微波联合光动力治疗男男性接触HIV感染者肛周尖锐湿疣的临床分析  

Combined treatment of perianal condyloma acuminatum inHIV seropositive men who have sex with men with microwave and photo-dynamic therapy

作　　者：李水凤[1] 卢斯汉[1] 胡荣欣[1] 杜健群[1] 李英[1] 王军雄[1] 吴琼贤 梁健瑜[1] 许婍娴 郭淑娟 Li Shuifeng;Lu Sihan;Hu Rongxin;Du Jianqun;Li Ying;Wang Junxiong;Wu Qiongxian;Liang Jianyu;Xu QiXian;Guo Shujuan(Department of Dermatology,Eighth People's Hospital of Guangzhou,Guangzhou 510030,China)

机构地区：[1]广州市第八人民医院皮肤性病科,510030

出　　处：《中华实验和临床病毒学杂志》2019年第1期70-73,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：广州市医药卫生科技项目(20171A011263)。

摘　　要：目的分析男男性接触HIV感染者肛周尖锐湿疣的临床特征及微波联合光动力治疗的疗效。方法对260例使用微波联合光动力治疗肛周尖锐湿疣的男男性接触者的临床、实验室资料和疗效进行分析比较。结果肛周尖锐湿疣男男性接触者大多数为青年(243/260),疣体位置以肛内型和肛内外型为主(245/260),其中HIV感染组肛外型所占比例(8/220)小于非HIV感染组(7/40)。所感染的HPV型别以11型(70/118)、6型(44/118)和16型(40/118)最常见,其中HIV感染者相比非HIV感染者更容易出现高危型、混合型和多重HPV感染。超过一半(146/260)的患者光动力治疗只需1~3次,且HIV感染组和非HIV感染组所需光动力治疗的次数和光敏剂的数量差异无统计学意义。HIV感染组复发率(13.6%,30/220)与非HIV感染组(15.0%,6/40)比较,差异无统计学意义,且远低于同期单纯行微波治疗的患者(45%,18/40)。结论微波联合光动力治疗能显著降低男男性接触HIV感染者肛周尖锐湿疣的复发率。Objective To analyze the clinical features of perianal condyloma acuminatum in HIV infected men who have sex with men (MSM) and assess the effects of combined treatment of microwave and photodynamic therapy.Methods Clinical and laboratory data of 260 male patients with perianal condyloma acuminatum were collected and microwave combined with photodynamic therapy was applied on them.Results The majority of the patients with perianal condyloma acuminatum were young people (243/260).Warts were mainly located in the anus or from the outside to inside of the anus (245/260).Among them,the proportion of warts position of extraanal in HIV-infected group (8/220) was lower than that of non-HIV-infected group (7/40).HPV types 11 (70/118),6 (44/118) and 16 (40/118) were the most common types of HPV infection.People with HIV infection were more likely to develop high-risk,mixed types HPV infection and multiple HPV infection than those without HIV infection.More than half of the patients (146/ 260) needed only 1-3 sessions of photodynamic treatments.There was no significant difference in the times of photodynamic treatments and the numbers of photosensitizers required between the HIV-infected and non-HlV-infected groups.The recurrence rate of HIV-infected group (13.6%,30/220) was also similar to that of non-HIV-infected group (15.0%,6/40),but far lower than those who underwent microwave therapy alone (45%,18/40).Conclusions The combination therapy significantly reduced the recurrence rate of perianal condyloma acuminatum in HIV infected MSM.

关 键 词：乳头状瘤病毒 人 尖锐湿疣 人类免疫缺陷病毒 光动力 

分 类 号：R512.91[医药卫生—内科学]