The role of human papillomavirus deoxyribonucleic acid assay and repeated cervical cytologic examination in the detection of cervical intraepithelial neoplasia among human immunodeficiency virus-infected women. Cervical Disease Study Group of the American Foundation for AIDS Research Community Based Clinical Trials Network.

Abstract

OBJECTIVES:

We sought to measure the characteristics of a quantitative human papillomavirus deoxyribonucleic acid assay and repeated cervical cytologic examination in screening for cervical intraepithelial neoplasia among human immunodeficiency virus-infected women.

STUDY DESIGN:

Human immunodeficiency virus-infected women with screening CD4+ lymphocyte counts of < or = 500 cells/mm3 (n = 103) were examined by quantitative human papillomavirus deoxyribonucleic acid assay and serial cervical cytologic examination and by colposcopy with biopsy and endocervical curettage during the course of 1 year.

RESULTS:

Quantitative measures of total human papillomavirus deoxyribonucleic acid and high-risk human papillomavirus deoxyribonucleic acid were strongly associated with any cervical intraepithelial neoplasia (P = .005) and high-grade cervical intraepithelial neoplasia (P = .0006), but they improved the sensitivity and negative predictive value of baseline screening only slightly when combined with cervical cytologic examination. Incident cervical intraepithelial neoplasia occurred frequently (20%) during 1 year of follow-up and was more common among human papillomavirus-infected women. Repeated cytologic examination identified 60% of women with new cervical intraepithelial neoplasia.

CONCLUSION:

Human immunodeficiency virus-infected women with at least mild immunosuppression have a high incidence of cervical intraepithelial neoplasia, which warrants close follow-up. Those with high baseline human papillomavirus deoxyribonucleic acid levels may be at the highest risk for incident cervical intraepithelial neoplasia.

• Authors: J A Cohn, S Gagnon, M R Spence, D D Harrison, T R Kluzak, P Langenberg, C Brinson, A Stein, J Hellinger, Cervical Disease Study Group of the American Foundation for AIDS Research Community Based Clinical Trials Network
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 184 Issue 3 Pg. 322-30 (Feb 2001) ISSN: 0002-9378 [Print] United States
• PMID: 11228481 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Viral

Topics

• Adult
• Biopsy
• Colposcopy
• Curettage
• DNA, Viral (analysis)
• Female
• HIV
• HIV Infections (complications, immunology, virology)
• Histocytochemistry
• Humans
• Likelihood Functions
• Middle Aged
• Papillomaviridae (chemistry, genetics)
• Papillomavirus Infections (diagnosis, pathology, virology)
• ROC Curve
• Tumor Virus Infections (diagnosis, pathology, virology)
• Uterine Cervical Neoplasms (diagnosis, pathology, virology)
• Vaginal Smears
• Uterine Cervical Dysplasia (diagnosis, pathology, virology)