[Anorectal diseases in HIV-positive patients. A prospective study].

BACKGROUND

The acquired immunodeficiency syndrome (AIDS) has transformed in a illness pandemic and it is thought that 120 million of people will be infected by the year 2000. About thirty five percent of HIV positive patients will have rectal manifestations during their illness, and from these the most important anorectal manifestation are perianal sepsis, anal condyloma, hemorrhoidal disease, chronic diarrhea syndrome, anal ulcer and anorectal tumors.

PURPOSE: To determinate in our medical environment which anorectal manifestation have the most frequency in HIV positive patients.

PATIENTS AND METHOD: We developed a linear prospective, comparative and observational trial between December 1993 and December 1994, which included 83 patients distributed in 4 groups: 1) HIV homosexual patients with AIDS, 2) positive HIV homosexual patients without AIDS, 3) negative HIV homosexual patients, 4) negative HIV heterosexual patients. The statistical analysis was done through a chi 2 (Chi square) test.

RESULTS

In homosexual HIV patients with the disease, the most common lesion was the anal ulcer (55%). In positive HIV homosexual patients without disease and negative HIV homosexual patients the most frequent lesion is Condyloma acuminata (48 y 84%). In negative HIV heterosexual patients the most frequent disease was anal fistula (40%) and hemorrhoidal disease (36%).

CONCLUSION

In negative HIV patients and positive HIV patients without disease the most frequent anorectal lesion is condyloma acuminata; when immunosuppression begins by AIDS, anal ulcer appears and is transformed in the most frequent anorectal disease in AIDS patients.