AIDS患者肛周似瘤样肥大性单纯疱疹:5例病例报道

• 作 者: Nadal S.R. Calore E.E. Manzione C.R. 陈云茹
• 机 构: Emlio Ribas Infectology Institute Proctology Section R. Dr. V. de C. Pinto 381 apt. 23 CEP 05415-03
• 出 处: 世界核心医学期刊文摘(胃肠病学分册)
• 发表日期: 2006年05期
• 关键词: 单纯疱疹 肛周 肥大性 细胞计数 单纯性疱疹病毒 疣状 人乳头瘤病毒 组织学检查 硬膜外麻醉 免疫组化法

Five patients (4 males; mean age, 46.4 years) with pain-ful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.

Five patients (4 males; mean age, 46.4 years) with pain-ful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4 + counts ranged from 73 to 370 / mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, consisting mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.