Case Study: A New Treatment for HPV Related Anal Neoplasia

Following random biopsies of a scar from a previous anal polyp removal 12 years prior, a 70 - year - old white female was diagnosed with a high grade squamous epithelial lesion in 2015. A year later she developed tenderness at the site and the lesion was found to be superficially invasive. She was HPV positive. Rather than the usual care of topical chemotherapy, laser, cryotherapy or further excision, with the help of her primary care physician she opted for lopinavir - ritonavir, an antiviral drug used in the treatment of HIV, that has been used experimentally to treat lesions related to HPV. She used the drug as an anal suppository twice daily for 2 weeks. It was repeated yearly. Treatment was started in 2017 and by March of 2018 the lesion was gone. By June of 2020 she was HPV negative and has remained so with no recurrence as of May 2024. Lopinavir - ritonavir is a relatively simple, effective treatment for HPV related anal lesions. More research is needed.