HOMOSEXUAL MEN, SEROPOSITIVITY AND CONDYLOMATOUS INFECTION IN PROCTOLOGY NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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HOMOSEXUAL MEN, SEROPOSITIVITY AND CONDYLOMATOUS INFECTION IN PROCTOLOGY

Serono Symp Publ Raven; 78:295-304 1990. Unique Identifier : AIDSLINE ICDB/92678079
Fenzy A; Doco-Fenzy M; Clavel C; Birembaut P; Medical Group Saint Remi, 22 rue Simon, 51100 Reims, France

Abstract: Human papillomavirus (HPV)-induced condyloma has been recognized only recently as a sexually transmitted disease (STD). Some HPV condylomata are associated with dysplasia or in situ carcinomas and invasive squamous-cell carcinomas. The authors, in private practice in a town of 230,000 inhabitants in France, have examined systematically 3000 surgically resected anal lesions encountered over a 10-yr period. In this series, three cases of mild to severe dysplasia, developed on giant condylomata acuminata and two cases of invasive cancers developed on infraclinical condylomata recognized as hemorrhoidal prolapse with eroded and keratinized mucosa. Based on the authors' experience and published results, condylomatous infection in homosexual men and its relation to cancer and AIDS are discussed. Topics include predisposing factors in homosexual men; early detection; HPV screening; dysplasia and anal squamous cell carcinoma; in situ carcinoma; role of homosexual and heterosexual sodomitical practices; prevention and treatment; HIV seropositivity and condylomata; role of immune deficiency; and surgical risk in AIDS. Of the STDs that homosexual men can get, HPV infections probably are the most frequent. Anal intercourse undeniably predisposes to condyloma and the risk increases with the frequency of intercourse. HPV 11 is the most frequently encountered virus in anal pathology, but HPV 16 or 18 are not rare. Homosexual men seem to be more at risk for squamous cell carcinoma, but the relative risk figures (20-50 times that of heterosexuals) should be confirmed by more and better statistical studies on dysplasias and anal invasive cancers with HPV typing in both sexes. HIV serology must be provided for each patient (pt) harboring condylomata. Seropositive pts need a careful and frequent survey of their venereal warts, with immediate removal if they recur. Immune dysfunction is a high-risk factor for HPV infection and squamous cell carcinoma. Anorectal surgery in pts with AIDS is risky. Preventive measures for HPV anal warts are the same as for any STD. (38 Refs)
Keywords: Anus Neoplasms/*PATHOLOGY Carcinoma in Situ/PATHOLOGY Carcinoma, Squamous Cell/PATHOLOGY Cell Transformation, Neoplastic/PATHOLOGY Condylomata Acuminata/*PATHOLOGY Female *Homosexuality Human HIV Infections/*PATHOLOGY Male Neoplasm Invasiveness Opportunistic Infections/PATHOLOGY *Papillomavirus/ULTRASTRUCTURE Precancerous Conditions/*PATHOLOGY Rectal Neoplasms/*PATHOLOGY Rectum/PATHOLOGY Risk Factors Tumor Virus Infections/*PATHOLOGY MONOGRAPH REVIEWKWDanusneoplasms/KWDpathologycarcinomainsitu/pathologycarcinoma,squamouscell/pathologycelltransformation,neoplastic/pathologycondylomataacuminata/KWDpathologyfemaleKWDhomosexualityhumanhivinfections/KWDpathologymaleneoplasminvasivenessopportunisticinfections/pathologyKWDpapillomavirus/ultrastructureprecancerousconditions/KWDpathologyrectalneoplasms/KWDpathologyrectum/pathologyriskfactorstumorvirusinfections/KWDpathologymonographreview
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Copyright © 1992 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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