Condition

HPV Infection

Human papillomavirus - Most common STI

1.3B
People Affected
150
Active Trials
104M
New Cases/Year
423K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Surgical Excision / Electrocautery / Laser Ablation
95% Effectiveness• 92% Confidence• 78% Safety• 2 trials• 7.5K participants
HIGH EvidenceGood ValueDose: Surgical removal of lesions
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
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78
DangerousModerateSafe

Time to Effect

Immediate clearance, 1-4 weeks healing

Duration

Single procedure, 1-4 weeks healing

Response Rate

95%

Remission Rate

95%

Number Needed to Treat (NNT)

1

Common Side Effects:

Pain: 70%
Scarring: 40%
Infection: 10%
Bleeding: 7%
Dyspigmentation: 15%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,700

Side Effects

$150

Total Annual

$1,850

Cost-Effectiveness

GOOD

Cost per Remission

$1,947

Cost per Responder

$1,947

Treatment Outcomes
Primary Outcomes
Complete Resolution of Visible Anogenital WartsMedian number of lesions: 5
-100% (Reduction to 0 lesions)
Histological Resolution of Cervical Intraepithelial Neoplasia (CIN2/3)Presence of CIN2/3 on biopsy at treatment site
-100% (Complete resolution of CIN2/3 on follow-up biopsy)
Reduction in 6-Month Recurrence Rate of Anogenital Warts Post-ClearanceExpected 6-month recurrence rate (untreated/conservative management): 45%
-44.4% (Reduced recurrence rate by 20 percentage points (e.g., from 45% to 25%))
Secondary Benefits
Improvement in Patient-Reported Quality of Life (HPV-Impact Profile score)HPV-Impact Profile (HIP) score: 60/100 (higher score indicates greater negative impact)
-30% (-18 points on HIP score)
Reduction in HPV-related Psychological Distress (GAD-7 score)Generalized Anxiety Disorder-7 (GAD-7) score: 12/21 (moderate anxiety)
-40% (-4.8 points on GAD-7 score)
Reduction in HPV Viral Load at Treated SiteHigh HPV viral load: 1.0 x 10^7 copies/cell
-99.99% (Reduction to <1.0 x 10^3 copies/cell (often undetectable))
Common Side Effects
Pain
+70%
Scarring
+40%
Infection
+10%

Clinical Trial Phases:

Phase 4
2
Trichloroacetic Acid (TCA)
80% Effectiveness• 88% Confidence• 80% Safety• 4 trials• 6K participants
HIGH EvidenceGood ValueDose: 80-90% solution, applied weekly
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

1-4 weeks per session

Duration

Multiple sessions over 4-12 weeks

Response Rate

80%

Remission Rate

80%

Number Needed to Treat (NNT)

2

Common Side Effects:

Local pain: 80%
Burning sensation: 60%
Ulceration: 40%
Scarring: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,000

Side Effects

$50

Total Annual

$1,050

Cost-Effectiveness

GOOD

Cost per Remission

$1,312.5

Cost per Responder

$1,312.5

Treatment Outcomes
Primary Outcomes
Number of Anogenital Warts7 warts
-80% (-5.6 warts)
Total Anogenital Wart Area2.5 cm²
-85% (-2.125 cm²)
Patient-Reported Anogenital Wart Symptom Score7/10 (0-10 bother scale)
-70% (-4.9 points)
Secondary Benefits
Pain/Discomfort Score (VAS)4/10 (0-10 VAS)
-50% (-2 points)
Anogenital Wart-Related Quality of Life (QoL) Score50/100 (lower is worse QoL)
+20% (+10 points)
Self-Esteem Scale Score65/100 (lower is worse self-esteem)
+10% (+6.5 points)
Common Side Effects
Local pain
+80%
Burning sensation
+60%
Ulceration
+40%

Clinical Trial Phases:

Phase 4
3
Cryotherapy (Liquid Nitrogen)
70% Effectiveness• 90% Confidence• 80% Safety• 11 trials• 10K participants
HIGH EvidenceGood ValueDose: Applied for 5-30 seconds, repeated weekly/bi-weekly
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

