Journal of Antivirals & Antiretrovirals
Open Access
ISSN: 1948-5964
ISSN: 1948-5964
Sadie Jones
Cardiff University, UK
Posters & Accepted Abstracts: J Antivir Antiretrovir
Introduction: Results of a randomized controlled trial of treatment of VIN3 with cidofovir and imiquimod are reported (RT3 VIN). Complete response occurred in 61% and 57% of patients treated with imiquimod and cidofovir respectively. Treatment is associated with significant side effects and if ineffective, on-going symptomatology and risk of malignant progression. A predictive biomarker of treatment response is an attractive prospect and the potential of HPV characteristics as such biomarkers were investigated. HPV E2 DNA methylation significantly correlated with clinical outcome in both treatments arms and has good potential as a biomarker. Methods: DNA from 167 cases of histologically confirmed VIN3 from the RT3 VIN clinical trial was studied. HPV positive cases were identified using Greiner PapilloCheck�?® and HPV 16 type-specific PCR. The HPV characteristics tested included: Integration status, DNA methylation status and gene expression levels. Data were correlated with clinical outcome using SPSS. Results: HPV E2 DNA methylation >4% predicted response to treatment with cidofovir with a sensitivity of 88.2% and a specificity of 84.6%. Conversely, for treatment with imiquimod E2 DNA methylation <4% was found to predict response with a sensitivity of 70.6% and specificity of 62.5%. Conclusion: Opposing levels of HPV E2 DNA methylation demonstrate potential as a predictive biomarker for the treatment of VIN with cidofovir and imiquimod and warrants further investigation. These drugs appear to work best in two different sub-groups of the disease; their targeted use could significantly reduce the dependency on surgery in management of this disease.
Emal: jenbuechel@yahoo.com