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HIV — SCE Infectious Diseases MCQ

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HardHIV MedicineHIVSCE Infectious Diseases

A man living with HIV has biopsy-confirmed anal high-grade squamous intraepithelial lesion after high-resolution anoscopy. In a service able to provide treatment and structured surveillance, which strategy is supported by the ANCHOR trial?

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Correct answer: C — Treat HSIL by ablation or excision with protocolised post-treatment surveillance

ANCHOR showed that treating anal HSIL in people with HIV reduced progression to anal cancer compared with active monitoring. Treatment may be ablative or excisional and requires structured surveillance because recurrence is common. HPV vaccination prevents future infection but does not eradicate established HSIL; neither proctectomy nor ART intensification is routine treatment.

Reference: ANCHOR trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2201048