Review Article
Larry Luber Martinez R, Juan D
Abstract
Anal cancer is a serious health problem in HIV-positive Men who have Sex with Men (MSM), and precursor lesions like anal intraepithelial neoplasia; are well defined. Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)- associated anal cancer precursor lesion, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men and women (MSMW). There is a paucity of data published on the progression of high-grade AIN to invasive cancer as well as on clinical and virological characteristics comparing anal margin and anal canal carcinoma. Men who are infected with HIV and MSM are at particularly high risk for persistent HPV infection and HPV-induced lesions. The treatment of high-grade squamous intraepithelial lesions (HISL) in HIV positive MSM associating the adjuvant vaccine against HPV is likely to be cost-effective, with benefits reported in the age group above 38 years. It is convenient to design large controlled studies that enroll the MSM population infected with HIV, as in our patient; to evaluate the benefits of the HPV vaccine.