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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Colposcopy is not necessary to assess the risk to the cervix in HIV-positive women: An international cohort study of cervical pathology in HIV-1 positive women
International Journal of Cancer, Volume 121, No. 11, Year 2007
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Description
The objectives of this prospective multicentre international cohort study are to describe the characteristics of a cohort of HIV-1 positive women and determine the best management system by comparing cervical pathology according to results of cytology, colposcopy and human papillomavirus (HPV) testing at baseline and throughout follow-up. A. Cohorts of known HIV-positive women were recruited from 6 hospital-based European centres and a community-based South African centre. Following registration, women were reviewed every 6 months to undergo cervical surveillance including cytology, colposcopy, histopathology and HPV testing, using the HPV hybrid capture assay. Independent risk factors for the incidence of cytological abnormality and acquisition/clearance of HPV infection during follow up were identified. A total of 1,534 women were recruited, 400 of which were from South Africa. At baseline, among European women, 66% had normal cytology and half were HPV negative and among South African women, 45% had normal cytology and one third (32%) were HPV negative. The sensitivity of cytology (≥ASCUS) matched with that of colposcopy to detect CIN2+. Rate of detection of high grade CIN at 2 years was similar in European and South African women (11 and 9.3%, respectively). Cytology and HPV testing alone were each sufficiently sensitive as a screening test at 2 yearly intervals. Our data confirm the high prevalence of low-grade cytological abnormalities and high-risk HPV infection. Cytology appears to be sufficient for cervical surveillance, with HPV testing being less specific with poor positive predictive value. There appears to be no additional benefit from routine colposcopy. © 2007 Wiley-Liss, Inc.
Authors & Co-Authors
Kitchener, Henry Charles
United Kingdom, Manchester
The University of Manchester
United Kingdom, London
St Mary's Hospital
Nelson, Linsey
United Kingdom, Manchester
The University of Manchester
Adams, Joanna
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Mesher, David
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Sasieni, Peter David
United Kingdom, London
Barts and the London School of Medicine and Dentistry
Cubie, Heather Ann
United Kingdom, Edinburgh
Royal Infirmary of Edinburgh
Moore, Catherine
United Kingdom, Edinburgh
Royal Infirmary of Edinburgh
Heard, Isabelle
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Agarossi, Alberto
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Casolati, Elena A.
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Denny, Lynette A.
South Africa, Cape Town
University of Cape Town
Bradbeer, Caroline
United Kingdom, London
St Thomas' Hospital
Lyons, Fiona
Ireland, Dublin
St James's Hospital
Beattie, Gerry
United Kingdom, Edinburgh
Nhs Lothian
Niemieç, Tomasz
Poland, Warsaw
Instytut Matki I Dziecka
Statistics
Citations: 44
Authors: 15
Affiliations: 11
Identifiers
Doi:
10.1002/ijc.22947
ISSN:
00207136
e-ISSN:
10970215
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female