Anorectal human papillomavirus: current concepts

Area of Science:

• Anorectal diseases
• Oncology
• Infectious diseases

Background:

• Anorectal human papillomavirus (HPV) infection is increasingly prevalent, associated with evolving sexual behaviors and human immunodeficiency virus (HIV) co-infection.
• Clinical manifestations and disease progression of anorectal HPV vary by viral serotype.
• HPV serotypes 6 and 11 cause benign warts, manageable with local treatments, while HPV 16, 18, and 31 are linked to precancerous lesions and anal squamous cell carcinoma.

Purpose of the Study:

• To highlight the clinical significance of anorectal HPV infection.
• To emphasize the importance of recognizing and managing HPV-related dysplastic lesions.
• To discuss current and emerging strategies for the prevention and treatment of anorectal HPV and associated cancers.

Main Methods:

• Review of clinical presentations and natural history of anorectal HPV infection based on serotypes.
• Evaluation of diagnostic and management strategies for benign and dysplastic anorectal lesions.
• Assessment of the impact of vaccination on anorectal HPV infection rates.

Main Results:

• HPV serotypes 6 and 11 are associated with benign anorectal warts, treatable with various local modalities.
• High-risk HPV serotypes (16, 18, 31) are implicated in dysplastic lesions with malignant potential, necessitating timely intervention.
• Early identification and management of high-grade dysplastic lesions are critical for preventing invasive anal cancer.
• Vaccination studies show promising efficacy for anorectal HPV prevention in specific populations.

Conclusions:

• Effective management of anorectal HPV involves distinguishing between low-risk and high-risk serotypes and lesions.
• Prompt eradication of high-grade dysplastic lesions is essential to prevent anal cancer progression.
• Vaccination strategies are evolving and show potential for reducing the burden of anorectal HPV infections and related cancers.