(57) Intralesional Cidofovir: A Promising Treatment for Refractory Genital Warts in Pediatric Patients

Background: Human Papillomavirus (HPV) infections can lead to genital warts (GW) in pediatric patients, posing significant treatment challenges. Currently, no FDA-approved therapies for GW exist for children under 12, and conventional treatments often result in high recurrence rates. Emerging evidence suggests that intralesional Cidofovir, a broad-spectrum antiviral, may be effective for refractory GW, as demonstrated in related conditions like recurrent laryngeal papillomatosis.

Case: We present a case of a 2-year-and-8-month-old girl with persistent GW, unresponsive to multiple treatment regimens, including podophyllotoxin, liquid nitrogen, imiquimod, and trichloroacetic acid. After 2 years of failed therapies and a persistent HPV genotype 11 infection, she underwent surgical excision with intralesional Cidofovir instillation. Two years post-treatment, the patient remained asymptomatic, with no recurrence of vulvar lesions, and a negative HPV PCR molecular test.
Ethics Approval:
This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna, in accordance with institutional guidelines.

Comments: This case underscores the potential of intralesional Cidofovir as a promising treatment for refractory GW in pediatric patients. Given the lack of approved therapies for children and the high recurrence rates associated with conventional treatments, Cidofovir may offer a new therapeutic option. Further studies are necessary to explore its efficacy as a first-line treatment for this vulnerable population.
Financial Disclosure:
The authors have no financial relationships relevant to this case to disclose.