Anogenital Warts (AGWs) are benign proliferations caused by Human Papillomavirus (HPV) infection on the genital or anal areas. Various therapeutic options are available for the treatment of AGWs but there is no best or ideal therapy, and the recurrence of AGWs is significantly high. A promising new therapy that is currently being evaluated is immunotherapy with the intralesional Bacillus Calmette-Guérin (BCG) vaccine. Two cases of a 23-year-old woman and a 41-year-old man were presented with manifestations of condyloma acuminata type AGWs. The patients were immunocompetent and received single dose intralesional BCG vaccine on the largest lesion. Clinical improvements of AGWs lesions were noted starting on the 14th day after receiving therapy by the disappearance of some lesions with no recurrence and side effects. Intralesional BCG vaccine activates the immune system, treats other AGWs lesions that do not receive an intralesional injection, and also prevents recurrence. Although the intralesional BCG vaccine is effective for treating AGWs, further evaluation is still needed for its recurrence.
The clinical manifestation of anogenital warts (AGW) resulting from Human Papillomavirus (HPV) infection is influenced by host immune responses. Interferon (IFN)-α contributes to antiviral activity, while Interleukin (IL)-2 plays an important role in cellular immunity. Tuberculin purified protein derivative (TPPD) has been investigated as an immunotherapeutic agent. This exploratory quasi-experimental study analyzed 12 AGW patients treated with intralesional TPPD (5 tuberculin units weekly for six injections). Tissue samples were collected at baseline and week 2, and serum samples at baseline and week 6. IFN-α and IL-2 expression in tissue was assessed using immunohistochemistry (IHC), and serum levels were measured using ELISA. TPPD therapy was associated with increased IFN-α and IL-2 expression in tissue (p = .047 and p = .019) and higher serum IL-2 levels (p = .030), while serum IFN-α did not change significantly. Clinically, 4 of 12 patients achieved complete response, whereas others showed partial, minimal, or no improvement, and 6 patients required subsequent destructive treatment. Local and systemic cytokine changes did not correlate with lesion regression. These findings suggest that cytokine upregulation reflects immune activation rather than determining lesion clearance, and between-group comparisons should be interpreted cautiously due to baseline.