Document Detail


Treatment of anal human papillomavirus-associated disease: a long term outcome study.
MedLine Citation:
PMID:  18574114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment for human papillomavirus (HPV)-associated anal canal disease has been unsatisfactory. The objective of our study was to determine the treatment outcome in our cohort with anal HPV disease. Overall, 181 patients were evaluated over a median period of 19.1 months (range = 2.8-125.5). Eighty-eight patients (48.6%) with high-grade anal intraepithelial neoplasia (AIN) and 82 patients (45.3%) with low-grade AIN underwent treatment. One hundred and forty-one patients (77.9%) received laser ablative treatment as an outpatient procedure. The treatment yielded cure, defined as a disease-free state at 12 months after treatment, in 63.0% (114/181). Median time to cure for the cohort was 31.5 months (95% confidence interval: 23.0-40.0). Treatment outcome showed no evidence of being affected by age, sexual preference, history of smoking or presence of high-grade disease. Median time to cure was significantly affected by a positive HIV status (P = 0.02) and the extent (volume) of the disease (P = 0.01). Contrary to the current view that treatment of HPV-related anal disease is difficult, unrewarding due to recurrences and may lead to substantial morbidity, we demonstrate that effective treatment is possible for both low- and high-grade AIN. These findings should help with the general desire to introduce screening for AIN for at-risk groups.
Authors:
M Nathan; N Hickey; L Mayuranathan; S L Vowler; N Singh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of STD & AIDS     Volume:  19     ISSN:  0956-4624     ISO Abbreviation:  Int J STD AIDS     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-24     Completed Date:  2008-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007917     Medline TA:  Int J STD AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  445-9     Citation Subset:  IM; X    
Affiliation:
Department of Sexual Health, Homerton University Hospital, London E9 6SR. mayura.nathan@homerton.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Anus Diseases / therapy*,  virology
Anus Neoplasms / pathology,  therapy*,  virology
Carcinoma, Squamous Cell / pathology,  therapy*,  virology
Female
Humans
Laser Therapy / utilization*
Male
Middle Aged
Papillomaviridae
Papillomavirus Infections / complications,  therapy*,  virology
Time Factors
Treatment Outcome
Warts / therapy*,  virology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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