Diagnostic Test Accuracy of Mobile Colposcope, HR-HPV Testing, VIA for Detection of Cervical High-grade Squamous Intraepithelial Lesions in Women Living With HIV
Conditions: Uterine Cervical Neoplasms; HIV/AIDS Intervention: Diagnostic Test: Screening for HSIL Sponsors: University of Bern; Centre for Infectious Disease Research in Zambia; Cervical Cancer Prevention Program in Zambia; International Agency for Research on Cancer Not yet recruiting
Conclusion: HPV16 prevalence is lower in African American compared with Caucasian women with HIV and cervical precancer, independent of immune status. Future studies to determine why these racial differences exist are warranted, and whether there are similar associations between race and invasive cervical cancer in women with HIV. Further, HPV types not covered by quadrivalent and bivalent vaccines may play an especially important role in cervical precancer among HIV-positive African American women, a possible advantage to using nonavalent HPV vaccine in this population.
Conclusion: Most HIV+ women receiving care in a safety-net system did not receive sufficient screening for cervical cancer and remained at exceptionally high risk of developing high-grade dysplasia.
Conclusions: A recommended terminology for use in US colposcopic practice was developed, with comprehensive and minimal criteria for reporting.
Conclusions: Current cervical cancer screening guidelines for WLHIV are largely appropriate. CD4+ cell count may inform risk-tailored strategies.
Conclusion: With the goal to minimize the number of false negatives (e.g. not miss CIN2+ posttreatment) in this population that is high-risk due to both prior cervical disease and HIV infection, HR-HPV-based algorithms are recommended.
Conclusions p16INK4a ELISA did not perform well as a screening test for CIN2+ detection among HIV-infected women due to low specificity. Our study contributes to the ongoing search for a more specific alternative to HPV testing for CIN2+ detection.