Imiquimod Treatment of Anal Intraepithelial Neoplasia in HIV-Positive Men

Abstract
Like cervical cancer, anal cancer is causally linked to persistent infection with high-risk human papillomavirus (HPV) types such as HPV-16 or HPV-18.1-3 In human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), anal HPV prevalence is approximately 90%, and infections with multiple HPV types are common.4-6 Consequently, HIV-positive MSM have a strongly increased risk for anal cancer and its precursor, anal intraepithelial neoplasia (AIN). Despite highly active antiretroviral therapy (HAART), the incidence and prevalence of AIN and anal cancer have not decreased in HIV-positive MSM.6-8 In a recent study, 52% of HIV-positive men presented with advanced AIN.6

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