{ "abstract": "Purpose: To compare efficacy and safety of topical trichloroacetic acid (TCA) versus electrocautery (ECA) for the treatment of human papillomavirus (HPV)-associated anal intraepithelial neoplasia (AIN) in people living with HIV (PLWH).\n\nMethods: The TECAIN-study was a prospective, multicentre, randomised (1:1 block-randomisation), open-label, non-inferiority trial in PLWH with histologically confirmed AIN recruited from seven German proctological units. The primary endpoint (PE) was therapeutic success defined as a combination of complete clinical response evaluated by high-resolution-anoscopy and histological AIN-clearance/regression four weeks after the end-of-treatment (4-weeks-follow-up, 4WFU). Secondary endpoints were assessed at 4WFU and 24WFU. Efficacy was analysed in the intention-to-treat-population as primary analysis with a non-inferiority margin of -12%.\n\nResults: Of 659 PLWH screened with HRA, 257 patients with AIN were randomised. Therapeutic outcome was assessed in 233 PLWH (TCA n = 118, ECA n = 115). The PE was reached in 62 patients of the TCA-group (52.5%) versus 71 patients of the ECA-group (61.7%) (difference in proportion − 9.2%, 95%CI -21.8% to 3.5%). While non-inferiority of TCA could not be shown for the PE at 4WFU, TCA was non-inferior to ECA at 24WFU (therapeutic success 50.8% vs. 48.7% (difference 2.2%, 95%CI -10.7% to 15.0%)). Adverse events occurred in 67.8% in both groups at 4WFU (mostly mild or moderate). Severe treatment-related pain was significantly less frequent in the TCA-group (4.2%) compared to the ECA-group (14.8%). HPV-findings did not differ between treatment groups between baseline and follow-up visits.\n\nConclusion: TCA is an effective, well-tolerated and less complex alternative to ECA for the treatment of AIN in PLWH.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02882-z.", "abstract_shown": true, "affiliations": [ "Department of Dermatology and Venereology, Clinic for Dermatology and Venerology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany", "HPSTD (HIV/AIDS, Proctology, STD) Outpatient Clinic, University Hospital Essen, University Duisburg-Essen, Essen, Germany", "Department of Dermatology, Venereology and Allergology, Helios St. Elisabeth Hospital, University Witten/Herdecke, Oberhausen, Germany", "WIR – Walk In RuhrInterdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Bochum, Germany", "Present Address: Derma Center, Rietkötter & Jablonka, Gelsenkirchen, Germany", "Department of Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany", "Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany", "Department of General, Visceral, Thoracic and Vascular Surgery, Colorectal Surgery and Proctology, University Hospital Bonn, Bonn, Germany", "Present Address: Department of General, Visceral and Coloproctological Surgery, Evangelical Amalie Sieveking Hospital, Hamburg, Germany", "Centre for Clinical Studies Essen, c/o IMIBE, University Hospital Essen, Essen, Germany", "Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, Essen, Germany", "Institute of Virology, National Reference Centre for Papilloma-and Polyomaviruses, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany" ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0, 1 ], "name": "Stefan Esser", "orcid": "0000-0002-3625-9650" }, { "affs": [ 2 ], "name": "Alexander Kreuter", "orcid": "0000-0003-2275-499X" }, { "affs": [ 3 ], "name": "Anja Potthoff", "orcid": "0000-0001-5323-1281" }, { "affs": [ 0, 1, 4 ], "name": "Robert Jablonka" }, { "affs": [ 5 ], "name": "Mark Oette", "orcid": "0000-0003-0832-3309" }, { "affs": [ 6 ], "name": "Martin F. Sprinzl", "orcid": "0000-0002-4544-9560" }, { "affs": [ 7, 8 ], "name": "Daniel Exner", "orcid": "0000-0003-4876-1805" }, { "affs": [ 9 ], "name": "Konstantinos Bilbilis", "orcid": "0009-0008-8746-409X" }, { "affs": [ 10 ], "name": "Hildegard Lax", "orcid": "0000-0001-6808-7438" }, { "affs": [ 10 ], "name": "Eva-Maria Huessler", "orcid": "0000-0002-8144-5428" }, { "affs": [ 11 ], "name": "Steffi Silling", "orcid": "0000-0002-9555-3876" }, { "affs": [ 11 ], "name": "Ulrike Wieland", "orcid": "0000-0003-3480-4413" } ], "bibtex": "https://research.draconitic.com/paper/2acb6fkyr1djb.bib", "cited_by": 2, "doi": "10.1007/s15010-026-02882-z", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13727835/", "id": "2acb6fkyr1djb", "issns": [ "0300-8126", "1439-0973" ], "landing_url": "https://doi.org/10.1007/s15010-026-02882-z", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Research" ], [ "openalex", "2746|Colorectal and Anal Carcinomas" ] ], "openalex": "W7167941958", "pdf_url": "https://link.springer.com/content/pdf/10.1007/s15010-026-02882-z.pdf", "pmcid": "PMC13727835", "pmid": "42430115", "published": "2026-07-10", "publisher": null, "ris": "https://research.draconitic.com/paper/2acb6fkyr1djb.ris", "sources": [ { "first_seen": "2026-11-06T12:23:38Z", "native_id": "PMC13727835", "source": "pmc", "url": "https://doi.org/10.1007/s15010-026-02882-z" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2746|Colorectal and Anal Carcinomas", "subfield": "surgery" } ], "title": "Topical trichloroacetic acid versus electrocautery for treatment of anal intraepithelial neoplasia in people living with HIV: a multicentre, randomised, non-inferiority trial (TECAIN-study)", "title_text": "Topical trichloroacetic acid versus electrocautery for treatment of anal intraepithelial neoplasia in people living with HIV: a multicentre, randomised, non-inferiority trial (TECAIN-study)", "type": "peer-reviewed", "updated_at": "2026-11-07T12:20:57Z", "url": "https://research.draconitic.com/paper/2acb6fkyr1djb", "venue": "Infection", "versions": [] }