       Document 0064
 DOCN  M9610064
 TI    High grade anal dysplasia in visually normal mucosa in homosexual men:
       seven cases.
 DT    9601
 AU    Surawicz CM; Critchlow C; Sayer J; Hurt C; Hawes S; Kirby P; Goldbaum G;
       Kiviat N; Department of Medicine, University of Washington School of;
       Medicine, Seattle, USA.
 SO    Am J Gastroenterol. 1995 Oct;90(10):1776-8. Unique Identifier : AIDSLINE
       MED/96023250
 AB    BACKGROUND: Anal cancer and anal human Papillomavirus (HPV) infection
       are increased in homosexual men. METHODS: We screened high risk
       homosexual men as part of a longitudinal study examining the effect of
       HIV infection on the risk of development of high grade anal
       intraepithelial neoplasia (AIN II, III). RESULTS: We found seven men who
       had histological evidence of AIN II-III with visually normal findings by
       anoscopy. Two men were HIV-seronegative, five were HIV-seropositive, and
       only one of the HIV-seropositive men had a low CD4 count < 200. Abnormal
       cytological results seen over follow-up periods of 3 months to 2.5 yr
       suggest the persistence of visually inapparent anal abnormalities. Two
       of the men had had small internal warts at earlier examinations, and
       three of the seven men subsequently developed visually abnormal anal
       findings. All men had HPV 16 DNA detected at some point. CONCLUSIONS: We
       hypothesize that high grade anal neoplasia may develop deep in the
       glands and can be detected by cytology before visible lesions are
       detected even with the aid of a colposcope. However, the implications of
       finding high grade anal cytology are not known at this time. Natural
       history studies are ongoing.
 DE    Adult  Anus/*PATHOLOGY  Anus Neoplasms/*PATHOLOGY/VIROLOGY  DNA,
       Viral/ANALYSIS  *Homosexuality, Male  Human  HIV
       Seropositivity/PATHOLOGY  Intestinal Mucosa/*PATHOLOGY  Longitudinal
       Studies  Male  Middle Age  Papillomavirus, Human/GENETICS/ISOLATION &
       PURIF  Risk Factors  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

