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Anal Warts an concern
Aug 30, 2000

I have been HIV positive since 1989, but since June of 1999, I started slowly developing anal warts. My doctor has finally agreed to provide some treatment - but the acid in "Wartoc" is hurting and burning. I feel that in men, doctors are not so quick to treat, not wanting to recognize that for many of us, our anus is as much a sexual organ as the vagina is for women. Is there anything less invasive that can be given for treatment? They are uncomfortable, and not very pleasant. One dermatologist suggested that in time they would go away as my viral load should go up with successful VL counts. My CD4 has been 10-20 for three years so I don't think so. Surgery is too invasive as far as my current pair of physicians are concerned. Any advice?? I am concerned about anal cancer developing as a result of not treating. Should I be concerned?

Bob In Canada

Response from Dr. Boyle

Dear Bob:

There are many treatments for anal warts, some of which you have listed, and consulting with your dermatologist and perhaps a surgeon may help you to evaluate which is best for you. Many patients have problems with the topical treatments, and surgical removal or electro-surgery are effective options. Anal cancer (related to Human papilloma virus or "HPV") is a potential problem and over the past 2 decades there has been a significant increase in the incidence of this disease in gay men. This is another reason for treatment/removal of the warts. Screening for anal cancer can be done with an anal Pap smear, but this underestimates the its incidence. Anal colposcopy, anoscopy, and biopsy are other methods of evaluating for anal cancer. You should discuss these with your doctor and decide on what is appropriate for you. Further information can be found at www.medscape.com.

Brian Boyle, M.D., J.D.



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