Comparison Effect between Imiquimod Cream 5% and Zinc Sulphate Solution 20% in Treatment and Prevention of Recurrence of External Genital Warts

Abstract

ABSTRACT
Background: Condylomata acuminate is a highly prevalent sexually transmitted infection,
seen predominantly in young adults caused by low-risk types of HPV (type 6 or 11).
Genital warts are associated with adverse psychological effects resulting in decreased
quality of life and increasing medical care costs.
Objective: At present there is no specific treatment available to cure HPV infection. We
compared the two methods of treatment, imiquimod cream 5% and with zinc sulphate
solution 20% in regard to efficacy of treatment, prevention of recurrence and side effects.
Methods: This clinical trial performed in private clinics in Baghdad and Al-Ramadi, Iraq for
the period from the 1st of January 2013 to 1st of April 2015, included 70 patients with
external genital warts. They were divided into 2 groups, group A: 35 patients applied
imiquimod cream 5% locally on warts once daily, three times a week for 12 weeks. Group
B: 35 patients applied zinc sulphate solution 20% locally two times daily for 12 weeks.
Patients in both groups evaluated for efficacy and side effects of each treatment at the
end of the study. Those patients who are cured completely are followed for a further
period of 12 weeks for recurrence of warts.
Results: In this study we found that zinc sulphate solution 20% was more effective than
imiquimod cream 5% in the primary treatment of external genital warts. Also, it was
associated with less recurrence rate compared with imiqumod cream 5%.The side effects
were more with zinc sulphate solution 20% but all were mild and well tolerated in both
groups.
Conclusion: The efficacy of zinc sulphate solution 20%in treatment of external genital
warts was greater than imiquimod cream 5% and it was associated with lower recurrence
rate but more side effects, all were mild and tolerable.
Keywords: Imiquimod, Zinc sulphate solution, Genital wart.