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19.06.2024 | Humane Papillomviren | CME Fortbildung

HPV-bedingte anale Präkanzerosen

verfasst von: Dr. med. Luisa Bopp, Dr. med., Prof. Dr. med. Ulrike Wieland

Erschienen in: CME | Ausgabe 6/2024

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Zusammenfassung

Anale intraepitheliale Neoplasien (AIN) stellen Vorläuferläsionen des Analkarzinoms dar, und werden, wie über 90% aller Analkarzinome, durch persistierende Infektionen mit Hochrisiko (HR)-Humanen Papillomvirus (HPV)-Typen wie HPV16 verursacht. Anale HPV-Infektionen sind bei Männern und Frauen in den meisten Fällen transient. Bei Männern, die Sex mit Männern haben (MSM), insbesondere bei begleitender HIV-Infektion, sind anale HPV-Infektionen sehr häufig und oft persistierend, weswegen diese Patientengruppen Hochrisikopopulationen für AIN und Analkarzinome darstellen. Diagnostische Methoden zum Nachweis von intraanalen AIN sind die Analzytologie und die hochauflösende Anoskopie mit gezielter Biopsie-Entnahme für die Histologie. Bei der Therapie lassen sich ablative Möglichkeiten wie die elektrokaustische Abtragung von topischen Behandlungsmethoden wie Imiquimod oder Trichloresssigsäure unterscheiden, wobei alle Therapiearten hohe Rezidivraten aufweisen. Neuere Daten zeigen, dass AIN-Screening gefolgt von der Therapie höhergradiger AIN die Entstehung von Analkarzinomen reduzieren kann. Ein jährliches Analkrebsscreening sollte bei Hochrisikogruppen wie Personen mit HIV-Infektion erfolgen. Zur Senkung der Prävalenz von AIN und Analkarzinomen müssen die HPV-Impfraten bei jungen, HPV-naiven Personen deutlich erhöht werden.
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Metadaten
Titel
HPV-bedingte anale Präkanzerosen
verfasst von
Dr. med. Luisa Bopp, Dr. med.
Prof. Dr. med. Ulrike Wieland
Publikationsdatum
19.06.2024
Verlag
Springer Medizin
Erschienen in
CME / Ausgabe 6/2024
Print ISSN: 1614-371X
Elektronische ISSN: 1614-3744
DOI
https://doi.org/10.1007/s11298-024-3884-x

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