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Internal Genital Warts
Mar 2, 2001

I was diagnosed HIV positive about five weeks ago, with a CD4 count of 750 and Viral Load of 91,000. In the same time period I began having rectal bleeding. A biopsy on the lesion indicates I have an internal genital wart. The doctor tells me it is pre-cancerous and should be removed. He also tells me it is unusual to have genital warts internally and he is communicating with others to determine best how to have it removed. So most of this is over my head. Do I have Cancer or not? What is my future with this? Oh yea, I am on Sustiva and Combivir; but at this time do not know the effectiveness of them, however, I am tolerating them very well.

Response from Dr. Dezube

Genital warts are caused by the HPV virus (human papilloma virus), which is different from the HIV virus. Although warts are NOT cancer, in time, they can lead to cancer both in the cervix (in women) and the anal cancer (both sexes). Typically there is an orderly transition from a pre-cancerous lesion to a cancerous one. The bottom line is that you probably do NOT have cancer from what you told me. HOWEVER, it would pay to have the warts removed since in time they will grow. Internal warts are NOT uncommon. We see them all the time. Although external warts can be treated with Aldara cream, it is harder to treat internal warts. Typically an anal surgeon (proctologist) will need to remove them surgically. We usually burn the base of the warts with a CO2 laser, but different surgeons will perform different procedures. Once they are removed, you will still need to have someone look up your anal canal on a regular basis to see whether they have come back.

If you are not currently practicing safe anal sex, I would recommend it for you can easily get reinfected with HPV and you can easily infect others with HPV.

GOOD LUCK.


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