Hybrid capture as a tool for cervical lesions screening in HIV-infected women: insights from a Brazilian cohort
Jalil, Emilia Moreira; Luz, Paula M; Quintana, Marcel; Friedman, Ruth Khalili; Madeira, Rosa M Domingues S; Andrade, Angela Cristina; Chicarino, Janice; Moreira, Ronaldo Ismerio; Derrico, Monica; Levi, José Eduardo; Russomano, Fabio; Veloso, Valdilea Gonçalves; Grinsztejn, Beatriz.
Braz. j. infect. dis
; 22(1): 16-23, Jan.-feb. 2018. tab, graf
Artigo
em Inglês
| LILACS | ID: biblio-951626
ABSTRACT
Introduction:
Cervical cancer remains an important burden for HIV-infected women in the era of combination antiretroviral therapy. Recommendations for cervical screening in these women diverge and may include high-risk HPV (HRHPV) testing. We aimed to evaluate the clinical usefulness of a single HRHPV testing for cervical screening of HIV-infected women.Methods:
723 HIV-infected women from a Brazilian prospective cohort were included between 1996 and 2012. Inclusion criteria were normal cervical cytology at baseline and having a HRHPV-test at baseline. We calculated incidence rates of any squamous intraepithelial lesion (SIL) and high grade SIL+ (HSIL+) and negative predictive values (NPV) within 12 and 36 months. Hazard Ratios were obtained using Cox proportional hazards regression models.Results:
Incidence rate for both outcomes was low (9.9 cases per 100 PY [95% CI 8.8-11.0] for any SIL and 1.3 cases per 100 PY [95% IC 0.9-1.8] for HSIL+). Women with a HRHPV positive status at baseline had 1.7-fold (95% CI 1.3-2.2) and 3.2-fold (95% CI 1.5-7.1) increased risk of presenting any SIL and HSIL+, respectively, during follow-up. Negative-HRHPV test presented high NPV for both periods and outcomes (any SIL 92.4% [95% CI 89.7-94.6] for 12 months and 80.9% [95% CI 77.2-84.3] for 36 months; and HSIL+ 99.8% [95% CI 98.9-100.0] for 12 months and 99.0 [95% CI 97.6-99.7] for 36 months).Conclusions:
Incidence of any and high grade cytological abnormality was significantly higher among HIV-infected women with positive-HRHPV test. A single negative-HRHPV test helped reassure follow-up free of cytological abnormalities through three years of follow-up in HIV-infected women with negative cytology.
Biblioteca responsável:
BR1.1
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