[Anorectal malignancies and dysplasia in HIV-positive men who have sex with men].
Since the HIV epidemic, the incidence ofanorectal (pre)malignancies in men who have sex with men (MSM) is increasing. The incidence is likely to increase further in the coming years, given that HIV-positive MSM are living longer thanks to powerful antiretroviral treatment. Persistent human papillomavirus (HPV) infection is a major risk factor for the development of anal (pre)malignancies. Less is known about the natural history of anal intraepithelial neoplasia (AIN). Screening in HIV-positive and HIV-negative MSM for anorectal malignancies or dysplasia is cost-effective if the incidence is sufficiently high. Treatment options range from watchful waiting for asymptomatic grade-1 AIN to excision or radio(chemo)therapy for anorectal carcinoma. HPV vaccines are in development. Especially in HIV-positive MSM with anorectal complaints or genital warts in their medical history, one should consider these malignancies.
van der Snoek
E M
EM
Afd. Dermatologie en Venereologie, Erasmus MC, Postbus 2040, 3000 CA Rotterdam. e.vandersnoek@erasmusmc.nl
van der Ende
M E
ME
Schouten
W R
WR
den Hollander
J C
JC
van der Meijden
W I
WI
D001005:Anus Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000191:economics; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000150:complications; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*