Postępowanie z pacjentem proktologicznym zakażonym wirusem HIV

*Małgorzata Kołodziejczak¹, Paweł Święcki², Agnieszka Kucharczyk¹, Ewa Firląg-Burkacka²

Summary
HIV infection is frequently accompanied by proctological diseases. According to various statistics from 6% up to 34% of seropositive patients suffer from them. Diseases of anorectal area are also the most frequent cause of the surgical intervention in patients infected with HIV. For the appropriate assessment of the patient infected with HIV before the surgery it is necessary to obtain recent results of tests from the HIV treatment clinic. Period of healing is growing proportionally to the stage AIDS progression, and the number of septic complications is inversely proportional to the CD4 lymphocytes count. This article presents methods of treatment of specific conditions in patients diagnosed with HIV and advanced AIDS: condylomas of perianal area and anal canal, fistulas, fissures, hemorrhoidal disease and abscesses. Indications for elective surgery should be considered with caution and surgeon should closely co-operate with specialist in infectious diseases when qualifying the HIV infected patient for surgery. Taking into consideration the growing number of patients infected with HIV and HPV, one should expect the considerable increase in the number of cases of anal cancer, what was reflected in numerous papers concerning the anal cancer during the last AIDS conference in Brussels.

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