Human Papillomavirus Infection of the Anal Canal and it's Relation to Anal Disease

Jenny McCloskey

    Research output: ThesisDoctoral Thesis

    2319 Downloads (Pure)

    Abstract

    [Truncated] Genital warts have been increasing in incidence over the last few decades to being the
    most common infection seen in clinics treating sexually transmissible infections prior
    to the advent of human papillomavirus quadrivalent vaccination. They have been
    thought to be a cosmetic and nuisance problem and only caused by low-risk genotypes
    of human papillomavirus. Research has demonstrated that warts are often mixed
    infections with both low and high-risk human papillomavirus infection present, and
    they are associated with intraepithelial neoplasia, and malignancy. Over the time this
    thesis has been written, the importance of anal cancer as an emerging entity has risen,
    particularly because even though it is a rare disease, there are increasing disease rates
    in both men and women, and it is considered to be in epidemic proportions in some
    sub populations (HIV-positive men and women, and HIV-negative men). In addition,
    ways of identifying anal cancer precursors have developed and include anal cytology
    and anal cytology screening for anal cancer precursors, and a highly specialised clinical
    skill called ‘high resolution anoscopy’ to recognise and histologically confirm the
    presence of anal precancer. In addition to my surgical skill of scissor excision of
    anogenital warts I have become proficient in high resolution anoscopy and
    consequently have been able to research the use of this skill along with cytology and
    histopathology to identify anal cancer precursor lesions in high-risk individuals. The
    HPV vaccines developed commercially to date are designed for HPV naive individuals,
    and hence for those with persistent HPV infection there is a need for a therapeutic
    vaccine or treatment.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2012

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