive option.

Option B:

You can try Cryotherapy or Podophyllotoxin, and be mentally prepared for recurrences.

Option C:

You can try Cryotherapy or Podophyllotoxin, and 1 immune-booster (i.e. medicinal mushrooms, Ellagic acid + Annona Muricata extract)

Option D:

You can try Cryotherapy or Podophyllotoxin, 1 immune-booster and – topically – Panavir gel. Panavir gel should be applied 2 times daily (5 days before the treatment, 10 days after the treatment).


Option E:

Combine Cryotherapy or Podophyllotoxin with Inosine Pranobex: 3g daily (1g in the morning/afternoon/evening) for 4 weeks. If you do this, then the chances for recurences are as low as 6-7%.

What about ALDARA?

If you are a man, then it’s a total waste of time.
If you are a woman, then you can try it (it has 60% effectiveness in females).

What about ACV, Thuja, homeopathic medicines?

Forget about it. It’s your health. Don’t waste your time on methods without any clinical trials. You can check Google Scholar and search for clinical trials.

Alternative HPV treatments / cure research / clinical trials 2018

Photodynamic Therapy

Photodynamic therapy (PDT), sometimes called photochemotherapy, is a form of phototherapy involving light and a photosensitizing chemical substance, used in conjunction with molecular oxygen to elicit cell death (phototoxicity). PDT has proven ability to kill microbial cells, including bacteria, fungi and viruses. PDT is popularly used in treating acne. It is used clinically to treat a wide range of medical conditions, including wet age-related macular degeneration, psoriasis, atherosclerosis and has shown some efficacy in anti-viral treatments, including herpes. It also treats malignant cancers including head and neck, lung, bladder and particular skin. The technology has also been tested for treatment of prostate cancer, both in a dog model and in prostate cancer patients. It is recognised as a treatment strategy that is both minimally invasive and minimally toxic. (Wikipedia)

In case of genital warts / cancer caused by HPV it is possible to use Photodynamic Therapy (PDT) with 5-aminolevulinic acid (ALA). It’s called ALA-PDT.

For more informations check this PDF file, page no. 14 and following pages:

Immunotherapy with Virus Like Particles (VLPs)

Genital warts are caused by infection with human papillomavirus type 6 (HPV6) or less commonly the closely related HPV 11.1,2 While benign, these lesions commonly persist, with less than half of immunocompetent patients resolving infection within six months.3 Despite use of destructive therapies including electrocautery, cryotherapy, or application of podophyllotoxin or trichloroacetic acid, disease recurrence is common.4 However, generation of specific immunity to papillomavirus proteins appears important for clearance, as immunosuppressed individuals with impaired cell mediated immunity clear genital warts more slowly, and more commonly have recurrence after treatment.5

The major papillomavirus protein L1 self assembles into virus like particles, which, together with alum based adjuvants, are the basis of vaccines licensed for use for prevention of HPV infection. L1 virus like particles, in animal models, can induce strong cell mediated immune responses including cytotoxic T-cell responses if delivered without adjuvant. A phase 1 open label safety trial of unadjuvanted HPV6 VLPs (VLP immunotherapy) in patients with treatment refractory genital warts had observed regression of disease that would not have been expected from previous studies of therapy in similar patients.9 Therefore a randomized placebo controlled trial was undertaken to establish whether VLP immunotherapy could reduce the recurrence of genital warts following locally destructive therapy.

Read the whole article:

Lopimune (Lopinavir/Ritonavir) as a Treatment for HPV-Related Pre-Invasive Cervical Disease

A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6–73.2%). Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6–82.8%) had no dysplasia and 4/22 (18.2%, 95%CI: 9.9–65.1%) were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions.

Read the whole article:

Panavir – antiviral medicine from Russia

Panavir – biologically active substance of Panavir is ”GG17” – plant polysaccharide, relating tohexose glycoside class. It main dosage form – intravenous solution 0,004% in 5 ml ampoules (single therapeutic dose). Additional dosage form: rectal suppositories, vaginal suppositories, gel for outward application. Preparation has original pharmacologic property, non-toxic in therapeutic dose (LD50 ~ 3000 therapeutic dose). It is successfully used where ordinary antiviral preparations are not effective or contraindicative or have unsatisfactorily effect: chronic tick-borne encephalitis, ophthalmoherpes, herpes zoster (shingles), cytomegalovirus, Epstein-Barr virus, Human papilloma virus. Now Panavir tests for treatment chronic hepatitis B and C.

