Screening Anal Dysplasia in HIV-Infected Patients: Is There an Agreement Between Anal Pap Smear and High-Resolution Anoscopy-Guided Biopsy?

Nahas, Caio Sérgio Rizkallah; Filho, Edesio Vieira da Silva; Segurado, Aluísio Cotrim; Genevcius, Raphael F.F.; Gerhard, Renê; Gutierrez, Eliana Battaggia; Marques, Carlos Frederico Sparapan; Cecconello, Ivan; Nahas, Sérgio Carlos

doi:10.1007/dcr.0b013e3181b98f36

Cited by 54 publications

(63 citation statements)

References 19 publications

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“…Finalmente, nuestro estudio sugiere un cambio epidemiológico, tanto en la prevalencia como en las características de la PAR en pacientes portadores de VIH/ SIDA, situación que debe ser considerada para el diseño de programas de seguimiento y tamizaje de carcinoma del canal anal en nuestro país, como ya ha sido implementado en otros países 21 .…”

Section: Discussionunclassified

Prevalencia de patología ano-rectal en pacientes portadores de VIH/SIDA

et al. 2012

Rev. chil. infectol.

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Section: Discussionunclassified

Prevalencia de patología ano-rectal en pacientes portadores de VIH/SIDA

et al. 2012

Rev. chil. infectol.

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“…10,12,15 A new anoscopy six months thereafter is indicated for patients with positive findings. 12 In cases of initial negative cytology, this procedure should be repeated in order to decrease the possibility of false-negative results.…”

Section: Discussionmentioning

confidence: 99%

“…17 Some authors consider HRA as a complementary screening test for high-risk patients. 10 However, there is a tendency to keep HRA as a complementary method to evaluate patients with abnormal anal cytology, since HRA is cheaper and less available than the cytology. Nonetheless, when available, it can also be used as a screening procedure, which increases the sensitivity for identification of anal intraepithelial neoplasia.…”

Section: Anal Cryptmentioning

confidence: 99%

“…High-grade lesions in the cervix appear to be a risk factor for AIN, as compared to low-grade lesions. 10,21,25 It is suggested that women with vulvar lesions related to cervical alterations are at a greater risk of presenting abnormal anal cytology, when compared to women with isolated cervical alterations. 23 HIV-infected women have a higher frequency of abnormal anal cytology in relation to seronegative women, with abnormal cytology in up to 26% of cases.…”

Section: Risk Factors Implicated In Anal Intraepithelial Neoplasiamentioning

confidence: 99%

“…There are few studies comparing anal cytology efficacy in detecting intraepithelial lesions with other methods such anoscopy and histology. Nahas et al 10 demonstrated that considering histology as the gold-standard anal cytology had a sensitivity of 61% and 60% specificity for detecting anal intraepithelial neoplasia (AIN) of any degree. Concerning high-grade AIN, the sensitivity and specificity were, respectively, 16% and 97%, concluding that anal cytology is not sensitive enough to rule out anal dysplasia and should therefore be complemented by high-resolution anoscopy.…”

Section: Introductionmentioning

confidence: 99%

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HPV infection and intraepithelial lesions from the anal region: how to diagnose?

Carvalho¹,

Ferreira²,

Bueno³

2011

Braz J Infect Dis

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In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy. Keywords: anal canal; papillomavirus infections; cell biology; carcinoma in situ.identify these pre-invasive lesions is being questioned. Such questions relate to the groups to be screened and the best way to implement it such screening. The purpose of this study was to review the literature about the use of anal cytology and anoscopy to screening and evaluation of anal intraepithelial neoplasia. ANAL CYTOLOGYAnal cytology is a noninvasive method of screening, which is performed primarily by anal secretion collection through a brush (Dacron swab) introduced into the anal canal and removed with gentle rotation movements. It is indicated to avoid anal sex and douching in the day before the procedure, since these practices can decrease cellular recovery. Special caution should be taken for not touching anal canal warts and rectum walls with the brush to avoid any fecal contamination.

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