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Human papillomavirus (HPV) detection and typing using the PapilloCheck test and cytological examination were carried out in anal samples collected from 67 men seropositive for human immunodeficiency virus (HIV) who have sex with men. Fifty (74.6%) patients had anal HPV infection, 46 (68.7%) had high-risk (HR) HPV infection, and 38 (56.7%) had multiple infection involving 2-9 (median, 3) HPV types. The HPV types identified most frequently were HPV 44/55 (19.4%), HPV 53 (19.4%), HPV 16 (16.4%), HPV 39 (16.4%), and HPV 42 (14.9%). Thirty-two of the 66 interpretable smears (48.5%) revealed cytological abnormalities: 9 (13.4%) atypical cells of undetermined significance, 20 (30.3%) low-grade intraepithelial lesions, and 3 (4.5%) high-grade intraepithelial lesions. Cytological abnormalities were associated significantly with HPV detection (P < 0.001), multiple HPV infection (P < 0.001), and increased number of HPV types (P < 0.001). The HPV types associated most frequently with cytological abnormalities were HPV 39 (28.1%), HPV 42 (28.1%), HPV 53 (28.1%), HPV 16 (25.0%), HPV 44/55 (25.0%), and HPV 59 (21.9%). HPV DNA detection as well as cytological abnormalities were associated neither with HIV RNA detection in plasma nor with CD4+ T-cell count. Differences in age or in time since HIV acquisition were not observed in patients with or without cytological abnormalities. The present study confirms the high prevalence of anal HR-HPV infection and cytological abnormalities in men infected with HIV who have sex with men. HPV testing and/or cytological analysis may be helpful in selecting the patients to be referred to proctological examination.

Human papillomavirus 16 is ubiquitously frequent among human immunodeficiency virus -positive men having sex with men, and more strongly associated with high-grade anal lesions than other high-risk types, confirming it as a target for anal cancer prevention.

Summary Background  A treatment approach for patients with haemorrhoidal disease and other anal disease, which includes the use of topical corticosteroids and other topical combination products, is widely accepted, but little has been published to compare such treatments. This publication is a valuable collection of reading material for gastroenterologists, proctologists, general practitioners, dermatologists and other clinicians who are responsible for diagnosing and managing patients with haemorrhoidal disease. Aims  To review and collect existing treatment approaches for haemorrhoidal disease, by reviewing global experience from clinicians that will contribute towards improving best practice in the management of patients. Methods  The articles include overviews of haemorrhoidal disease, differential diagnosis, topical treatment and surgical practices and patient outcomes. Case studies further reinforce treatments from individual specialists. Results  The articles between them address the classification of haemorrhoids, dermatological differential diagnoses of anal and perianal disease, and the therapeutic management of different haemorrhoidal diseases including invasive surgical and non‐invasive topical combination treatments. The case studies indicate the positive impact of appropriate treatment in everyday clinical practice. Conclusion  This publication will reinforce best practice in the causative and symptomatic treatment of haemorrhoidal disease. Aliment Pharmacol Ther 31 (Suppl. 1), 1–58

The present study shows that PPB with 40 mL 0.75% ropivacaine (300 mg) was a simple, effective, and safe method to provide better postoperative analgesia than PCA alone following surgical hemorrhoidectomy. In addition, PPB was shown to significantly reduce opioid consumption intraoperatively and during the first postoperative day.

Background Prospective data on the natural history of anal human papillomavirus (HPV) infection are scarce in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Methods We analyzed incidence and clearance of HPV-16 and HPV-18 in a French cohort of HIV-infected MSM, aged ≥35 years, followed-up annually (n = 438, 2014–2018). Results Human papillomavirus-16 and HPV-18 incidence were similar (~10% incident infections at 24 months). Human papillomavirus-16 incidence was higher among high-grade versus no lesion at baseline (adjusted incidence rate ratio = 3.0; 95% confidence interval, 1.07–8.18). Human papillomavirus-16 cleared significantly slower than HPV-18 (32% versus 54% by 24 months). Conclusions In conclusion, anal HPV-16 is more persistent than HPV-18, and its incidence correlates with a prior detection of high-grade lesions.

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Qu'est-ce que la thrombose ? L'explication physiopathologique n'est pas certaine, mais il s'agit d'un caillot qui se forme dans les plexus hémorroïdaires externes, il induit parfois une réaction inflammatoire, avec ici de l'oedème, ce qui majore la douleur. Liens d'intérêts : Les auteurs déclarent ne pas avoir de lien d'intérêt.