Read the whole article:

Combined therapy: remove genital warts + use Inosine Pranobex

This study evaluates the effectiveness of immunomodulating drug isoprinosine in a comprehensive treatment of genital warts in men. Most of the patients were aged 20-30 years. The combination therapy was found to have long term effectiveness. In the group of patients undergoing only destructive methods of treatment relapse after 8 month follow-up was diagnosed in 32% and in patients of the combination therapy group (destruction plus isoprinosine) – in 7% of patients. The pharmacological action of the drug (immunostimulating, antiviral) and the effectiveness of its combination with destructive therapies justify the use of inosine pranobex (isoprinosine) both in the complex therapy of genital warts and for the prevention of the disease recurrence.


How to cure HPV genital warts with Photodynamic therapy

Photodynamic therapy (ALA-PDT) is usually used against ACNE, but it’s off label usage (against genital warts) is very effective and has very low reccurence rate.

Study 1:

The patient, a 30-year-old man with numerous genital condylomata acuminata (CA), has had unsuccessful treatment with liquid nitrogen, 20% podophyllin, and repeated 0.5% podophyllotoxin solution with 5% imiquimod (Figure 1). Before the appearance of CA, he experienced acute orchiepididimitis and a Candida infection. The patient was immunologically examined, and the lower level of lymphocytes, slightly reduced level of IgM, and C4 complement were revealed. Results from a human immunodeficiency virus examination were negative. After the therapeutic failure mentioned above, photodynamic therapy (PDT) was initiated using 20% aminolevulinic acid (5-ALA) in a gel. The photosensitizer was applied to lesions and 10 mm of surrounding skin in a 1-mm-thick layer under occlusive dressing for 3 hours and then removed with saline and nonwoven gauze. The site was immediately irradiated with noncoherent red light with an emission spectrum of 580 to 680 nm wavelength (Medeikonos PDT-Model 200, Medeikonos AB, Sweden). The total light dose was 50 J/cm(2); light intensity ranged from 70 to 90 mW/cm(2). Because of persistent fluorescence during photodynamic therapy, the treatment was repeated 10 times in 2-week intervals with a follow-up of 1, 3, and 6 months after its completion. After the last PDT treatment, the persistent fluorescence disappeared completely. The absence of fluorescence corresponded with a healed clinical finding without scarring and pigmentation (Figure 2). The period from the initiation of PDT to the consolidation of CA was 22 weeks. During PDT treatment, the patient felt only mild burning, which disappeared after the illumination stopped. Six months after the therapy, there were no signs of recurrent disease.

Source: Genital warts treated by photodynamic therapy.

Study 2:

Our trial provided a complete cure rate of nine of 15 subjects after five PDT sessions. Perianal lesions showed a particularly rapid remission. While progressing towards total lesion clearance, the immunohistochemical pattern was dominated by dense CD4+ T lymphocytes infiltrating the superficial dermis, accompanied by an accumulation of Langerhans cells. Simultaneously, CD8 began to increase in the lesions of responding patients, and Langerhans cells seemed to migrate towards the dermis. CD68+ macrophages apparently did not participate in the immune inflammatory response.

Source: Immunological activity of photodynamic therapy for genital warts.

Study 3:

Genital warts were relieved in 107 out of the 110 cases (cure rate: 97.3%). Male patients had significantly better treatment outcomes at the urethral orifice than those in other affected parts. In the 107 patients, the cure rate of male patients was 98.8%, and they were cured after being treated four times. In contrast, female patients, who were cured after 5 times of treatment, had the cure rate of 91.7%. Their cure rates were similar (χ(2)=0, P>0.05), but the males were cured after significantly fewer times of treatment than the females (t=-7.432, P<0.05). Five patients suffered from mild tingling or burning sensation upon dressing at the urethral orifice, and the others were all free from systemic adverse reactions. After illumination, a small portion of the patients had mildly red, swelling, painful affected parts, with mild edema that almost disappeared within three days. Three patients relapsed at the urethral orifice and were then cured after further treatment.

Source: Therapeutic effects of topical 5-aminolevulinic acid photodynamic therapy.

European Dermatology Forum about Photodynamic therapy:

Download PDF file and look at point 6.6

Check other clinical studies about Photodynamic therapy vs. genital warts:

Download PDF file