Introduction.

Anogenital warts have become one of the most common sexually transmitted diseases reported in the Western World. The frustration of treatment for both patient and carer is well recognised. Current available methods rely principally on ablation of visible lesions, with hospital-based treatments often requiring multiple attendance by out-patients. Overall, the current failure rate, recurrence rate, and side-effects of these treatments are highly unsatisfactory. Imiquimod, recently launched in the US under the brand name Aldaratrade mark cream, represents the most interesting and innovative approach to therapy to become available in many years. Imiquimod is an immune response modifier, therefore this symposium report addresses the vital issues of the immune based response to human papilloma virus (HPV) infection, as well as the problems of persistence caused by HPV disease. The mechanisms by which imiquimod can induce an inflammatory and cell-mediated response are discussed. Also reviewed are the consequent imiquimod clinical results and the reasons why they show great cause for optimism in HPV treatment. As a home-based effective treatment with a low recurrence rate, imiquimod has already generated enthusiasm on an international scale. This symposium report presents the thoughts and experiences of medical specialists from various countries regarding the treatment of genital HPV infections and the place for imiquimod in clinical practice.