Predictors of Resolution and Recurrence of Anal High-Grade Squamous Intraepithelial Lesions in People With HIV
Joy C. Zhang, Maria C. Geba, Yvonne Newberry, Laura Quass-Ferdinand, Tania A. Thomas, Sook HoangObjective
High-resolution anoscopy (HRA) with ablation of high-grade squamous intraepithelial lesions (HSIL) can prevent the development of anal cancer in people with HIV (PWH). We sought to characterize factors associated with successful HSIL resolution or local or metachronous recurrence.
Methods
We conducted a retrospective study of 62 PWH who underwent HRAs from December 1, 2017 to July 1, 2022. Participants were ≥30 years old with ≥2 HRAs and ≥1 HSIL lesions. Poisson and logistic regressions were used to assess factors associated with HSIL resolution and local or metachronous recurrence of HSIL.
Results
Of 62 PWH, 85.5% had resolution of at least 1 HSIL. Undergoing ≥5 HRAs with thermoablation was associated with HSIL resolution (adjusted rate ratio [aRR] = 2.82) (confidence interval [CI] = 1.55–5.15),
Conclusion
Our study supports the utility of HRA/ablation for HSIL treatment with >85% of participants experiencing resolution of at least 1 HSIL. We found that having more HRAs was associated with a higher likelihood of resolution. However, the high rate of recurrence and progression to HSIL highlights the need for continued surveillance after treatment.