1-4 weeks per session

Duration

Multiple sessions over 4-12 weeks

Response Rate

70%

Remission Rate

70%

Number Needed to Treat (NNT)

3

Common Side Effects:

Pain: 85%
Blistering: 60%
Ulceration: 30%
Hypopigmentation: 20%
Scarring: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,000

Side Effects

$50

Total Annual

$1,050

Cost-Effectiveness

GOOD

Cost per Remission

$1,500

Cost per Responder

$1,500

Treatment Outcomes
Primary Outcomes
Number of Genital Warts5 warts
-80% (-4 warts)
Total Wart Area15 mm²
-85% (-12.75 mm²)
Patient-Reported Lesion Burden Score (0-10 scale)6/10
-75% (-4.5 points)
HPV DNA Viral Load in Lesions1.0 x 10^7 copies/mg tissue
-90% (-9.0 x 10^6 copies/mg tissue)
Secondary Benefits
Genital Wart-Specific Quality of Life Score (0-100 scale, higher is better)40/100
+50% (+20 points)
Pain/Discomfort Score (VAS 0-10)4/10
-75% (-3 points)
Sexual Function Index Score (0-30, higher is better)15/30
+40% (+6 points)
Common Side Effects
Pain
+85%
Blistering
+60%
Ulceration
+30%

Clinical Trial Phases:

Phase 4
4
Imiquimod
60% Effectiveness• 85% Confidence• 72% Safety• 11 trials• 10K participants
HIGH EvidenceGood ValueDose: 3.75% or 5% cream, 3-5 times/week
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
72
DangerousModerateSafe

Time to Effect

4-16 weeks

Duration

Up to 16 weeks

Response Rate

60%

Remission Rate

60%

Number Needed to Treat (NNT)

4

Common Side Effects:

Local erythema: 70%
Erosion: 40%
Itching: 30%
Burning: 20%
Flu-like symptoms: 7%

Annual Cost of Care

Drug Cost

$1,200

Monitoring

$300

Side Effects

$100

Total Annual

$1,600

Cost-Effectiveness

GOOD

Cost per Remission

$2,667

Cost per Responder

$2,667

Treatment Outcomes
Primary Outcomes
Mean Number of External Anogenital Warts5 warts
-70% (-3.5 warts)
Mean Total Wart Area100 mm²
-80% (-80 mm²)
Patients with Incomplete Clearance of External Anogenital Warts100% of patients
-40% (-40 percentage points)
Secondary Benefits
HPV DNA Detection in External Anogenital Warts90% of patients
-30% (-27 percentage points)
Genital Wart Symptom and Impact Scale (GW-SIS) Score15/30 points
-50% (-7.5 points)
Itching/Discomfort Score (VAS 0-10)7/10 points
-60% (-4.2 points)
Common Side Effects
Local erythema
+70%
Erosion
+40%
Itching
+30%

Clinical Trial Phases:

Phase 4
5
Podofilox
55% Effectiveness• 80% Confidence• 75% Safety• 50 trials• 5K participants
HIGH EvidenceGood ValueDose: 0.5% solution or gel, applied 2x daily for 3 days, 4 days rest, repeat for 4 cycles
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
75
DangerousModerateSafe

Time to Effect

2-6 weeks

Duration

Up to 4-6 weeks

Response Rate

55%

Remission Rate

55%

Number Needed to Treat (NNT)

3

Common Side Effects:

Local erythema: 70%
Burning sensation: 60%
Pain: 40%
Erosion: 30%
Itching: 25%

Annual Cost of Care

Drug Cost

$800

Monitoring

$200

Side Effects

$50

Total Annual

$1,050

Cost-Effectiveness

GOOD

Cost per Remission

$1,909

Cost per Responder

$1,909

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+55%
Response Rate
+55%
Remission Rate
+55%
Common Side Effects
Local erythema
+70%
Burning sensation
+60%
Pain
+40%

Clinical Trial Phases:

Phase 4