Anal dysplasia in HIV-infected women with cervical and vulvar dysplasia Journal Article


Authors: Stier, E. A.; Krown, S. E.; Chi, D. S.; Brown, C. L.; Chiao, E. Y.; Lin, O.
Article Title: Anal dysplasia in HIV-infected women with cervical and vulvar dysplasia
Abstract: Objective. To describe the findings of high-resolution anoscopy (HRA) in human immunodeficiency virus (HIV)-infected women with a history of lower genital tract dysplasia. Materials and Methods. A retrospective chart review of all HIV-infected women undergoing HRA from 2002 to 2003 was conducted. Demographic and clinical information, including the most recent cervical and vaginal cytologic results and colposcopic evaluations, were collected from medical records. These data were compared with anal cytologic and histologic findings from HRA. Results. Eight patients were identified, with a mean age of 42 years. The mean duration of known HIV infection was 12 years. All eight patients had a previous history of treatment for cervical dysplasia or carcinoma. Five patients also had a history of high-grade vulvar dysplasia. The most recent cervical and vaginal cytologic results for all patients were abnormal. Seven patients underwent HRA because of suspected anal intraepithelial neoplasia (AIN); of these, four patients had perianal warts and three had diffuse high-grade vulvar dysplasia. One patient was referred for HRA because of high-grade dysplasia on vaginal cytologic analysis with a negative colposcopic and urologic evaluation. All eight patients (100%) had abnormal anal cytologic results with histologically proven AIN. Five patients had AIN 2,3, and three patients had AIN 1 and anal condyloma. Two of the three patients with AIN 1 had high-grade perianal dysplasia. Conclusions. High-resolution anoscopy identified anal dysplasia in 100% of eight HIV-infected women with human papilloma virus-related dysplasia of the lower genital tract. High-resolution anoscopy should be considered as part of the evaluation for the extent of disease in HIV-infected women with cervical and vaginal dysplasia, condyloma, and dysplasia of the perineum.
Keywords: adult; clinical article; human immunodeficiency virus infection; hysterectomy; antiretrovirus agent; virus load; cd4 antigen; endoscopic biopsy; endoscopy; lymphocyte count; uterine cervix cytology; dysplasia; colposcopy; uterine cervix dysplasia; uterine cervix carcinoma in situ; uterine cervix conization; rectum biopsy; condyloma; hpv; vulva disease; vagina cytology; anal dysplasia; anus disease; vulvectomy; human; female; article; hiv-infected women; vulvar dysplasia
Journal Title: Journal of Lower Genital Tract Disease
Volume: 8
Issue: 4
ISSN: 1089-2591
Publisher: Lippincott Williams & Wilkins  
Date Published: 2004-10-01
Start Page: 272
End Page: 275
Language: English
DOI: 10.1097/00128360-200410000-00002
PROVIDER: scopus
PUBMED: 15874871
DOI/URL:
Notes: J. Lower Genital Tract Dis. -- Cited By (since 1996):8 -- Export Date: 16 June 2014 -- CODEN: JLGDF -- Source: Scopus
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MSK Authors
  1. Elizabeth Yu Chiao
    7 Chiao
  2. Carol Brown
    161 Brown
  3. Dennis S Chi
    658 Chi
  4. Oscar Lin
    295 Lin
  5. Elizabeth A Stier
    12 Stier
  6. Susan Krown
    155 Krown