[AIDS and anorectal pathology]

Anorectal lesions are uncommon in patients infected by the HIV virus (13%, 1 female and 15 males in our personal series). Certain neoplastic lesions are specific and must suggest the possibility of AIDS: Kaposi sarcoma, non-Hodgkin's malignant lymphoma and, in young subjects, intra-epithelial dysplasias, carcinomas in situ or squamous cell of the anus. Other lesions encountered in proctology should also raise the suspicion of HIV infection: anorectal lesions of STD including florid papillomatosis, most frequently (25%) in its severe and recurrent form, extensive herpetic lesions refractory to the usual treatments, Cytomegalovirus ulcers. The clinical history, specifying sexual habits, a history of drug abuse and looking for the presence of chronic diarrhoea, and a complete clinical examination looking for lymphadenopathy are important elements to be considered in favour of the diagnosis. Apart from painful emergencies requiring an immediate surgical procedure, the therapeutic of the patient's general state, the stage of the disease and the expected benefit for the patient's comfort.