# Treatment of Condyloma Acuminata with Tirbanibulin 1% Ointment in People Living with HIV: A Case Series with Literature Review

## TL;DR

This case series explores the use of tirbanibulin 1% ointment for treating genital warts in people living with HIV, showing promising results for small lesions.

## Contribution

The study presents the first case series of tirbanibulin 1% ointment for treating condyloma acuminata in people living with HIV.

## Key findings

- Two out of three patients with small condylomas showed complete resolution.
- Adverse events were mild to moderate and short-lived.
- Tirbanibulin may be a viable treatment option for small condylomas in people living with HIV.

## Abstract

Background: Condyloma acuminata (CA) are dysplastic lesions caused by human papillomavirus (HPV) infection. Condylomata acuminata are common in Human Immunodeficiency Virus- (HIV) infected individuals and have been linked to HIV transmission. Current therapeutic options for CA encompass laser, cryotherapy, imiquimod, sinecatechins, podophyllotoxin, and trichloroacetate. These topical therapies have limitations caused by significant local skin reactions, high recurrence rates, prolonged application times, and, in some cases, a supposed lower efficacy in people living with Human Immunodeficiency Virus (PLWH). Previous studies evaluated the effect in the CA treatment of tirbanibulin 1% ointment since it is a synthetic antiproliferative drug approved for the topical treatment of actinic keratoses, acting in two distinct ways: it inhibits microtubule polymerization and Src kinase signaling. Human papilloma virus can up-regulate the kinases Src and Yes, so the tirbanibulin efficient treatment of CA may be due to the suppression of Src kinase signaling. Methods: Here, we present for the first time a retrospective case series of three PLWHIV affected by CA. Case: The patients experienced variable outcomes, with complete resolution of smaller condylomas for 2 out of 3 patients. Adverse events were local and of mild to moderate severity, lasting one week or less. Conclusions: While in need of larger studies, it is possible to hypothesize tirbanibulin 1% ointment as a therapeutic alternative for people living with HIV, especially for condylomas smaller than 1 cm in size.