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HRA and IRC treatment
Feb 16, 2012

Hi Nelson and thank you for your support to this valuable forum.

I am a recently diagnosed with HIV. With meds luckily I am now UD with high CD4 and % with all labs in normal range.

Following your advice here in the forum, I had my first HRA in Sept 2011 and was diagnosed with extensive Condyloma acuminata (internal anal warts). I was given aldara to apply although I understand that this is not the normal treatment for internal warts. I will be having a follow up HRA next month for a review. Due to the difficulty in applying the aldara cream internally I expect my anal warts condition to have remained the same. At my last visit with the doctor we discussed IRC treatment in his office to treat at my next visit. Do you recommend IRC as the gold standard treatment of excessive internal anal warts or laser or other? Would you recommend to have the condyloma tissue for biopsy for diagnosis of type of HPV as well or is this not so important? Thank you

Response from Mr. Vergel

There are several ways to treat internal anal warts. Aldara suppositories is one of them, although this option may not be too effective in those with lots or large warts.Sometimes other options like Trichloracetic acid (TCA) 80-90% solution, electrosurgery and laser are used depending on the case. Extensive intra-anal warts are best removed under general anesthesia. You should review each option with your colon rectal doctor.

You may want to read these guidelines from the NY State Health Department so that you can discuss your options with your physician:

Human Papillomavirus (HPV)- Clinical Guidelines


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