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Imiquimod Improves Anal Neoplasia in Men with HIV

Clinical response seen in 77 percent of patients who followed treatment guidelines

THURSDAY, Nov. 23 (HealthDay News) -- The local immune response modifier imiquimod appears to be safe and effective for treating anal intraepithelial neoplasia in HIV-positive men, according to the results of an open-label pilot study published in the November issue of the Archives of Dermatology.

Alexander Kreuter, M.D., of the Ruhr University Bochum in Germany, conducted a prospective open-label trial of imiquimod cream or suppositories for 28 HIV-positive men with perianal or intra-anal neoplasia. Patients were asked to perform an overnight treatment three times a week for 16 weeks.

In all, 77 percent of patients who applied imiquimod as instructed showed clinical and histologic clearance by the end of treatment. The clinical response included a reduction in human papillomavirus (HPV) load and HPV types, and was still apparent after five months of follow-up in 78 percent of the original responders.

"The high primary response rates, the low recurrence rates, the significant decrease in HPV loads, and the tolerable side effects shown in this pilot study should encourage the initiation of larger studies to compare imiquimod therapy for anal intraepithelial neoplasia with ablative techniques," the authors conclude.

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