57. Intralesional Cidofovir: A Promising Treatment for Refractory Genital Warts in Pediatric Patients

Abstract

Background

Human Papillomavirus (HPV) infections can lead to genital warts (GW) in pediatric patients, posing significant treatment challenges. Currently, no FDA-approved therapies for GW exist for children under 12, and conventional treatments often result in high recurrence rates. Emerging evidence suggests that intralesional Cidofovir, a broad-spectrum antiviral, may be effective for refractory GW, as demonstrated in related conditions like recurrent laryngeal papillomatosis.

Case

We present a case of a 2-year-and-8-month-old girl with persistent GW, unresponsive to multiple treatment regimens, including podophyllotoxin, liquid nitrogen, imiquimod, and trichloroacetic acid. After 2 years of failed therapies and a persistent HPV genotype 11 infection, she underwent surgical excision with intralesional Cidofovir instillation. Two years post-treatment, the patient remained asymptomatic, with no recurrence of vulvar lesions, and a negative HPV PCR molecular test. Ethics Approval: This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna, in accordance with institutional guidelines.

Comments

This case underscores the potential of intralesional Cidofovir as a promising treatment for refractory GW in pediatric patients. Given the lack of approved therapies for children and the high recurrence rates associated with conventional treatments, Cidofovir may offer a new therapeutic option. Further studies are necessary to explore its efficacy as a first-line treatment for this vulnerable population. Financial Disclosure: The authors have no financial relationships relevant to this case to disclose.