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anal warts; what follow up do you need if they have been removed?
Nov 8, 2002

My friend just had external warts removed and is HIV positive, what can I expect now that they have been removed, dose he need to be tested each year to see if they are coming back or just let it go, I am always going to be there for him no matter what.

Response from Dr. Dezube

Anal warts are caused by the HPV virus (human papilloma virus, also known as the wart virus). Although your friend's warts have been removed, he most likely still has an HPV infection. HPV infection is chronic and most patients, particularly HIV'ers, do not clear the infection. The lower the CD4 count, the greater the risk that the HPV infection will cause symptoms and disease. As a consequence, your friend should be followed at least yearly. Depending upon the expertise in your geographic area, such follow-up could include a PAP smear, anoscopy, or both. A PAP smear is a procedure by which a swab is inserted up the butt and the cells of the butt are examined for early signs of cancer. An anoscopy is a procedure where a scope is inserted up the butt so that a health provider can look at the cells lining the butt. The importance of follow-up, paricularly in HIV-positive patients, can not be stressed enough.


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