Anal Condyloma and Its Associations with HIV Infection-CMUH Experience

肛門尖形濕疣及其與人類免疫不全病毒之關聯－中國醫藥大學附設醫院之經驗

梁世國(Shi-Guo Liang) ； 蔡俊岳(Chun-Yueh Tsai) ； 張振昌(Chen-Chang Chang) ； 丁文謙(Wen-Chien Ting)

《中華民國大腸直腸外科醫學會雜誌》 16卷3期 (2005/09) Pp. 73-80

https://doi.org/10.6312/SCRSTW.2005.16(3).09410

摘要

目的　肛門尖形濕疣很難治療又很容易復發，它和人類免疫不全病毒的相關性又使其臨床變化更加複雜。我們回溯四年內在中國醫藥大學附設醫院所記錄的此類病例，旨在介定此類疾病之特徵、復發的危險因子，及其和人類免疫不全病毒的關聯。
方法　回溯性回顧三十七個因肛門尖形濕疣而住院接受手術的病人，收集相關臨床資料並予以分析其對復發的影響。受人類免疫不全病毒感染之病人之術前免疫狀況，亦做為復發因子之研究。
結果　所有病人平均接受71.6週的追蹤。主要臨床症狀為肛門腫塊，平均病程10.8週。33.3%的病人復發。年齡、性別、肛管內病灶、輔助治療、電燒灼次數及人類免疫不全病毒感染均非復發之危險因子。十個病人在術前已感染人類免疫不全病毒，其病毒量、CD4血球比率、CD4血球數均非復發之危險因子。其中三人是藉由術前篩檢而知。此三人中有二人有復發之情形，另一人於術後一個月住院、並於術後三個月後因廣泛性感染而死亡。
結論　肛門尖形濕疣易復發，危險因子並無法由此報告得知。此類病人易意外發現合併人類免疫不全病毒感染，故此類病人應接受人類免疫不全病毒的常規篩檢。

關鍵字

免疫不全病毒 ； 肛門尖形濕疣 ； 危險因子

並列摘要

Purpose. Anal condyloma is recurrent and difficult to treat. Its close association with human immunodeficiency virus (HIV) infection further complicates its clinical course. In the present study, we reviewed our experience of anal condyloma during the past four years. The goal was to determine disease characteristics, risk factors for recurrence, and association with HIV infection.
Methods. A retrospective review was performed on 37 consecutive patients who underwent surgical interventions for anal condyloma. Demographic details were recorded and used for analysis of risk factors for recurrence. Data of HIV-infected patients were analyzed to determine the effect of preoperative immune status on the risk factors for recurrence and on recurrence itself.
Results. Mean follow-up period was 71.6 weeks. Major presenting symptom was an anal mass. Mean duration of symptoms was 10.8 weeks. Anal condyloma recurred in 33.3% of patients. Age, gender, intra-anal canal lesion, adjuvant therapy, number of electrocauterization sessions, HIV status, and rapid plasma regain (RPR) status did not significantly increase relative risk for recurrence. Ten patients were HIV-infected preoperatively. HIV was detected incidentally in 3 of these by screening, anal condyloma was recurrent in 2 of the 3, and the third died from fulminant infection three months after surgery. Viral load, CD4 percentage, and CD4 counts insignificantly affected recurrence rate.
Conclusions. Anal condyloma recurs frequently after surgery. No risk factors for recurrence were identified. Incidental finding of HIV infection is relatively common. Thus, screening patients with anal condyloma for concurrent HIV infection is necessary.

並列關鍵字

HIV ； Anal condyloma ； Risk factors