Bansil P., Lim J., Byamugisha J., Kumakech E., Nakisige C., Jeronimo J.A.
Reproductive Health Global Program, PATH, Seattle, WA, United States; Department of Gynaecology and Obstetrics, Makerere University, Kampala, Uganda; Reproductive Health Global Program, PATH, Kampala, Uganda; Department of Obstetrics and Gynecology, Mulago National Referral Hospital, Kampala, Uganda
Bansil, P., Reproductive Health Global Program, PATH, Seattle, WA, United States; Lim, J., Reproductive Health Global Program, PATH, Seattle, WA, United States; Byamugisha, J., Department of Gynaecology and Obstetrics, Makerere University, Kampala, Uganda; Kumakech, E., Reproductive Health Global Program, PATH, Kampala, Uganda; Nakisige, C., Department of Obstetrics and Gynecology, Mulago National Referral Hospital, Kampala, Uganda; Jeronimo, J.A., Reproductive Health Global Program, PATH, Seattle, WA, United States
Objective: Women infected with human immunodeficiency virus (HIV) have a higher risk of HPV infections and developing cervical cancer, thus screening them is imperative. This study was aimed to evaluate and compare the performance of 3 cervical cancer screening options among HIV-infected women in Uganda. Materials and Methods: Data from 2,337 Ugandan women who reported their HIV status were obtained from a population-based cervical cancer screening study. Women were offered 3 screening tests: vaginal and cervical careHPV and visual inspection with acetic acid (VIA), and the results were evaluated by HIV status. Results: The prevalence of HIV infection was 16.5%. Women infected with HIV had a higher prevalence of cervical intraepithelial neoplasia grade 2+ (CIN2+) than uninfected women (12.9% vs 1.7%; p < .001). The sensitivity for cervical careHPV among the HIV-infected women was 94.3% compared to 81.3% among the uninfected women. Whereas the sensitivity for vaginal careHPV was also higher among the HIV-infected women, the sensitivity of VIA was higher among the uninfected women. The mean vaginal and cervical careHPV signal strength was higher in the HIV-infected women than in the uninfected women (p < .001). Conclusions: CareHPV is very sensitive for detecting CIN2+ in HIV-infected women, even using a vaginal sample. The sensitivity of careHPV in HIV-infected women is higher than in HIV-uninfected women. However, additional research is needed to determine the best option for screening and triage of HPV-positive women that can be implemented in low-resource settings, especially among HIV- and HPV-positive women. © 2015, American Society for Colposcopy and Cervical Pathology.
acetic acid; adolescent; adult; Article; cancer screening; cervical care human papilloma virus; comparative study; controlled study; female; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; Human immunodeficiency virus prevalence; major clinical study; predictive value; screening test; sensitivity and specificity; Uganda; uterine cervix cancer; uterine cervix carcinoma in situ; uterine cervix cytology; vaginal care human papilloma virus; virus load; visual system examination