AMC-046 Screen Failure Form Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus Source Form: NCI FormBuilder: NCT00550589



  1. 8/26/12 8/26/12 -
  2. 5/22/15 5/22/15 -
  3. 6/3/15 6/3/15 - Julian Varghese
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June 3, 2015


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AMC-046 Screen Failure Form NCT00550589

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  1. StudyEvent: AMC-046 Screen Failure Form
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Biopsy/Cytology Status
Anal cytology performed
Most Severe Anal Cytology Result (If yes Please record the result from the cytology form)
High-resolution anoscopy performed
Perianal biopsy performed
Perianal biopsy result (If yes)
Screen Failure
Primary reason for screen failure

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