International Journal of STD & AIDS > Volume 18, Number 8 > Pp. 538-542

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Original research articles

The frequency of high-grade intraepithelial neoplasia in anal/perianal warts is higher than previously recognized

J C McCloskey, C Metcalf, M A French, J P Flexman, V Burke and L J Beilin

Sexual Health Services, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia; Department of Anatomical Pathology, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia; Department of Clinical Immunology, Royal Perth Hospital and School of Surgery and Pathology, University of Western Australia, Perth, Western Australia, Australia; Department of Microbiology, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia

A retrospective review of the prevalence of intraepithelial neoplasia (IN) in surgically removed perianal/anal warts from December 1995 to December 2004 was undertaken in patients referred to the Sexual Health Clinic at Royal Perth Hospital. Data were analysed from 115 men and 38 women, 29 of whom had HIV infection (27 men and two women). Perianal/anal IN within the warts was found in 78% (52% high grade) of men with HIV infection. In men without HIV infection, the overall rate of IN within warts was 33% (20% high grade). The IN rate was 8.3% for HIV-negative women (2.8% high grade). Rates of IN within perianal/anal warts in men with or without HIV infection are higher than previously reported, and suggest the likelihood of a substantial increase in the future incidence of anal cancer. The association between IN and genital warts needs to be further studied.

Key Words: GENITAL WARTS • PERIANAL INTRAEPITHELIAL NEOPLASIA • ANAL INTRAEPITHELIAL NEOPLASIA • TREATMENT • HUMAN IMMUNODEFICIENCY VIRUS

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