PMID- 28695429 OWN - NLM STAT- MEDLINE DCOM- 20180828 LR - 20181113 IS - 1179-1888 (Electronic) IS - 1175-0561 (Print) IS - 1175-0561 (Linking) VI - 19 IP - 1 DP - 2018 Feb TI - Cryotherapy for Intra- and Perianal High-Grade Squamous Intraepithelial Lesions in HIV-Positive Men who have Sex with Men. PG - 127-132 LID - 10.1007/s40257-017-0311-z [doi] AB - BACKGROUND: Available treatment options for anal high-grade squamous intraepithelial lesions (HSIL) in HIV-positive men who have sex with men (MSM) are limited by low response rates and frequent recurrences. Cryotherapy is an established therapeutic option for several pre-malignant skin disorders. METHODS: This retrospective, non-randomized study included HIV-positive MSM who received intra- and/or perianal HSIL cryotherapy treatment between 30 December 2008 and 23 April 2015. Cryotherapy was applied in sessions 4-6 weeks apart for a maximum of five sessions. Patients received a follow-up high-resolution anoscopy (HRA) to assess treatment response. Complete and partial treatment responders were followed-up after 6 months and then every 6-12 months to investigate recurrent HSILs. RESULTS: Of 64 patients [median age 48 years; interquartile range (IQR) 42-56] included in the study, six were lost to follow-up. In total, 35 (60%) of 58 patients responded to treatment. Of 64 patients, 31 (48%) reported one or more side effects, of which anal pain or tenderness and mild blood loss were reported most frequently. A total of 19 patients who responded to cryotherapy were adequately followed-up for over 18 months, of whom 13 (68%) had recurrent HSILs. CONCLUSION: Cryotherapy is capable of clearing HSIL in HIV-positive MSM, and treatment success rates are comparable with those reported for current treatment modalities. The treatment is well tolerated, and side effects are relatively mild. Future studies should therefore compare the efficacy and tolerability of cryotherapy with those of current treatment modalities in randomized controlled trials. FAU - Siegenbeek van Heukelom, Matthijs L AU - Siegenbeek van Heukelom ML AUID- ORCID: 0000-0001-9062-4105 AD - Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Room F4-106, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.l.vanheukelom@amc.uva.nl. AD - Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. m.l.vanheukelom@amc.uva.nl. AD - Department of Dermatology, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. m.l.vanheukelom@amc.uva.nl. FAU - Gosens, Karien C M AU - Gosens KCM AD - Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. AD - Department of Dermatology, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. FAU - Prins, Jan M AU - Prins JM AD - Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Room F4-106, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. AD - Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. FAU - de Vries, Henry J C AU - de Vries HJC AD - Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. AD - Department of Dermatology, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. AD - STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), 1018 WT, Amsterdam, The Netherlands. LA - eng PT - Journal Article PL - New Zealand TA - Am J Clin Dermatol JT - American journal of clinical dermatology JID - 100895290 SB - IM MH - Adult MH - Anal Canal/diagnostic imaging/pathology/surgery MH - Anus Neoplasms/diagnostic imaging/etiology/pathology/*surgery MH - Carcinoma, Squamous Cell/diagnostic imaging/etiology/pathology/*surgery MH - Colposcopes MH - Cryosurgery/adverse effects/*methods MH - Dermatologic Surgical Procedures/adverse effects/methods MH - Endoscopy, Gastrointestinal/instrumentation/methods MH - Feasibility Studies MH - Follow-Up Studies MH - HIV Seropositivity/*complications MH - Humans MH - Male MH - Middle Aged MH - Neoplasm Recurrence, Local/diagnostic imaging/epidemiology/pathology/*surgery MH - Retrospective Studies MH - Sexual and Gender Minorities MH - Skin/pathology MH - Treatment Outcome PMC - PMC5797558 COIS- INFORMED CONSENT: Not applicable. ETHICS APPROVAL: Not applicable. FUNDING: No sources of funding were used to conduct this study or prepare this manuscript. CONFLICT OF INTEREST: MLSH, KCMG, HJCV, and JMP have no conflicts of interest. EDAT- 2017/07/12 06:00 MHDA- 2018/08/29 06:00 PMCR- 2017/07/10 CRDT- 2017/07/12 06:00 PHST- 2017/07/12 06:00 [pubmed] PHST- 2018/08/29 06:00 [medline] PHST- 2017/07/12 06:00 [entrez] PHST- 2017/07/10 00:00 [pmc-release] AID - 10.1007/s40257-017-0311-z [pii] AID - 311 [pii] AID - 10.1007/s40257-017-0311-z [doi] PST - ppublish SO - Am J Clin Dermatol. 2018 Feb;19(1):127-132. doi: 10.1007/s40257-017-0311-z.