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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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Flat warts
Feb 24, 2004

Hi, I've been positive for 21 years. I have unsightly flat warts all over my arms and legs. I've tried over and over to have them burned off with liquid nitrogen and have even had lazer treatment on them. Of course, I'm scarring my skin at the same time. No matter what, they just keep comming back bigger and worse than before. Is there anything else at all that I can do about this or am I doomed to let them continue spreading adding to my already freakish appearance due to my severe lipodystrophy and to my growing depression?

M

Response from Dr. Conway

I'm sorry to hear about your persistent problem.

The key to the treatment of warts in HIV-infected people is to control the HIV. Recurrent warts may be an indication to start HAART if you are not already on it. This may solve the problem, or at least help it.

Beyond this, there are many other treatment options, such as local podophyllin or bleomycin (rather than liquid nitrogen). Systemic immunostimulants (such as Imiquimod) can be helpful, but only along with effective HAART. Some antivirals (such as Cidofovir) have been used in some cases, but their efficacy is unclear. Surgery is only useful if there are a few (very few) resistant lesions.



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