Human Papilloma Virus Type and Recurrence Rate After Surgical Clearance of Anal Condylomata Acuminata

D'ambrogio, Aris; Yerly, Stéphane; Sahli, Roland; Bouzourene, Hanifa; Demartines, Nicolas; Cotton, Michael; Givel, Jean-Claude

doi:10.1097/olq.0b013e3181a866a3

Cited by 31 publications

(36 citation statements)

References 32 publications

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“…A possible explanation for this finding is that it is a consequence of including male populations with at‐risk behaviours in the study. For example, having multiple sexual partners and practising RAI are common in MSM and have been shown to be associated with an elevated risk of recurrence of condylomata . In the group of patients with anal condylomata described here, there was a higher proportion of MSM and more cases of STIs (mainly syphilis and gonorrhoea) than in the population without anal condylomata, which suggests at‐risk sexual behaviours in these subjects.…”

Section: Discussionmentioning

confidence: 63%

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Darwich

Videla

et al. 2012

HIV Medicine

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BackgroundGenital infections with low-risk (LR) and high-risk (HR) human papillomavirus (HPV) genotypes are associated with ano-genital condylomata and anal squamous cell cancer. HPV-related pathologies in HIV-infected men are a serious concern. In this study, the prevalence of anal condylomata and their association with cytological abnormalities and HPV infection in the anal canal in HIV-infected men [men who have sex with men (MSM) and heterosexuals] were estimated. MethodsThis was a cross-sectional study based on the first visits of patients in the Can Ruti HIV-positive Men (CARH·MEN) cohort. Anal condylomata were assessed by clinical and proctological examination. Samples from the anal canal were collected for HPV genotyping and cytological diagnoses. ResultsA total of 640 HIV-infected men (473 MSM and 167 heterosexuals) were included in the study. The overall prevalence of anal condylomata was 25% [157 of 640; 95% confidence interval (CI) 21-28%]; in MSM it was 28% and in heterosexuals it was 15% [odds ratio (OR) 2.2; 95% CI 1.4-3.5]. In patients with anal condylomata, HPV infection in the anal canal was more prevalent (92% vs. 67% in those without anal condylomata; OR 8.5; 95% CI 3.2-22). This higher HPV prevalence involved at least two HPV genotypes (OR 4.0; 95% CI 2.2-7.1), mainly HR genotypes (OR 3.3; 95% CI 1.7-6.4). Similarly, the cumulative prevalence of HPV-6 and HPV-11 was higher in patients with anal condylomata (63% vs. 19% in those without anal condylomata). Having anal condylomata was associated with higher prevalences of cytological abnormalities (83% vs. 32% in those without anal condylomata; OR 6.9; 95% CI 3.8-12.7) and high-grade squamous intraepithelial lesions (HSILs) (9% vs. 3% in those without anal condylomata; OR 9.0; 95% CI 2.9-28.4) in the anal canal. ConclusionsHIV-infected men with anal condylomata were at risk of presenting HSILs and harbouring multiple HR HPV infections in the anal canal. Although MSM presented the highest prevalence of anal condylomata, heterosexual men also had a clinically important prevalence. Our findings emphasize the importance of screening and follow-up for condylomata in the anal canal in HIV-infected men.

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Section: Discussionmentioning

confidence: 63%

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Darwich

Videla

et al. 2012

HIV Medicine

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“…The lower response rate and the higher recurrence rate of warts in the anal area reduce the total efficacy of the combined regimen. Epidemiology studies have revealed HPV 6 and 11 as the most frequently encountered viruses in patients with anal CA, and HPV 11 was present in the majority of those recurrences (25). Schlappner et al (26) suggest that a hidden focus of infection, namely anorectal condylomata that cannot be visualized externally by simple inspection, may result in an unsatisfactory response to treatment in the anal area.…”

Section: Discussionmentioning

confidence: 99%

A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata

Chai

Zheng

et al. 2011

Photoderm Photoimm Photomed

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“…Treatment is expensive, estimated to cost over $800 per incident case in the United States[11]. Recurrence, defined as reappearance of condyloma within 12 months after complete clearance, ranges from 4% to 50%, depending on treatment modality and immune competence[12], [13]. In one private practice (SEG), all HIV-negative MSM were offered qHPV off-label regardless of age, history of anogenital condyloma, history of anal high-grade squamous intraepithelial lesion (HSIL), or prior HPV infection.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Anal Condyloma with Quadrivalent Human Papillomavirus Vaccination of Older Men Who Have Sex with Men

Swedish

Goldstone

2014

PLoS ONE

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BackgroundThe quadrivalent human papillomavirus vaccine (qHPV) is FDA-approved for use in males 9 to 26 years old to prevent anogenital condyloma. The objective of this study is to determine if qHPV is effective at preventing anal condyloma among men who have sex with men (MSM) aged 26 years and older.MethodsThis post-hoc analysis of a nonconcurrent cohort study evaluated 210 patients without history of anal condyloma and 103 patients with previously-treated anal condyloma recurrence-free for at least 12 months prior to vaccination/time zero. We determined the rate of anal condyloma development in vaccinated versus unvaccinated patients.Results313 patients with mean age 42 years were followed for median 981 days. During 773.6 person-years follow-up, condyloma developed in 10 (8.6%) vaccinated patients (incidence of 3.7 per 100 person-years) and 37 (18.8%) unvaccinated patients (incidence 7.3 per 100 person-years; p = 0.05). Multivariable hazards ratio showed that qHPV was associated with decreased risk of anal condyloma development (HR 0.45; 95% CI 0.22–0.92; p = 0.03). History of anal condyloma was associated with increased risk of anal condyloma development (HR 2.28; 95% CI 1.28–4.05; p = 0.005), as was infection with oncogenic HPV (HR 3.87; 95% CI 1.66–9.03; p = 0.002).ConclusionsAmong MSM 26 years of age and older with and without history of anal condyloma, qHPV reduces the risk of anal condyloma development. A randomized controlled trial is needed to confirm these findings in this age group.

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Human Papilloma Virus Type and Recurrence Rate After Surgical Clearance of Anal Condylomata Acuminata

Abstract: HPV 11 is associated with higher recurrence rate of ACA. This makes routine clinical HPV typing questionable. Follow-up is required to identify recurrence and to treat it early, especially if HPV 11 has been identified.

Cited by 31 publications

References 32 publications

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata

Prevention of Anal Condyloma with Quadrivalent Human Papillomavirus Vaccination of Older Men Who Have Sex with Men

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