Sylvia Heloisa Arantes Cruz
Faculdade de Ciências Médicas da Santa Casa de São Paulo, Brazil
Title: Anal intraepithelial neoplasia in HIV-positive patients: a review
Biography
Biography: Sylvia Heloisa Arantes Cruz
Abstract
HIV-positive patients are described with a high rate of anal dysplasia. One of the main causes for the progress of this disorderly epithelial growth in anal mucosa is the concomitant HIV and HPV infection. HPV acts as a cofactor for the persistent anal dysplasia which will provide a precursor lesion for anal squamous cell carcinoma. The rate of anal cancer has increased nowadays. This dysplasia is described as either high-grade anal intraepithelial (HAIN) or low-grade anal intraepithelial (LAIN). The aim of this study is to compare the findings of the screening in HIV-positive and negative patients and perform a review of the literature. We evaluated 131 HIV-positive and negative patients at CRT/AIDS São Paulo who had previously anal intercourse from January 2013 to December 2014. All of the patients underwent the high-risk HPV DNA test, anal Pap smear protocol and high resolution anoscopy. The anal lesions were treated with 90% trichloroacetic acid (TCA) and 5% imiquimod for 12 weeks. The statistical analysis was performed using chi-squared test and the significance level was set at less than 5%. 57 HIV-positive male patients, 35 HIV-negative male patients and 39 HIV-negative female patients were evaluated. 18 HIV-positive patients had anal lesions and 43 patients were positive for the high-risk HPV DNA test and had anal dysplasia. In conclusion, anal dysplasia was more common in HIV-positive patients. High-risk HPV infection was related to anal dysplasia.