***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a r and omized study , we have evaluated the treatment of cervical human papillomavirus ( HPV ) lesions by CO2 laser vaporization .  Fifty patients with abnormal Papanicolaou smears and histological evidence of cervical HPV infection associated or not with cervical intraepithelial neoplasia ( CIN ) grade I were r and omized to either a treatment or a control group . The cervical swabs were obtained every 3 months in both groups and examined for HPV type 16 DNA by the polymerase chain reaction . After a follow-up period of 12 months no significant differences were found between the laser treatment and the control groups in relation to the disappearance of the abnormal Papanicolaou smear . Two patients in the treatment group and 3 in the control group had a conization because of development of CIN I or aggravation of the concomitant CIN found at the initial visit . The percentage of women who demonstrated HPV in their cervical smears at 12 months ' follow-up was identical in the two groups , supporting the hypothesis that HPV is a persistent infection during which the virus is widespread in the vaginal epithelium OBJECTIVE To evaluate the effect of alpha-interferon as an adjuvant to laser or fluorouracil treatment in patients with recurrent genital human papillomavirus ( HPV ) infection . METHODS Sixty-two females and 21 males were treated for recurrent HPV infection , with either fluorouracil ( Efudex 5 % ) cream or laser ablation of the lesions . Half of the patients were then r and omly treated with adjuvant alpha-interferon , to the lesions for patients treated with fluorouracil , or beneath areas previously treated by laser , once a week , for 8 weeks . The other half of the patients did not receive interferon adjuvant . Evaluation of both groups was done using colposcopy and acetic acid , to assess recurrence rates up to 1 year after treatment . RESULTS Of the 83 patients followed for 1 year , colposcopy revealed recurrent anogenital lesions in 3 of 45 receiving interferon , compared with 9 of 38 patients treated without adjuvant interferon . CONCLUSION Interferon is effective as adjuvant treatment in controlling the recurrence of genital HPV A series of 119 women with Human papillomavirus ( HPV ) infections of the uterine cervix and /or vagina were included in the present study , where the efficacy of cryotherapy and CO2‐laser vaporization was assessed after a mean follow‐up of 14 months ( SD 6 months ) after treatment , as related to the natural history of the disease . Routine Papanicolaou ( PAP ) smears with HPV‐induced changes were the basis for patient recruitment . Patients with cervical HPV lesions ( HPV‐NCIN , HPV‐CIN l or II ) were r and omly allocated into  laser ( 55 women ) and  cryotherapy ( 42 women ) groups . Women with combined lesions ( HPV‐CIN & HPV‐VAIN ) were treated by laser ( 22 patients ) . The cure rate after laser vaporization  was practically identical to that of cryotherapy , 64 % and 54 % , respectively ( difference not statistically significant ) . The success rate was significantly lower ( 40 % ) for the combined lesions ( HPV‐CIN & HPV‐VAIN)(p<0.05 ) . The residual disease encountered in patients after the first treatment with cryotherapy and laser was classified as HPV‐NCIN in 78.9 % and 37.0 % , respectively . The number of patients is still too small to draw reliable conclusions on the effects of these therapy modes , as related to HPV type of lesion ( HPV 6 , 11 , 16 , 18 , 31 and 33 ) . The cure rates  for both cryotherapy and laser in our treatment groups were significantly higher than the spontaneous regression rate ( p < 0.001 ) , suggesting that treatment by either cryotherapy or CO2,‐laser vaporization significantly changes the natural history of genital HPV infections . More patients and longer follow‐up are still needed , however , to fully establish the efficacy of the current treatment modalities in gynecological HPV infections The efficacy of systemic interferon-alpha ( IFN-alpha n1 ; Wellferon ) treatment on genital human papillomavirus ( HPV ) infections was studied in a double-blind , placebo-controlled trial . A total of 120 women were r and omly allocated to receive either interferon ( IFN , n = 60 ) or placebo ( n = 60 ) . In both treatment groups , 15 patients with lesions induced by each of the four HPV types ( HPV 6 , 11 , 16 , and 18 ) were included . The dose of IFN was 1.5 x 10(6 ) IU subcutaneously three times for the first week followed by 3 x 10(6 ) IU three times weekly for a further 6 weeks . The control patients received matching placebo injections . Ten patients ( three IFN-treated and seven placebo-treated ) were lost to follow-up . As determined by colposcopy , cytological and histological examinations , and HPV typing ( in situ hybridization , ISH ) , 8 IFN-treated patients ( 14 % ) and 11 placebo-treated patients ( 18 % ) showed complete response ( CR ) at the 8th week . The corresponding figures were 22 ( 37 % ) and 25 ( 43 % ) at the 24th week and 28 ( 49 % ) and 25 ( 49 % ) at the 52nd week , respectively . The total number of HPV DNA negative patients at Week 8 was 29 ( 49 % ) in the IFN group and 24 ( 40 % ) in the placebo group ( statistically nonsignificant ) . At Week 24 , 37 ( 63 % ) of the IFN-treated patients and 39 ( 67 % ) of the placebo-treated patients were HPV DNA negative . In 2 placebo-treated cases , cervical lesions progressed to CIN III and were treated by conization after the 24th week . There were 4 recurrences ( 7 % ) in the IFN group and no recurrences in the placebo group at the 24th week , corresponding figures at the 52nd week being 6 ( 11 % ) and 4 ( 7 % ) , respectively . When the clinical efficacy was evaluated in relation to the histological grade of lesion and four different HPV types , there were no differences in CR or in the number of HPV DNA negative patients between the two study groups . In conclusion , systemic IFN-alpha therapy did not show any significant therapeutic effect on genital HPV infections ( by HPV types 6 , 11 , 16 , and 18 ) compared to placebo Forty-six patients with biopsy-proven cervical koilocytosis , which in 19 cases was associated with CIN I , were r and omized to treatment by  cervical laser vaporization or to follow-up without therapy . The polymerase chain reaction was used to examine the paraffin-embedded cervical biopsies for human papillomavirus ( HPV ) types 6 , 11 , 16 , 18 and 33 by polymerase chain reaction and molecular hybridization technique . Twenty biopsies contained HPV DNA , in 17 cases of the putatively oncogenic types HPV 16 and HPV 18 . During a mean follow-up of 28 months , the lesions resolved in 37 women , 5 women had progression to CIN III lesions , and 4 women had persisting disease . Lesions not harboring any of the 5 HPV types showed a high spontaneous regression rate of 88 % , which was not improved by the laser therapy . In the HPV-positive lesions , resolution occurred in only 29 % of untreated lesions , but in 92 % of those treated by laser . The difference is significant ( P = 0.007 ) . It is concluded that in patients with cervical koilocytosis , the HPV diagnosis could be of practical value in identifying patients who might benefit from treatment OBJECTIVE --To determine the efficacy and morbidity of fine loop diathermy excision of the cervical transformation zone as applied to the management of out patients with abnormal cervical smears . DESIGN -- Prospect i ve programme trial with six month follow up . SETTING --Two hospital based colposcopy clinics . PATIENTS --616 Patients aged 16 - 60 with abnormal cervical smears . INTERVENTIONS --After colposcopic and cytological assessment excision of the cervical transformation zone by fine loop diathermy under local anaesthesia in the outpatient department . MAIN OUTCOME MEASURES --Time to complete the treatment , immediate morbidity in terms of discomfort and bleeding , and cytological and colposcopic findings at six months . RESULTS --Treatment was completed in a mean of 3.47 minutes ( SD 1.99 ) . Immediate morbidity was minimal , and histological specimens were adequate in over 90 % of cases . Almost two thirds of patients were treated at their first visit to the clinic . 