Prevalence of high-grade dysplasia and cancer in the anal canal in human papillomavirus–infected individuals
| Autor: | Babak Mirin, Iradj Sobhani, Dominique Hénin, Jean Pierre Marmuse, Thérèse Lehy, Anne Claude Crémieux, Claude Carbon, Albert Vuagnat, Michel Mignon, Florence Hervatin, C. Vissuzaine, Francine Walker |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology HIV Positivity Anal Canal Gastroenterology Anal Mucosa Recurrence HIV Seronegativity Internal medicine HIV Seropositivity Prevalence medicine Humans Anal cancer Papillomaviridae Anus Diseases Hepatology medicine.diagnostic_test business.industry Papillomavirus Infections virus diseases Anoscopy Anal dysplasia Middle Aged Anal Infection Anal canal Condyloma Acuminatum Anus Neoplasms medicine.disease Tumor Virus Infections medicine.anatomical_structure Condylomata Acuminata Female France business Follow-Up Studies |
| Zdroj: | Gastroenterology. 120:857-866 |
| ISSN: | 0016-5085 |
| DOI: | 10.1053/gast.2001.22446 |
| Popis: | The incidence of anal cancer is higher in patients with anal canal condyloma, a sexually transmitted disease, than in the general population. We determined the prevalence of anal dysplasia and cancer in patients with anal canal condyloma with respect to human immunodeficiency virus (HIV) status, immunity status, and human papillomavirus types.In 174 consecutive patients (114 HIV positive, 60 HIV negative) with anal canal condyloma, lesions were cured, and the patients were then followed up prospectively. Langerhans cells (LCs) in normal anal mucosa were quantified, and viruses (Epstein-Barr virus, cytomegalovirus, human simplex virus 1, and various human papillomavirus [HPV] types) were characterized on inclusion. During follow-up (median 26 months), relapsed condylomas were resected and examined histologically. HIV load and CD4 T-lymphocyte counts in serum were determined at each visit.Several factors differed significantly between HIV-positive and HIV-negative patients: LCs/mm anal tissue (15 vs. 30), oncogenic HPV (27% vs. 13%), other current anal infections (44% vs. 0%), and sex ratio (93% vs. 73% male). During follow-up, condylomas relapsed in 75% of the HIV-positive patients, with 19 high-grade dysplasias (HGDs) and 1 invasive carcinoma, but in only 6% of HIV-negative patients, with 1 HGD. Male sex, HIV positivity, and15 LCs/mm tissue were independent risk factors for condyloma relapse. HIV positivity, HGD before inclusion, and condyloma relapse were independent risk factors for HGD and cancer. Serum HIV load was associated with relapse, whereas CD4 T-lymphocyte counts were not.The prevalence of HGD and carcinoma is higher in HIV-positive than in HIV-negative patients, probably because of HPV activity. HIV-positive patients with high serum HIV load and/or a history of anal dysplasia should be examined by anoscopy, and condylomas should be analyzed histologically. |
| Databáze: | OpenAIRE |
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