1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York 2Department of Medicine, Montefiore Medical Center, New York, New York 3Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Dis Colon Rectum. 2014 Jun;57(6):752-61. doi: 10.1097/DCR.0000000000000080.
Men who have sex with men have increased prevalence of both human papillomavirus and anogenital condyloma.
Risk factors for multiple treatment and recurrence of anal condyloma were examined.
This is a retrospective study of HIV-negative men who have sex with men who were treated for anal condyloma.
This study was conducted in a private surgical practice.
The patients were HIV-negative men who have sex with men, aged 18 years or older.
INTERVENTION(S): Ablation with electrocautery or CO2 laser was performed, as well as excision and topical imiquimod condyloma treatment adjuvant.
Primary clearance, defined as 4 months of condyloma-free survival posttreatment, and recurrence, defined as any anal condyloma diagnosis after primary clearance.
Of 231 participants, 207 achieved primary clearance (median age, 32.0 years) and were followed (median, 18.2 months) after primary treatment. Most had intra-anal and perianal condyloma (56%), were treated with electrocautery ablation (79.2%), and required 1 treatment (range, 1-6) for clearance. There were 57 recurrences (median, 12 months). One-third each had minimal, moderate, or extensive disease. Forty-six percent of patients received imiquimod posttreatment adjuvant. High-grade dysplasia was found in 31% at presentation and 43% during follow-up. Factors associated with requiring multiple treatments for clearance were participants having moderate disease (adjusted odds ratio, 6.0 (1.7-21.4)) and receiving imiquimod adjuvant (adjusted odds ratio, 4.7 (2.0-10.6)). No single factor predicted recurrence, but those with moderate disease experienced recurrences significantly sooner (median, 25 months of follow-up).
This was a retrospective chart review, it was limited to a single practice, and it excluded those who did not achieve primary clearance.
Most men who have sex with men have intra-anal and perianal condyloma and concomitant high-grade dysplasia is common. Most achieved clearance with 1 treatment. Having both intra-anal and perianal condyloma, increased severity of disease, and imiquimod adjuvant were significant predictors of requiring multiple treatments for clearance. No identified risk factors proved a significant predictor of recurrence.
男男性行为者的人乳头瘤病毒和肛门生殖器湿疣患病率均增高。
检查肛门湿疣多次治疗和复发的风险因素。
这是一项对接受肛门湿疣治疗的 HIV 阴性男男性行为者进行的回顾性研究。
这项研究在一家私人外科手术机构进行。
患者为 HIV 阴性男男性行为者，年龄 18 岁或以上。
用电灼或 CO2 激光进行消融，以及切除和局部咪喹莫特湿疣治疗辅助。
主要清除率，定义为治疗后 4 个月无湿疣生存；复发，定义为主要清除后任何肛门湿疣诊断。
231 名参与者中，207 名达到主要清除（中位年龄 32.0 岁），并在主要治疗后（中位随访 18.2 个月）接受随访。大多数人患有肛门内和肛门周围湿疣（56%），用电灼消融治疗（79.2%），并需要 1 次治疗（范围，1-6 次）以清除湿疣。57 人复发（中位时间 12 个月）。三分之一的人疾病程度轻微、中度或广泛。46%的患者接受了咪喹莫特辅助治疗。就诊时发现 31%有高级别上皮内瘤变，随访时发现 43%有高级别上皮内瘤变。需要多次治疗才能清除的因素包括中度疾病（调整后比值比，6.0[1.7-21.4]）和咪喹莫特辅助治疗（调整后比值比，4.7[2.0-10.6]）。没有单一因素可预测复发，但中度疾病患者复发时间更早（中位随访时间 25 个月）。
这是一项回顾性图表审查，仅限于一家机构，且排除了未达到主要清除的患者。
大多数男男性行为者有肛门内和肛门周围湿疣，且共同存在的高级别上皮内瘤变很常见。大多数人通过 1 次治疗达到清除。肛门内和肛门周围都有湿疣、疾病严重程度增加和咪喹莫特辅助治疗是需要多次治疗才能清除的显著预测因素。没有确定的风险因素是复发的显著预测因素。
