Comparing the efficacy of chemical cautery to cryosurgery on CD4+ status of HIV patients with condyloma acuminata

Abstract

Introduction: Condyloma acuminata (CA) is one of the sexually transmitted infections caused by human papillomavirus (HPV). Condyloma acuminata patients are usually coin-fected with human immunodeficiency virus (HIV), particularly those with low CD4+ levels. Chemical cautery and cryosurgery are therapeutic modalities for CA, aiming to remove lesions and prevent recurrence, especially in patients with HIV. Objective: To compare the efficacy of chemical cautery to cryosurgery on CD4+ status of HIV patients with CA. Methods: A cross-sectional retrospective study was conducted in patients with CA visiting the Dermatology and Venereology outpatient clinic and the voluntary counseling and testing (VCT) clinic of Dr. Moewardi Hospital Surakarta, Indonesia from January 2018 to December 2020. The data were taken from the medical records of patients. These subjects were grouped into CA with HIV and without HIV. The data were statistically analyzed with t-tests followed by multivariate regression tests, and a p-value of <0.05 was considered significant. Results: Seventy-eight patients with CA were included in the study, comprising 41 subjects with HIV infection and 37 subjects without HIV infection. The subjects were predominantly male (68%). Of all the subjects, 70.5% received chemical cautery, and the remaining had cryosurgery. Multivariate regression tests obtained no significant differences in CD4+ levels between chemical cautery and cryosurgery (p=0.138 vs p=0.907). Conclusion: Either chemical cautery or cryosurgery is effective in improving the clinical condition of patients with CA. Although chemical cautery results in a higher level of CD4+ than cryosurgery, statistically both therapies have no significant difference regarding CD4+ status.