Persistence and clearance of high‐risk human papillomavirus and cervical dysplasia at 1 year in women living with human immunodeficiency virus: a prospective cohort study

Objective Evaluate 1‐year outcomes of cervical cancer screening and treatment using primary high‐risk human papillomavirus (HPV) testing in women living with human immunodeficiency virus (HIV). Design Prospective cohort study. Setting HIV treatment centre in Botswana. Population Women living with HI...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2021-11, Vol.128 (12), p.1986-1996
Main Authors: Luckett, R, Painter, H, Hacker, MR, Simon, B, Seiphetlheng, A, Erlinger, A, Eakin, C, Moyo, S, Kyokunda, LT, Esselen, K, Feldman, S, Morroni, C, Ramogola‐Masire, D
Format: Article
Language:English
Subjects:
Cancer screening
Cervical cancer
Cervical cancer screening
Cervix
Cohort analysis
Dysplasia
HIV
HPV persistence
Human immunodeficiency virus
Human papillomavirus
Immune system
low‐ and middle‐income countries
Medical screening
Womens health
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Summary:Objective Evaluate 1‐year outcomes of cervical cancer screening and treatment using primary high‐risk human papillomavirus (HPV) testing in women living with human immunodeficiency virus (HIV). Design Prospective cohort study. Setting HIV treatment centre in Botswana. Population Women living with HIV. Methods Participants underwent cervical cancer screening with high‐risk HPV testing and triage evaluation at baseline and 1‐year follow up. Excisional treatment was offered as indicated. Histopathology was the reference standard. Main outcome measures Persistence, clearance and incidence of high‐risk HPV infection; and persistence, progression, regression, cure and incidence of cervical dysplasia. Results Among 300 women screened at baseline, 237 attended follow up (79%). High‐risk HPV positivity significantly decreased from 28% at baseline to 20% at 1 year (P = 0.02). High‐risk HPV persistence was 46% and clearance was 54%; incidence was high at 9%. Prevalence of cervical intraepithelial neoplasia Grade 2 (CIN2) or higher was most common in participants with incident high‐risk HPV (53%). CIN2 or higher was also common in those with persistent high‐risk HPV (32%) and even in those who cleared high‐risk HPV (30%). Of the high‐risk HPV‐positive participants at baseline with
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.16758