Loading...
Please wait, while we are loading the content...
Similar Documents
Imiquimod treatment of anal intraepithelial neoplasia in HIV-positive men.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Wieland, Ulrike Brockmeyer, Norbert H. Weissenborn, Soenke Jan Hochdorfer, Bettina Stuecker, Markus H. F. Swoboda, Jochen Altmeyer, Peter Josef Pfister, Herbert Kreuter, Alexander |
| Copyright Year | 2006 |
| Abstract | OBJECTIVE To evaluate the treatment of anal intraepithelial neoplasia (AIN) with the local immune response modifier imiquimod in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). DESIGN Prospective, nonrandomized, open-label pilot study, with a mean follow-up time of 9(1/2) months. SETTING Dermatology department of a university hospital. Patients Twenty-eight consecutive HIV-positive MSM with histologically confirmed perianal (n = 23) or intra-anal (n = 5) AIN. Intervention Overnight treatment with self-applied imiquimod cream (perianal AIN) or suppositories (intra-anal AIN) 3 times a week for 16 weeks. MAIN OUTCOME MEASURES Response to treatment was documented using clinical, cytologic, and histologic criteria. Human papillomavirus (HPV) typing and HPV DNA load determination for the high-risk HPV types 16, 18, 31, and 33 were performed. RESULTS Seventeen (61%) of all 28 patients included in the study and 17 (77%) of the 22 patients with AIN, who applied imiquimod as instructed, showed clinical and histologic clearance at the end of therapy. Four patients had residual AIN and 1 patient did not improve. Clinical response was accompanied by a sharp decline in HPV DNA loads and by a reduction in the number of HPV types, but long-term HPV clearance was rarely achieved. In the follow-up period, AIN cleared in 3 patients with residual AIN. Fourteen (78%) of 18 imiquimod responders with at least 5 five months of follow-up had a normal cytologic and clinical picture at the end of the follow-up period. Three primary responders developed a recurrence. In 6 noncompliant patients, there was no clinical or morphological improvement and the HPV DNA loads remained high. CONCLUSIONS Imiquimod appears to be a safe and effective treatment option for AIN in HIV-positive MSM. Clinical response is accompanied by a significant decrease in high-risk HPV DNA load. These results should encourage controlled randomized studies of imiquimod treatment of AIN. |
| Starting Page | 68 |
| Ending Page | 72 |
| Page Count | 5 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://archderm.jamanetwork.com/journals/DERM/articlepdf/409616/dst60020_1438_1444.pdf |
| Alternate Webpage(s) | http://www.praxis-stenkamp-swoboda.de/pdf/Wieland_Imiquimod_AI_%20HI_%202006.pdf |
| Alternate Webpage(s) | http://archderm.jamanetwork.com/pdfaccess.ashx?url=/data/journals/derm/5044/dst60020_1438_1444.pdf |
| PubMed reference number | 17116834v1 |
| Volume Number | 142 |
| Issue Number | 11 |
| Journal | Archives of dermatology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anal Fissure Anus Chemical Modifier Follow-Up Report HIV Infections Hospitals, University Human Papillomavirus Immunologic Deficiency Syndromes Intraepithelial Neoplasia Neoplasms Patients Perianal Pruritus Ani Suppository anal dysplasia imiquimod |
| Content Type | Text |
| Resource Type | Article |
