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https://observatorio.fm.usp.br/handle/OPI/33344
Title: | Hybrid capture as a tool for cervical lesions screening in HIV-infected women: insights from a Brazilian cohort |
Authors: | JALIL, Emilia Moreira; LUZ, Paula M.; QUINTANA, Marcel; FRIEDMAN, Ruth Khalili; MADEIRA, Rosa M. Domingues S.; ANDRADE, Angela Cristina; CHICARINO, Janice; MOREIRA, Ronaldo Isrnerio; DERRICO, Monica; LEVI, Jose Eduardo; RUSSOMANO, Fabio; VELOSO, Valdilea Goncalves; GRINSZTEJN, Beatriz |
Citation: | BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, v.22, n.1, p.16-23, 2018 |
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. (C) 2017 Sociedade Brasileira de Infectologia. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - IMT Artigos e Materiais de Revistas Científicas - LIM/52 Artigos e Materiais de Revistas Científicas - ODS/03 |
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art_JALIL_Hybrid_capture_as_a_tool_for_cervical_lesions_2018.PDF | publishedVersion (English) | 777.53 kB | Adobe PDF | View/Open |
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