[Treatment of HPV-associated Anal Lesions in HIV-positive Patients - Comparison of Surgical Treatment and Topical Therapy with Imiquimod].
Behandlung HPV-assoziierter analer Läsionen bei HIV-positiven Patienten – chirurgische Abtragung vs. topische Therapie mit Imiquimod.
Journal
Zentralblatt fur Chirurgie
ISSN: 1438-9592
Titre abrégé: Zentralbl Chir
Pays: Germany
ID NLM: 0413645
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
pubmed:
4
7
2018
medline:
2
11
2019
entrez:
4
7
2018
Statut:
ppublish
Résumé
In HIV In this study, we contrasted surgical resection and topical imiquimod therapy of HPV-associated anal lesions in HIV This was a retrospective analysis of 97 HIV In 53/97 patients (54%), HPV-associated anal disease was diagnosed upon the first visit. In approx. 50% of the patients, the HIV infection was adequately controlled (52 patients with viral load < 40 copies [53.6%]) under cART. The mean age was 41.0 ± 11.6 years. In 7/53 patients with macroscopic C. ac., low-grade and in 18/53 patients high-grade AIN were additionally confirmed. Success rates of surgical resection, imiquimod treatment and the combination of the two were compared. Complete remission of C. ac. and AIN four weeks after treatment was considered a therapeutic success. For C. ac., success rates with imiquimod were 5/25 (20.0%) vs. surgery* 30/57 (52.6%, Mann-Whitney U test p < 0.05) vs. surgery+imiquimod 7/15 (46.7%). For AIN, success rates with imiquimod were 4/24 (16.7%) vs. surgery* 47/83 (56.7%, Mann-Whitney U test p < 0.05) vs. surgery+imiquimod 9/21 (42.8%). In 7/92 (13%) of surgical treatments, complications were reported: four minor and two significant bleeding episodes and one perianal thrombosis. No side effects of imiquimod were documented besides skin irritation. Surgery is more effective than topical imiquimod as initial therapy of HPV-related anogenital disease in HIV Regelmäßige proktologische Untersuchungen sind bei HIV Es sollte untersucht werden, ob sich chirurgische Abtragung und topische Therapie mit Imiquimod bez. Heilungsraten und Outcome bei HPV-assoziierten analen Läsionen unterscheiden und ob ein synergistischer Effekt vorliegt. Es wurden bei 97 HIV Bei 53/97 (54%) HIV Eine operative Erstbehandlung von HPV-assoziierten analen Läsionen bei HIV
Sections du résumé
OBJECTIVES
OBJECTIVE
In HIV
BACKGROUND
BACKGROUND
In this study, we contrasted surgical resection and topical imiquimod therapy of HPV-associated anal lesions in HIV
METHODS
METHODS
This was a retrospective analysis of 97 HIV
RESULTS
RESULTS
In 53/97 patients (54%), HPV-associated anal disease was diagnosed upon the first visit. In approx. 50% of the patients, the HIV infection was adequately controlled (52 patients with viral load < 40 copies [53.6%]) under cART. The mean age was 41.0 ± 11.6 years. In 7/53 patients with macroscopic C. ac., low-grade and in 18/53 patients high-grade AIN were additionally confirmed. Success rates of surgical resection, imiquimod treatment and the combination of the two were compared. Complete remission of C. ac. and AIN four weeks after treatment was considered a therapeutic success. For C. ac., success rates with imiquimod were 5/25 (20.0%) vs. surgery* 30/57 (52.6%, Mann-Whitney U test p < 0.05) vs. surgery+imiquimod 7/15 (46.7%). For AIN, success rates with imiquimod were 4/24 (16.7%) vs. surgery* 47/83 (56.7%, Mann-Whitney U test p < 0.05) vs. surgery+imiquimod 9/21 (42.8%). In 7/92 (13%) of surgical treatments, complications were reported: four minor and two significant bleeding episodes and one perianal thrombosis. No side effects of imiquimod were documented besides skin irritation.
CONCLUSION
CONCLUSIONS
Surgery is more effective than topical imiquimod as initial therapy of HPV-related anogenital disease in HIV
HINTERGRUND
UNASSIGNED
Regelmäßige proktologische Untersuchungen sind bei HIV
ZIEL DER ARBEIT
UNASSIGNED
Es sollte untersucht werden, ob sich chirurgische Abtragung und topische Therapie mit Imiquimod bez. Heilungsraten und Outcome bei HPV-assoziierten analen Läsionen unterscheiden und ob ein synergistischer Effekt vorliegt.
MATERIAL UND METHODEN
METHODS
Es wurden bei 97 HIV
ERGEBNISSE
UNASSIGNED
Bei 53/97 (54%) HIV
DISKUSSION
CONCLUSIONS
Eine operative Erstbehandlung von HPV-assoziierten analen Läsionen bei HIV
Autres résumés
Type: Publisher
(ger)
Regelmäßige proktologische Untersuchungen sind bei HIV
Substances chimiques
Aminoquinolines
0
Antineoplastic Agents
0
Imiquimod
P1QW714R7M
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
349-354Informations de copyright
Georg Thieme Verlag KG Stuttgart · New York.
Déclaration de conflit d'intérêts
Die Autoren geben an, dass kein Interessenkonflikt besteht.