Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus

DISEASE CHARACTERISTICS:

* Histologically confirmed perianal high-grade squamous intraepithelial lesions (HSIL) within the past 12 weeks

  * The perianal skin (i.e., perianus) is defined as extending radially 5 cm from the anal verge
  * Lesions must cover a surface area of ≥ 3 square centimeters
  * Lesions extending outside the perianus (e.g., vulvar lesions on the posterior perineum bordering the perianus) are allowed
* Serologic documentation of HIV infection AND meets 1 of the following criteria:

  * Has been on stable highly active anti-retroviral therapy (HAART) for ≥ 12 weeks prior to study entry
  * Has a CD4 count of \> 200/mm³ AND is not receiving anti-retroviral therapy OR is currently receiving a non-HAART\* anti-retroviral regimen with no plans to initiate HAART within the next 12 weeks NOTE: \* A non-HAART regimen is considered to be a therapy that does not include a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor
* No untreated invasive cancer of the lower genital tract
* No concurrent neoplasia requiring cytotoxic therapy

PATIENT CHARACTERISTICS:

* Karnofsky performance status 70-100%
* Life expectancy ≥ 3 months
* Hemoglobin ≥ 8 g/dL
* ANC ≥ 1,000/mm³
* Platelet count ≥ 75,000/mm³
* Creatinine \< 1.5 times upper limit of normal (ULN)
* Total or conjugated (direct) bilirubin ≤ 2.5 times ULN
* AST and ALT ≤ 3 times ULN
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for 3 months after completion of study therapy
* No acute, opportunistic infection other than oral thrush, yeast vaginitis, or genital herpes within the past 14 days

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Recovered from prior ablative or surgical treatment of perianal dysplasia
* At least 4 weeks since prior topical treatment for perianal dysplasia

  * If any prior treatment caused significant trauma to ther area, healing should occur prior to starting treatment
* More than 14 days since prior acute treatment for infection (other than for oral thrush, yeast vaginitis, or genital herpes) or other serious medical illness
* No concurrent corticosteroids other than replacement doses
* No other concurrent investigational drugs except IND-approved anti-retroviral agents
* No concurrent systemic cytotoxic chemotherapy