Pre-cancerous cell changes sometimes 'hidden' in anal warts of gay men

via Aidsmap, by Michael Carter

Cancerous or “high-grade” pre-cancerous cells changes were detected in a high proportion of anal warts surgically removed from gay men, US investigators report in the July 1^st edition of Clinical Infectious Diseases.

The investigators believe that their findings could have implications for the management of anal warts.

There are two types of human papilloma virus (HPV) that can infect the anogenital tract. Strains of the virus that cause cauliflower-like anogential warts involve a low risk of anal cancer. However, some strains of the virus, especially HPV 16 and 18, can cause anal cancer and its precursor, the pre-cancerous cell changes called high-grade anal intraepithelial neoplasia (AIN).

Investigators wished to see if there was evidence of occult – or hidden – anal cancer or pre-cancerous cell changes in the anal warts which were surgically removed from 320 gay men, 50% of whom were HIV-positive. 

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HIV-positive men at high risk for anal cancer - not all of us aware

via EDGE Boston, by Matthew S. Bajko

Cancer researchers have found that since the introduction of highly active antiretroviral therapy HIV-positive men’s chances of having human papillomavirus (HPV) related anal cancers have increased. Yet many are not only unaware of their heightened risk but also do not know to seek HPV screening.

The lack of attention paid to HPV infections among HIVers has led to an incidence rate of anal cancer among HIV-positive men that now exceeds the highest incidence of cervical cancer among women reported anywhere in the world, recent studies have found.

"The incidence of human papillomavirus-associated anal cancer is unacceptably high among HIV-positive men who have sex with men, and possibly in HIV-positive women. Unlike most other malignancies occurring in the HIV-positive population, anal cancer is potentially preventable, using methods similar to those used to prevent cervical cancer in women," wrote Dr. Joel M. Palefsky, the co-leader of the cancer and immunity program at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, in an article this year in the medical journal Current Opinion in Oncology. "The high incidence of anal cancer among HIV-positive individuals must not be ignored, since it may be preventable."

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Anal warts and anal gonorrhoea associated with HIV infection in gay men

by Roger Pebody, via Aidsmap

The two sexually transmitted infections most strongly associated with HIV acquisition in gay and bisexual men are anal warts and anal gonorrhoea, Australian researchers report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

Herpes infections did not emerge as significant in this study, but men with warts were three times more likely to acquire HIV, and men with gonorrhoea were seven times as likely. The authors suggest that more frequent screening for anal sexually transmitted infections in gay men should be investigated as a means of HIV prevention.

Numerous observational studies have suggested that sexually transmitted infections (STIs) facilitate the acquisition and transmission of HIV. However most studies have been conducted among heterosexuals, and previous prospective studies have not examined the full range of sexually transmitted infections that are common in gay and bisexual men.

In particular, genital or anal warts have often been overlooked, and many studies have not distinguished between genital and anal infections.

Warts are caused by infection with certain strains of the human papilloma virus (HPV). Infection with other strains of HPV may lead to cervical or anal cancer, but people with warts are not more likely to develop cancer. A recent study found that men infected with cancer-causing HPV are more likely to acquire HIV.

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The art of preventing genital warts

via Fridae, by Jan Wijngaarden

It can be quite a shock when you get them, or perhaps even more if you encounter them unexpectedly in a partner, when feeling someone up – they feel like little hard / rough cauliflower-shaped heaps on the surface of the skin. Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or penis area, or around the anus. Click here to see an image. Be warned: It's not pretty.)

Genital (including anal) warts are caused by some subtypes of the Human Papilloma Virus (HPV), which is the most common sexually transmitted disease in many countries where data is available, including in the US, where the CDC estimates that over 20 million people are infected. It is easily transmitted, but in most people never leads to complications. This is exactly why HPV is spreading fast among gay men.

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