A 34-year-old man visited the office after seeing white plaques on his buccal mucosa while cleaning his teeth. He was HIV positive after an adequate workup, with a CD4+ T lymphocyte count of 280/mm³. He was referred to an infectious diseases expert for further evaluation, but he failed to keep appointments. The patient returns three years later after suffering from perirectal discomfort and itching for several months. He also experiences occasional rectal bleeding and frequently sees bright red blood on tissue after wiping. Because he believed he had hemorrhoids, the patient did not seek medical attention. A solitary, hard mass with superficial ulceration of about 2x2 cm is discovered in the anal canal during inspection. No hemorrhoids are present. There is no palpable regional lymphadenopathy. Which of the following pathogens is most likely responsible for this patient's current anal pathology?

Question

Quizplus · Accepted Answer

Eductional Objective: Human papillomavirus (HPV) types 16 and 18 have been linked to anal and cervical squamous cell cancer, respectively. HIV infection raises the risk of HPV infection and anal cancer; this risk is heightened in males who have sex with men.

A 34-Year-Old Man Visited the Office After Seeing White Plaques