Original research article Peripheral inflammatory biomarkers as predictors of recurrence in surgically- treated anogenital condylomata acuminata patients P Basim 1 and M Yuksel 2 Abstract The aim of this study was to examine the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with anogenital condylomata acuminata (CA) and their association with recurrence and squamous intraepithelial neoplasia development. We conducted a descriptive study in 95 patients that had undergone surgical treatment for CA. The descriptive data, disease characteristics, and pre-treatment periph- eral inflammatory biomarkers (PIBs) were recorded retrospectively. All parameters were compared in those with recurrent and non-recurrent CA. All PIBs were significantly higher in patients with the greatest genital wart size of >2 cm in the squamous intraepithelial lesion (SIL) group. Human papillomavirus (HPV) types 16, 18, 31 and 33, known to carry high risk for anogenital cancer, were significantly related to higher SII. Greater wart size, high-grade squamous intraepithelial lesion (HSIL), and higher PLR and SII values were highly associated with recurrent disease (p ¼ 0.003, 0.006, 0.005 and 0.000, respectively). Of all recurrences, 34.1% were explained by HSIL and increased PLR and SII values. The prediction of CA recurrence is important to determine those patients at high risk. PLR and SII can be used for risk analysis in selected patient groups. Keywords Condylomata acuminata, human papilloma virus, peripheral inflammatory biomarkers Date received: 18 December 2019; accepted: 23 July 2020 Introduction Anogenital human papillomavirus (HPV) infection affects millions of people worldwide and presents with a wide range of manifestations, from asymptom- atic infected carriers to condylomata acuminata (CA), even to invasive cancer. 1 One percent of sexually active adults is infected with HPV types 6 and 11 that are most commonly associated with the development of CA. 2 Although these two most commonly encountered HPV types have been proven to be low-risk for cancer development, infected patients are more prone to harbor the other nearly 120 types of HPV, of which 16, 18, 31, 33, 35, 45, 52 and 58 are more oncogenic, namely high-risk HPV types (HR-HPV), and causally linked to squamous intraepithelial lesions (SILs) and squamous cell carcinoma (SCC) of the anogenital area; thus, the clinical importance of being infected with HPV types 6 and 11 needs to be mapped out thoroughly since they form an environment for easy viral shedding and replication. 1,2 Another remarkable finding is that HPV-mediated lesions tend to become persistent or recur even in a patient group with a well- established immune system. 3 Persistent or progressive disease and carcinogenesis due to HPV infection prob- ably are also related to cofactors, such as smoking, sexually transmitted infection (STI) history, and 1 Department of General Surgery, Medical Faculty, Medipol University, Istanbul, Turkey 2 Department of Dermatology, Medical Faculty, Medipol University, Istanbul, Turkey Corresponding author: P Basim, Medipol University, Department of General Surgery, Istanbul, Turkey. Email: pelinakbaba@gmail.com International Journal of STD & AIDS 0(0) 1–9 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0956462420950562 journals.sagepub.com/home/std