Richel, O., Wieland, U., de Vries, H. J. C., Brockmeyer, N. H., van Noesel, C., Potthoff, A., Prins, J. M. and Kreuter, A. (2010). Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men. Br. J. Dermatol., 163 (6). S. 1301 - 1308. HOBOKEN: WILEY. ISSN 1365-2133
Full text not available from this repository.Abstract
Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical treatment of AIN, especially at the intra-anal location. Objectives To evaluate the efficacy and safety of self-administered topical 5-fluorouracil (5-FU) treatment of AIN in HIV-positive MSM. Methods High-resolution anoscopy (HRA) was performed and patients with AIN (grade 1-3) were treated with 5-FU twice weekly for a total of 16 weeks. HRA-guided lesional biopsies were repeated after 5-FU treatment for histopathological evaluation. Lesional swabs were obtained before and after treatment for HPV typing and HPV-DNA load determination of the high-risk types HPV16, 18, 31 and 33. Responding patients returned 6 months after treatment for follow-up. Results A total of 46 patients with AIN were included in this open prospective pilot study; 76% had multifocal disease and 74% had high-grade lesions (AIN 2 or 3). In an intention-to-treat analysis, 26 of 46 patients (57%) responded to 5-FU treatment. Eighteen patients (39%) had a complete clearance of AIN and eight patients (17%) had a partial response. Seventeen patients (37%) did not respond (unchanged grade of AIN in 16 patients and progression from low-to high-grade AIN in one patient). 5-FU treatment led to a significant decrease of HPV16-DNA load and cumulative high-risk HPV-DNA load in both responding and non-responding patients. Thirty-nine patients (85%) experienced side-effects during therapy, but only two discontinued 5-FU treatment. One patient was lost to follow-up. Six months later, 50% of the complete responders had a recurrence. Conclusions A substantial proportion of HIV-positive MSM with AIN completely cleared their lesions with topical 5-FU treatment. In those with partial response, pretreatment with topical 5-FU might facilitate subsequent ablative therapy.
| Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||
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| URN: | urn:nbn:de:hbz:38-491184 | ||||||||||||||||||||||||||||||||||||
| DOI: | 10.1111/j.1365-2133.2010.09982.x | ||||||||||||||||||||||||||||||||||||
| Journal or Publication Title: | Br. J. Dermatol. | ||||||||||||||||||||||||||||||||||||
| Volume: | 163 | ||||||||||||||||||||||||||||||||||||
| Number: | 6 | ||||||||||||||||||||||||||||||||||||
| Page Range: | S. 1301 - 1308 | ||||||||||||||||||||||||||||||||||||
| Date: | 2010 | ||||||||||||||||||||||||||||||||||||
| Publisher: | WILEY | ||||||||||||||||||||||||||||||||||||
| Place of Publication: | HOBOKEN | ||||||||||||||||||||||||||||||||||||
| ISSN: | 1365-2133 | ||||||||||||||||||||||||||||||||||||
| Language: | English | ||||||||||||||||||||||||||||||||||||
| Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||
| Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||
| Subjects: | no entry | ||||||||||||||||||||||||||||||||||||
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| URI: | http://kups.ub.uni-koeln.de/id/eprint/49118 |
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