A retrospective clinical study of the treatment of high-grade anal dysplasia by infrared coagulation in a population of HIV-positive men who have sex with men.
HIV-positive men who have sex with men (MSM) are at high risk of developing human papillomavirus-associated anal squamous cell cancer. Similar to the management of cervical dysplasia, clinicians are treating high-grade anal dysplasia to prevent progression to cancer. Initial treatments such as cold scalpel excision and electrofulguration have shown limited efficacy in a HIV-positive population. Infrared coagulation (IRC) is an outpatient treatment for high-grade anal dysplasia. This retrospective clinical study reports on 68 HIV-positive MSM with 78 biopsy proven high-grade anal lesions. Each lesion was treated with the IRC with re-biopsy of the treatment site a mean of 140 days later. Of the 74 evaluable lesions; 39 had anal intraepithelial neoplasia (AIN) 1, 20 had AIN 2, seven had AIN 3, and eight had normal epithelium. The IRC showed 64% efficacy per treated lesion and shows promise as a treatment modality for high-grade anal dysplasia in this population.
Cranston
R D
RD
Department of Infectious Disease, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. cranstonr@dom.pitt.edu
Hirschowitz
S L
SL
Cortina
G
G
Moe
A A
AA
D001004:Anus Diseases / Q000473:pathology* / Q000532:radiotherapy*; D001005:Anus Neoplasms / Q000517:prevention & control*; D001706:Biopsy; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome