Evaluation of soluble CD4 serum levels in patients with anogenital warts treated with intralesional tuberculin injection

Document Type : Original Article

Authors

1 Assistant Professor of Dermatology, Venereology and Andrology Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

2 Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

3 Department of Dermatology, Ismailia General Hospital, Egypt

4 Lecturer of Andrology, Infertility and Sexually Transmitted diseases Department of Andrology, Infertility and Sexually Transmitted diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Abstract

Introduction:
Anogenital warts are growths caused by human papilloma virus infection which causes significant psychosocial morbidity. Intralesional immunotherapy is a promising treatment that is able to stimulate a delayed-type hypersensitivity reaction to different antigens as well as wart tissue. This treatment is suggested to increase CD4 T helper 1 lymphocytes activity to destroy HPV.
Aim of the work:
Measurement of the level of serum sCD4 in patients with anogenital after intralesional tuberculin purified protein derivative injection.
Methods:
This study was carried out as pre-post interventional study on 49 patients with anogenital warts presented to Dermatology clinic and the Andrology Clinic, Suez Canal University hospital. Each patient was injected 10 units (0.2 ml) of PPD intralesionally in the largest or mother wart with two weeks interval till complete cure or six injections which was closer. Serum soluble CD4 was measured before and after injection using Sandwich ELISA technique.
Results:
Complete clinical wart recovery was obtained in 26 patients (53%) and mostly was after the sixth session (60.4%) of injection. Mean level of serum soluble CD4 was significantly higher after than before PPD injection 18.47 ±10.4 versus 44.48 ± 20.67 ng/ml respectively. Serum sCD4 levels were significantly correlated to clinical response rates as the higher the level of serum sCD4 the more wart recovery.
Conclusion:
Intralesional PPD injection is a promising effective modality in the treatment of anogenital warts. CD4 cells may have a role in anogenital wart eradication by PPD injection and significantly related to clinical response rates.

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