Squamous Intraepithelial Lesion of the Anus in a Man With HIV Infection

Susan C. Ball, MD, MPH

Disclosures

AIDS Read. 2004;14(9) 

In This Article

Treatment and Prevention

Once dysplasia has become invasive disease, treatment is aggressive. Combined-modality treatment with chemotherapy and radiation is the current standard of care, with surgery (colostomy) used to treat recurrent or residual disease. Results are excellent, with 3-year survival rates as follows: overall, 86%; colostomy-free, 73%; and disease-free, 67% in one study, which used 5-FU and cisplatin with radiation.[15]

With anal cancer being considered a sexually transmitted disease, efforts at prevention need to be made. Efforts at screening for anal dysplasia have yet to become widely accepted or practiced. There are many similarities with cervical cancer, but prevention as yet is not one. Identifying those persons most at risk to target for screening is important.

Terry, a gay white man who has had many sexual partners over the years, has not always practiced safer sex, as he admits and as his history of syphilis infections attests. While he denies a history of genital warts, it is likely that he has been asymptomatically infected with HPV of varying types on repeated occasions. He is upset to be told of the potential for cancer from an infection that he never knew he had. He asks you whether his HIV infection has been a factor in the development of SIL and potentially of anal cancer.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....