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May 22-23, 2019 | Rome, Italy
OF EXCELLENCE
IN INTERNATIONAL
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IMMUNOLOGY
AND CANCER THERAPY
2
nd
Global Summit on
Immunotherapy 2019
Immunology Case Reports | Volume 3
Accepted Abstract
EFFICACY AND SAFETY OF TOPICAL IMIQUIMOD USE IN HPV-INDUCED VULVAR LE-
SIONS IN TRANSPLANT RECIPIENTS: A CASE SERIES
Caroline Oliveira, Isabel do Val, Luis Guillermo Velarde
and
Susana Aidé
Universidade Federal Fluminense, Brazil
Background:
Chronic immunosuppression is recognized as one of the main risk factors for human papilloma-
virus (HPV) infection, persistence and consequently, development of HPV-induced genital lesions. The treat-
ment of some vulvar lesions is challenging because they are extensive, multifocal and recurrent. Topical im-
munomodulators as imiquimod have shown efficacy in the management of multiple malignant, precancerous
and viral conditions. The ability to locally induce an immune response, presumably against tumor and viral
antigens, makes topical immunomodulators a promising therapeutic option in organ transplant recipients.
There is limited information on safety of use in these patients. Also, most studies are on skin diseases not in
HPV-induced vulvar lesions. Complete response rates in high grade vulvar intraepithelial lesions ranged from
5% to 88% in immunocompetents. There is no data among immunosuppressed patients. This is a descriptive
study of the efficacy and safety of imiquimod in renal transplant patients with HPV-induced vulvar lesions in a
tertiary Hospital in Rio de Janeiro, Brazil.
Method:
Patients with HPV-induced vulvar lesions were retrospectively enrolled. A total of three patients ap-
plied one sachet of topical imiquimod 5% cream three times per week. Dosing continued for an average period
of 56 weeks regardless of lesion clearance. Patients were assessed for safety variables that included adverse
events, local skin reactions, laboratory results and indication of graft rejection.
Results:
No graft rejections or trends for a deterioration of graft function were detected. No complete response
was observed. Also, no progression of any lesion was observed.
Conclusion:
Imiquimod appears to be a safe additional option for the treatment of HPV-induced vulvar lesions
in patients with solid organ transplants. Other alternative treatments may be necessary for complete resolution
of the lesions. No similar response rates were observed for use in skin diseases in immunosuppressed patients.
Larger studies are required to confirm these results.
Immunol Case Rep 2019, Volume 3 | DOI: 10.4066/2591-7366-C2-006