Abstract
Anal cancer represents an increasing health problem, especially in immune-compromised patients, as HIVpositive patients. Notably, a significant higher incidence rate is reported among HIV infected patients with the advent of highly active antiretroviral therapy (HAART). To date, no randomised trial supports the correlation between existing screening strategies and reduced progression of anal intraepithelial neoplasia (AIN) to anal cancer or improved survival. Nevertheless, screening and treatment of AIN by topical agents should be implemented in high risk population. Data on invasive anal cancer treatment show that combined modality treatment (CMT) is the treatment of choice. Early reports on HIV-positive patients describe higher treatment toxicity and a relation with lower CD4 count and higher HIV viral load. More recently, reported outcomes seem to be similar in HIV-positive population and general population. Reports on a rise in local recurrence rates and in acute side effects along with a correlation with pre-treatment CD4 counts in HIV-positive patients, are not confirmed by all authors. The development of the first approved vaccine is a milestone in the field of anogenital cancers. However, many questions are still unresolved especially as concerns immunization in the setting of HIV infection.
Keywords: AIDS, anal cancer, HAART, HIV, HPV, treatment, CMT, HIV-positive, immune-suppression, lesions
Current HIV Research
Title: Anal Cancer: Focus on HIV-Positive Patients in the HAART Era
Volume: 9 Issue: 2
Author(s): Ernesto Zanet, Massimiliano Berretta, Ferdinando Martellotta, Bruno Cacopardo, Rossella Fisichella, Marcello Tavio, Salvatore Berretta and Umberto Tirelli
Affiliation:
Keywords: AIDS, anal cancer, HAART, HIV, HPV, treatment, CMT, HIV-positive, immune-suppression, lesions
Abstract: Anal cancer represents an increasing health problem, especially in immune-compromised patients, as HIVpositive patients. Notably, a significant higher incidence rate is reported among HIV infected patients with the advent of highly active antiretroviral therapy (HAART). To date, no randomised trial supports the correlation between existing screening strategies and reduced progression of anal intraepithelial neoplasia (AIN) to anal cancer or improved survival. Nevertheless, screening and treatment of AIN by topical agents should be implemented in high risk population. Data on invasive anal cancer treatment show that combined modality treatment (CMT) is the treatment of choice. Early reports on HIV-positive patients describe higher treatment toxicity and a relation with lower CD4 count and higher HIV viral load. More recently, reported outcomes seem to be similar in HIV-positive population and general population. Reports on a rise in local recurrence rates and in acute side effects along with a correlation with pre-treatment CD4 counts in HIV-positive patients, are not confirmed by all authors. The development of the first approved vaccine is a milestone in the field of anogenital cancers. However, many questions are still unresolved especially as concerns immunization in the setting of HIV infection.
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Zanet Ernesto, Berretta Massimiliano, Martellotta Ferdinando, Cacopardo Bruno, Fisichella Rossella, Tavio Marcello, Berretta Salvatore and Tirelli Umberto, Anal Cancer: Focus on HIV-Positive Patients in the HAART Era, Current HIV Research 2011; 9 (2) . https://dx.doi.org/10.2174/157016211795569087
DOI https://dx.doi.org/10.2174/157016211795569087 |
Print ISSN 1570-162X |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4251 |
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