Donna Sweet, M.D.Professor of Internal Medicine
University of Kansas School of Medicine - Wichita
Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. I am HIV positive and on Combivir and Sustiva. Now I am undetectable; however I have discovered that I have anal warts. What should I do, what is the remedy for these warts, and is it painful?
Donna Sweet, M.D.
Professor of Internal Medicine
University of Kansas School of Medicine - Wichita
It is very important that you see your doctor as soon as possible for treatment if you have anal warts. There is evidence that rectal/anal warts may lead to certain types of changes (dysplasia) that can lead to rectal/anal cancers, especially if they go untreated. Human Papilloma virus (HPV) infection is what causes warts and can last for a long time, especially in people who are HIV-positive. Anal warts are not directly related to your HIV infection but can last longer and be more difficult to treat as a result of being HIV positive. You need to see your health provider as soon as possible to discuss treatments. Some people "clear" an HPV infection but they can later be infected with HPV again or it can recur. However, dysplasias and warts can be removed. While there is some discomfort, if treated early the discomfort can be minimized. There are several ways to do this and your doctor will discuss these with you, recommending the best approach for your particular situation. Treatments include burning them with an electric needle (electrocautery) or a laser, freezing them with liquid nitrogen, surgery, treating them with chemicals like Trichloroacetic Acid (TCA), Podophyllin or Podofilox. And lastly, a new drug, imiquimod (Aldara), has been approved for treatment of genital warts. It is wonderful that your antiretroviral regimen is suppressing your virus well. Just remember that HPV is treatable, see your Dr. soon and I wish you the best of continued health.
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