{"title":"男同性恋HIV感染者中由人乳头瘤病毒引起的复发性巨大尖锐湿疣","authors":"Emy Kusumaningsih, Lita Setyowatie","doi":"10.20473/ijtid.v8i2.8375","DOIUrl":null,"url":null,"abstract":"Perianal giant condylomata acuminate (GCA) is a rare clinical condition associated with low-risk Human papillomavirus (HPV) type 6 and 11 infections. Human Immunodeficiency Virus (HIV) infection is one of the risk factors for GCA, that can increase the condylomata acuminate incidence and spread caused by HPV. A 28-year-old man came with a cauliflower-like mass complaint in his perianal and anal since 2 months ago. The patient did not complain of pain or itching on the mass but often bled when defecating. The patient is a male who has sex with men (MSM) and often changes partners. He has been diagnosed with HIV since 11 months ago and regularly taking anti-retroviral drugs, Efavirenz 600 mg daily. He was also diagnosed having lung tuberculosis at the same time, got 6 months treatment and was declared cured. The venereological examination of the perianal and anal region revealed erythematous and grayish stem-shaped vegetation and papules, verrucous surface, multiple, well defined, with 3 x 1.5 x 2 cm in size. A positive act of white examination was obtained. Blood tests revealed CD + 4 230 cells /μL. Polymerase chain reaction (PCR) examination for HPV obtained HPV types 6 and 11 infections. Histopathologic examination revealed acanthosis, papillomatosis, and hyperkeratotic epidermis and koilocytotic cells. The patient was treated with electrodesiccation three times but obtained mass in anal getting bigger with a size of 6 x 3 x 3 cm. Therefore, he agreed to be referred to the surgical department with an extensive surgical excision plan. Screening of GCA using PCR is not a routine examination but PCR has high sensitivity and specificity for determining the type of HPV, is useful for determining GCA prognosis and therapy, and is recommended for malignant and possible GCA recurrence detection","PeriodicalId":13538,"journal":{"name":"Indonesian Journal of Tropical and Infectious Disease","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"RECCURENT GIANT CONDYLOMATA ACUMINATA CAUSED BY HUMAN PAPILLOMA VIRUS IN HIV WITH HOMOSEXUAL MALE\",\"authors\":\"Emy Kusumaningsih, Lita Setyowatie\",\"doi\":\"10.20473/ijtid.v8i2.8375\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Perianal giant condylomata acuminate (GCA) is a rare clinical condition associated with low-risk Human papillomavirus (HPV) type 6 and 11 infections. Human Immunodeficiency Virus (HIV) infection is one of the risk factors for GCA, that can increase the condylomata acuminate incidence and spread caused by HPV. A 28-year-old man came with a cauliflower-like mass complaint in his perianal and anal since 2 months ago. The patient did not complain of pain or itching on the mass but often bled when defecating. The patient is a male who has sex with men (MSM) and often changes partners. He has been diagnosed with HIV since 11 months ago and regularly taking anti-retroviral drugs, Efavirenz 600 mg daily. He was also diagnosed having lung tuberculosis at the same time, got 6 months treatment and was declared cured. The venereological examination of the perianal and anal region revealed erythematous and grayish stem-shaped vegetation and papules, verrucous surface, multiple, well defined, with 3 x 1.5 x 2 cm in size. A positive act of white examination was obtained. Blood tests revealed CD + 4 230 cells /μL. Polymerase chain reaction (PCR) examination for HPV obtained HPV types 6 and 11 infections. Histopathologic examination revealed acanthosis, papillomatosis, and hyperkeratotic epidermis and koilocytotic cells. The patient was treated with electrodesiccation three times but obtained mass in anal getting bigger with a size of 6 x 3 x 3 cm. Therefore, he agreed to be referred to the surgical department with an extensive surgical excision plan. Screening of GCA using PCR is not a routine examination but PCR has high sensitivity and specificity for determining the type of HPV, is useful for determining GCA prognosis and therapy, and is recommended for malignant and possible GCA recurrence detection\",\"PeriodicalId\":13538,\"journal\":{\"name\":\"Indonesian Journal of Tropical and Infectious Disease\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indonesian Journal of Tropical and Infectious Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20473/ijtid.v8i2.8375\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indonesian Journal of Tropical and Infectious Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20473/ijtid.v8i2.8375","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
肛门周围巨大尖锐湿疣(GCA)是一种罕见的与6型和11型低风险人乳头瘤病毒(HPV)感染相关的临床疾病。人类免疫缺陷病毒(HIV)感染是GCA的危险因素之一,可增加尖锐湿疣的发病率和HPV引起的传播。一名28岁的男子自2个月前以来,肛门和肛周出现了花椰菜状的肿块。患者没有抱怨肿块疼痛或瘙痒,但排便时经常出血。患者是一名男性行为者(MSM),经常更换伴侣。自11个月前以来,他就被诊断出感染了艾滋病毒,并定期服用抗逆转录病毒药物,每天600毫克。同时,他还被诊断患有肺结核,接受了6个月的治疗,并被宣布治愈。肛周和肛门区域的性病学检查显示,有红斑和浅灰色的茎状植被和丘疹,表面有疣,多个,轮廓清晰,大小为3 x 1.5 x 2厘米。白色检查呈阳性。血液检查显示CD+4230细胞/μL。聚合酶链式反应(PCR)检测HPV获得6型和11型HPV感染。组织病理学检查显示棘皮病、乳头状瘤病、表皮角化过度和角质细胞增多。患者接受了三次电吸液治疗,但肛门肿块越来越大,大小为6 x 3 x 3厘米。因此,他同意转诊到外科,并制定了广泛的手术切除计划。使用PCR筛查GCA不是常规检查,但PCR对确定HPV类型具有高灵敏度和特异性,有助于确定GCA预后和治疗,并建议用于恶性和可能的GCA复发检测
RECCURENT GIANT CONDYLOMATA ACUMINATA CAUSED BY HUMAN PAPILLOMA VIRUS IN HIV WITH HOMOSEXUAL MALE
Perianal giant condylomata acuminate (GCA) is a rare clinical condition associated with low-risk Human papillomavirus (HPV) type 6 and 11 infections. Human Immunodeficiency Virus (HIV) infection is one of the risk factors for GCA, that can increase the condylomata acuminate incidence and spread caused by HPV. A 28-year-old man came with a cauliflower-like mass complaint in his perianal and anal since 2 months ago. The patient did not complain of pain or itching on the mass but often bled when defecating. The patient is a male who has sex with men (MSM) and often changes partners. He has been diagnosed with HIV since 11 months ago and regularly taking anti-retroviral drugs, Efavirenz 600 mg daily. He was also diagnosed having lung tuberculosis at the same time, got 6 months treatment and was declared cured. The venereological examination of the perianal and anal region revealed erythematous and grayish stem-shaped vegetation and papules, verrucous surface, multiple, well defined, with 3 x 1.5 x 2 cm in size. A positive act of white examination was obtained. Blood tests revealed CD + 4 230 cells /μL. Polymerase chain reaction (PCR) examination for HPV obtained HPV types 6 and 11 infections. Histopathologic examination revealed acanthosis, papillomatosis, and hyperkeratotic epidermis and koilocytotic cells. The patient was treated with electrodesiccation three times but obtained mass in anal getting bigger with a size of 6 x 3 x 3 cm. Therefore, he agreed to be referred to the surgical department with an extensive surgical excision plan. Screening of GCA using PCR is not a routine examination but PCR has high sensitivity and specificity for determining the type of HPV, is useful for determining GCA prognosis and therapy, and is recommended for malignant and possible GCA recurrence detection