Giant condyloma acuminatum in a patient with HIV infection: a case report

AIDS Research and Therapy https://doi.org/10.1186/s12981-026-00889-y Article in Press Giant condyloma acuminatum in a patient with HIV infection: a case report Chuanna Wang, Tianping Wang, Luhua Gao, Ye Zhang, Yushen Liu, Guozhan Jia, Zhuowei Zhao, Jing Li & Wen Kang Received: 11 March 2026 Accepted: 16 April 2026 Cite this article as: Wang C., Wang T., Gao L. et al. Giant condyloma acuminatum in a patient with HIV infection: a case report. AIDS Res Ther (2026). https://doi.org/10.1186/ s12981-026-00889-y A We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. E R P S S If this paper is publishing under a Transparent Peer Review model then Peer Review reports will publish with the final article. I T R E L C IN © The Author(s) 2026. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Giant condyloma acuminatum in a patient with HIV infection: A case report Chuanna Wang1,2†, Tianping Wang1†, Luhua Gao1†, Ye Zhang1, Yushen Liu1, Guozhan Jia3, Zhuowei Zhao4, Jing Li4*, Wen Kang1* ¹Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China ²School of Medicine, Yan’an University, Yan’an, Shaanxi, China ³Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China S S E ⁴Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China * Correspondence: Wen () † IN Kang E L C PR (); Jing Li I T AR These authors contributed equally to this work. Abstract Background Giant condyloma acuminatum (GCA), also known as Buschke-Löwenstein tumor, is a rare tumor-like lesion associated with human papillomavirus (HPV) infection. Although it is histologically benign, it behaves in a locally aggressive manner. GCA most commonly involves the external genitalia, perianal region, perineum, and rectum. It occurs more frequently in immunocompromised individuals, particularly those with advanced ACCEPTED ARTICLEMANUSCRIPT IN PRESS or suboptimally controlled human immunodeficiency virus (HIV) infection. Here, we report a case of perianal GCA in an HIV-infected patient and discuss the diagnostic and therapeutic challenges encountered, with the aim of informing clinical management of this disease. Case presentation We describe a 24-year-old man with a 7-year history of HIV infection who had suboptimal adherence to antiretroviral therapy (ART). Over the past 3 years, he developed a gradually enlarging perianal mass with intermittent bleeding and S S E purulent discharge. Over a 6-month period, he presented with PR progressive fatigue and exertional dyspnea. Laboratory evaluation IN revealed severe anemia and hypoproteinemia. The diagnosis of GCA E L C was established by histopathological examination of the perianal I T AR lesion, supported by imaging findings and clinical manifestations, and assessed for disease extent. He underwent wide local excision of the mass and received optimized antiretroviral therapy, cultureguided antimicrobial therapy, and supportive care. He experienced marked clinical improvement postoperatively. At 3-month follow-up, the wound had completely healed, anal sphincter function was preserved, and there was no evidence of recurrence. Conclusions This case illustrates a rare but clinically significant manifestation of HPV-related disease in the context of HIV- ACCEPTED ARTICLEMANUSCRIPT IN PRESS associated immunosuppression. GCA should be considered in the differential diagnosis for HIV-positive patients presenting with extensive anogenital masses. Early histopathological confirmation and multidisciplinary management facilitate timely diagnosis and intervention. Keywords Giant condyloma acuminatum (GCA), Buschke- Löwenstein tumor, HIV, HPV, Perianal disease, Immunosuppression, Case report Background S S E Giant condyloma acuminatum (GCA), also known as Buschke- PR Löwenstein tumor, is a rare condition associated with human IN papillomavirus (HPV) infection [1]. Its incidence has been estimated E L C to be approximately 0.1% in the general population, with a reported I T AR male-to-female ratio of 2.7:1 [2,3]. Although uncommon, cases have been reported during pregnancy [4]. Clinically, GCA most frequently involves the external genitalia, perianal region, perineum, and rectum [5]. Despite characteristics, GCA its generally exhibits benign clinically histopathological aggressive behavior, including infiltrative growth, frequent extension beyond 10 cm in maximum diameter, and marked local tissue destruction [6]. Multiple sexual partners, chronic genital inflammation, poor hygiene, and immunosuppression have been recognized as ACCEPTED ARTICLEMANUSCRIPT IN PRESS important risk factors for the development of GCA [7]. Individuals living with human immunodeficiency virus (HIV) are at particularly high risk of HPV acquisition due to impaired cellular immunity as well as shared routes of transmission. Accordingly, HIV-positive patients may experience more rapid progression and a higher likelihood of recurrence of GCA lesions, which can substantially complicate clinical management [8]. Given the rarity of GCA, highquality evidence regarding optimal treatment strategies and prevention remains limited. Here, we report a case of perianal GCA S S E in a 24-year-old man living with HIV. The patient achieved a PR favorable short-term outcome following guideline-concordant ART IN and complete surgical excision of the lesion. No recurrence was E L C observed at 3-month follow-up. I T AR Case presentation A 24-year-old man was admitted to our hospital on May 19, 2024, with a chief complaint of a progressively enlarging perianal mass over the prec (...truncated)