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safety and efficacy of topical cidofovir to treat high-grade perianal and vulvar intraepithelial neoplasia in hiv-positive men and women elizabeth a stier , 1 stephen e. Darragh , 7 maria da costa , 4 lori panther , 8 david aboulafia , 9 and joel m. an application to approve the use of topical cidofovir for acyclovir- resistant herpes virus infection was denied by the fda owing to the lack of phase iii data. Original article local administration of cidofovir for human papilloma virus associated skin lesions in transplant recipients hugo bonatti,1, felix aigner,1 eric de clercq,2 claudia boesmueller,1 andreas widschwendner,3 clara larcher,4 raimund margreiter1 and stefan schneeberger1 1 department of general and transplant surgery, innsbruck, austria. Cidofovir anhydrous is an anhydrous form of cidofovir, a synthetic, acyclic monophosphate nucleotide analog of deoxycytidine with antiviral activity, mostly used against cytomegalovirus (cmv). After incorporation into the host cell, cidofovir is phosphorylated by pyruvate kinases to its active metabolite cidofovir diphosphate. Cidofovir diphosphate, bearing structural similarity to nucleotides. For localized lesions such as anal or penile condylomata injection was used, whereas for widespread hpvassociated warts and for the hand recipient it seemed reasonable to use cdv gel. In terms of intervals of application and cdv concentration of the gel, for the two patients with widespread verrucae vulgares we initially used the 5 gel. Clinical responses to cidofovir applied topically to women with high grade vulval. High-grade vulval intraepithelial neoplasia (vin 3) a retrospective analysis of patient characteristics, management, outcome and relationship to squamous cell. Lesions were assessed with high-resolution anoscopy and biopsy at weeks 12 and 24. The primary endpoint was complete remission (cr) at week 12, defined as clinical and histological remission. We also evaluated partial remission defined as regression to low-grade squamous intraepithelial lesion. Results we included 17 hiv-infected patients with intraanal hsil. Cidofovir and imiquimod were active, safe, and feasible for treatment of vulval intraepithelial neoplasia and warrant further investigation in a phase 3 setting. Both drugs are effective alternatives to surgery for female patients with vulval intraepithelial neoplasia after exclusion of occult invasive disease. Determination of cidofovir in human plasma after low dose drug administration using high-performance liquid chromatography-tandem mass spectrometry. Clinical responses to cidofovir applied topically to women with high grade vulval intraepithelial neoplasia amanda tristram, alison fiander department of obstetrics and gynaecology, wales college of medicine, cardiff university, heath park, cardiff, cf14 4xn, uk received vailable online 16 september 2005 abstract objectives.