RESUMEN
OBJECTIVE: Evaluate 1-year outcomes of cervical cancer screening and treatment using primary high-risk human papillomavirus (HPV) testing in women living with human immunodeficiency virus (HIV). DESIGN: Prospective cohort study. SETTING: HIV treatment centre in Botswana. POPULATION: Women living with HIV. METHODS: Participants underwent cervical cancer screening with high-risk HPV testing and triage evaluation at baseline and 1-year follow up. Excisional treatment was offered as indicated. Histopathology was the reference standard. MAIN OUTCOME MEASURES: Persistence, clearance and incidence of high-risk HPV infection; and persistence, progression, regression, cure and incidence of cervical dysplasia. RESULTS: Among 300 women screened at baseline, 237 attended follow up (79%). High-risk HPV positivity significantly decreased from 28% at baseline to 20% at 1 year (P = 0.02). High-risk HPV persistence was 46% and clearance was 54%; incidence was high at 9%. Prevalence of cervical intraepithelial neoplasia Grade 2 (CIN2) or higher was most common in participants with incident high-risk HPV (53%). CIN2 or higher was also common in those with persistent high-risk HPV (32%) and even in those who cleared high-risk HPV (30%). Of the high-risk HPV-positive participants at baseline with Asunto(s)
Alphapapillomavirus
, Detección Precoz del Cáncer/estadística & datos numéricos
, Infecciones por VIH/virología
, Infecciones por Papillomavirus/diagnóstico
, Neoplasias del Cuello Uterino/diagnóstico
, Adulto
, Botswana
, Cuello del Útero/virología
, Femenino
, Estudios de Seguimiento
, VIH
, Humanos
, Incidencia
, Persona de Mediana Edad
, Infecciones por Papillomavirus/epidemiología
, Infecciones por Papillomavirus/virología
, Prevalencia
, Estudios Prospectivos
, Factores de Tiempo
, Triaje
, Neoplasias del Cuello Uterino/epidemiología
, Neoplasias del Cuello Uterino/virología
, Displasia del Cuello del Útero/diagnóstico
, Displasia del Cuello del Útero/epidemiología
, Displasia del Cuello del Útero/virología