58 Patients ( 9.4 % ) failed to attend for follow up at six months and one had had a hysterectomy . Of the 557 patients who attended for colposcopic and cytological follow up at six months , 506 ( 91 % ) were normal cytologically and 19 ( 3.4 % ) had histologically confirmed persistence of cervical intraepithelial neoplasia . The overall confirmed failure rate of the technique was 4.4 % . CONCLUSION --Loop diathermy excision is an effective treatment with low morbidity and is an appropriate modality for patients with abnormal cervical smears OBJECTIVE To assess whether cold coagulation to the cervix eliminates sub clinical wart virus infection and to determine the effectiveness of treatment for CIN I and II , using cold coagulation , by genitourinary physicians . DESIGN Prospect i ve study . SETTING Department of Genitourinary medicine in a large teaching hospital . PARTICIPANTS All patients who received cold coagulation to the cervix in a 1 year period , who had not had previous treatment . RESULTS 261 patients were enrolled into this study ; of these , 138 ( 53 % ) patients attended for repeat colposcopy and cytology at one year . Cure rates for lesions were 66 % for initial wart virus infection , 80 % for CIN I and 94 % for CIN II and III . Four ( 5 % ) cases in whom repeat cytology was normal had CIN which would have been missed if repeat colposcopy had not been performed at one year . CONCLUSIONS Cold coagulation is inappropriate treatment for sub clinical wart virus infection of the cervix but is useful for the management of patients with CIN . Repeat colposcopy following treatment to the cervix is not necessary if cervical cytology is normal Fifty women with human papillomavirus (HPV)-induced abnormal cervical smears were r and omly allocated to either CO2-laser vaporization or routine control . The success rate at the 6 months check was 100 % after laser treatment compared to that of 72 % in the control group ( p less than 0.05 ) . Although longer follow-up is needed to fully establish the efficacy of the treatment , the method seems appropriate to this large group of women at risk of developing cervical intraepithelial neoplasia Summary : Between February , 1988 , and January , 1991,222 women with histologically proven cervical wart virus infection without dysplasia were r and omized to be managed by 1 of 4 protocol s. Group 1 acted as control , Group 2 were asked to use condoms for 6 months , Group 3 underwent local ablative therapy and Group 4 were asked to use condoms after ablative therapy . Assessment at 2 and 3 years of follow‐up showed no statistically significant superiority for treatment over observation . Defaulters from follow‐up were over 50 % by the completion of the study Background and Objectives Treatment of  genital warts  is problematic . Numerous treatment modalities are available , but response to any therapy often is unsatisfactory . Recently , studies have suggested that interferons would be effective in the treatment of some  genital warts .  Goal of this Study To compare carbon dioxide laser with or without adjuvant subcutaneously administered interferon alpha-2b in the treatment of genital human papillomavirus infection . Study Design One hundred r and omized women with genital HPV infection were treated with carbon dioxide laser and adjuvant systemic interferon alpha-2b or carbon dioxide laser and placebo . Patients were followed colposcopically , cytologically , and by HPV DNA testing for 6 months . Results Complete response was seen in 62 % patients who received adjuvant interferon , and in 68 % patients who received placebo . However , recurrence was less common in patients treated with interferon who were infected with HPV 16/18 . Conclusion Only a subgroup of patients , women infected with HPV DNA 16/18 , benefited from adjuvant systemic interferon treatment Consensus interferon and interferon alfa-2a were used to treat patients with persistent human papillomavirus disease . Thirty-one patients were treated with either consensus interferon or a placebo ( 25 received active drug and 6 received placebo ) , and 24 patients were treated with interferon alfa-2a . Of the 25 patients who received consensus interferon , 19 ( 76 % ) showed either complete or partial clearing of condyloma 10 and 16 
    Output:
    
CONCLUSION The evidence we found in the medical literature regarding the efficacy of any therapy for sub clinical HPV infection without intraepithelial neoplasia of the uterine cervix was unsatisfactory