AIN is a treatment and is part of specialism hiv care

What is AIN?

AIN (anal intra-epithelial neoplasia) is defined as a change in the mucous membrane in and around the anus. With AIN there are abnormal cells in the mucous membrane. These abnormal cells can transform into anal cancer in 10-30% of cases. For this reason, AIN is treated as a precursor of anal cancer.


Origin of AIN

AIN is caused by the Human Papilloma Virus (HPV), the same virus that causes cervical cancer in women. The virus is probably present or was present in every sexually active person.


In HIV-positive (and HIV-negative) men who have sex with other men, AIN (and thus potentially anal cancer) occurs more often than in heterosexual men. Despite a properly customised medication, we can assume that the resistance of HIV-positive men is not capable of clearing HPV adequately enough.


In HIV-positive (and HIV-negative) men who have sex with other men, AIN (and thus potentially anal cancer) occurs more often than in heterosexual men. Despite a properly customised medication, we can assume that the resistance of HIV-positive men is not capable of clearing HPV adequately enough.


Diagnosis and treatment

Diagnosis

The screening for AIN is a preventive testing done to prevent complications around anal cancer.

Any aberrations become evident through High-Resolution Anoscopy (HRA). This is a strong microscope that enables the detection of aberrant cells at the micro level. This allows precursor stages of anal cancer and anal cancer itself to be detected early on.

We distinguish 4 different stages: no aberration, AIN 1, 2 or 3.

Treatment

If we diagnose AIN 2 or 3, the recommendation is to start treatment. There is not yet anal cancer, but definitely a precursor stage of it.

The treatment involves heat therapy. The areas of mucous membrane containing AIN 2 or 3 are burned away. This is done with an electric ‘pen’ that radiates heat. You are locally anaesthetised with lidocaine spray and an injection.

Sometimes a treatment with a cream, nitrogen or trichloroacetic acid is preferred. This is associated with your personal circumstances.

Check-ups

After a screening and/or treatment, you remain under the supervision of your anoscopy team.