Godfrey Catherine, Firnhaber Cynthia S, D'Souza Gypsyamber, Heard Isabelle
1 National Institute of Allergy and Infectious Diseases, National institutes of Health Bethesda, MD, USA.
2 Clinical HIV Research Unit, Department of Internal Medicine, University of Witwatersrand, Johannesburg, South Africa.
Int J STD AIDS. 2017 May;28(6):543-549. doi: 10.1177/0956462415615764. Epub 2015 Nov 4.
Anal cancer may be an emerging clinical problem in HIV-infected women particularly in resource-limited settings. Human papillomavirus (HPV) infection is a precursor to anal cancer and is prevalent in HIV-infected women, but the natural history of HPV infection and anal cancer precursors is not well described in this population. It is not known which specific dysplastic lesions in the anus are most likely to progress, and whether treatment of high grade squamous intraepithelial lesion reduces the incidence of anal cancer in women. Cervical HPV infection and associated lesions may be related to the pathogenesis and natural history of anal disease. Cervical screening is resource intensive but some limited infrastructure exists in most areas where cervical cancer is prevalent. Anal screening, however is not performed. It may be that the infrastructure for cervical screening may be leveraged in developing the appropriate research, screening and treatment tools for anal dysplasia.
肛门癌可能是HIV感染女性中一个新出现的临床问题，尤其是在资源有限的环境中。人乳头瘤病毒（HPV）感染是肛门癌的前兆，在HIV感染女性中很普遍，但该人群中HPV感染及肛门癌前病变的自然史尚未得到充分描述。目前尚不清楚肛门中哪些特定的发育异常病变最有可能进展，以及高级别鳞状上皮内病变的治疗是否能降低女性肛门癌的发病率。宫颈HPV感染及相关病变可能与肛门疾病的发病机制和自然史有关。宫颈筛查资源消耗大，但在大多数宫颈癌流行地区存在一些有限的基础设施。然而，肛门筛查并未开展。或许可以利用宫颈筛查的基础设施来开发针对肛门发育异常的合适研究、筛查和治疗工具。
