[Contribution of human papillomavirus second-generation hybrid capture test for the diagnosis of cervical pathology in HIV-infected outpatients]. / Contribución de la captura de híbridos de segunda generación del virus del papiloma humano en el cribado de afección cervical en mujeres con infección por el virus de la inmunodeficiencia humana.

ABSTRACT

BACKGROUND AND OBJECTIVE: The causal relationship between human papillomavirus (HPV) and cervical cancer is well established. The initial diagnosis of HPV-related cervical infection is currently performed by HPV-associated changes in cervical cytology. We aimed to study the accuracy and concordance between HPV ADN detection by second-generation hybrid capture (HC-2) and cervical cytological changes for the diagnosis of HPV cervical infection in human immunodeficiency virus (HIV+) outpatients. PATIENTS AND METHOD: From March 1999 to August 2002, 139 HIV+ patients were included. HPV infection was determined by cytology and HC-2. The accuracy and level of concordance between both techniques was analyzed. RESULTS: The applicability of the HC-2 test was 96%. Sixty-eight (49%) patients were diagnosed with HPV infection by HC-2. High-oncogenetic-risk HPV genotypes were detected in 64 (46%) patients. The sensitivity, specificity and positive and negative predictive values of HC-2 in HPV detection were 78%, 69%, 61% and 83%, respectively. The concordance was K = 0.44 (95% confidence interval, 0.29-0.60); p < 0.001. CONCLUSIONS: The HC-2 diagnostic technique for HPV-related cervical infection in HIV+ patients is a sensitive and specific test. The combined use of both tests might increase the diagnostic efficacy, and hence have positive repercussions on cervical pathology screening on an outpatient basis.