title: Anal cancer: Focus on HIV-positive patients in the HAART-era.
abstract: Anal cancer represents an increasing health problem, especially in immune-compromised patients, as HIV-positive patients. Notably, a significant higher incidence rate is reported among HIV infected patients with the advent of highly active antiretroviral therapy (HAART). To date, no randomised trial supports the correlation between existing screening strategies and reduced progression of anal intraepithelial neoplasia (AIN) to anal cancer or improved survival. Nevertheless, screening and treatment of AIN by topical agents should be implemented in high risk population. Data on invasive anal cancer treatment show that combined modality treatment (CMT) is the treatment of choice. Early reports on HIV-positive patients describe higher treatment toxicity and a relation with lower CD4 count and higher HIV viral load. More recently, reported outcomes seem to be similar in HIV-positive population and general population. Reports on a rise in local recurrence rates and in acute side effects along with a correlation with pre-treatment CD4 counts in HIV-positive patients, are not confirmed by all authors. The development of the first approved vaccine is a milestone in the field of anogenital cancers. However, many questions are still unresolved especially as concerns immunization in the setting of HIV infection.
authors.affiliation: Department of Surgery, University of Catania, Via S. Sofia, 180, 95100 Catania, Italy. 00bernius00@virgilio.it
authors.forename: Ernesto
authors.initials: E
authors.lastname: Zanet
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Martellotta
authors.forename: Bruno
authors.initials: B
authors.lastname: Cacopardo
authors.forename: Rossella
authors.initials: R
authors.lastname: Fisichella
authors.forename: Marcello
authors.initials: M
authors.lastname: Tavio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Berretta
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D019496:Cancer Vaccines / Q000276:immunology; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000517:prevention & control; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D015994:Incidence
chemical_list: D019496:Cancer Vaccines