The role of human papillomavirus deoxyribonucleic acid assay and repeated cervical cytologic examination in the detection of cervical intraepithelialneoplasia among human immunodeficiency virus-infected women

Citation
Ja. Cohn et al., The role of human papillomavirus deoxyribonucleic acid assay and repeated cervical cytologic examination in the detection of cervical intraepithelialneoplasia among human immunodeficiency virus-infected women, AM J OBST G, 184(3), 2001, pp. 322-330
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
0002-9378 → ACNP
Volume
184
Issue
3
Year of publication
2001
Pages
322 - 330
Database
ISI
SICI code
0002-9378(200102)184:3<322:TROHPD>2.0.ZU;2-B
Abstract
OBJECTIVES: We sought to measure the characteristics of a quantitative huma n papillomavirus deoxyribonucleic acid assay and repeated cervical cytologi c examination in screening for cervical intraepithelial neoplasia among hum an immunodeficiency virus-infected women. STUDY DESIGN: Human immunodeficiency virus-infected women with screening CD 4+ lymphocyte counts of less than or equal to 500 cells/mm(3) (n = 103) wer e examined by quantitative human papillomavirus deoxyribonucleic acid assay and serial cervical cytologic examination and by colposcopy with biopsy an d endocervical curettage during the course of 1 year. RESULTS: Quantitative measures of total human papillomavirus deoxyribonucle ic acid and high-risk human papillomavirus deoxyribonucleic acid were stron gly associated with any cervical intraepithelial neoplasia (P=.005) and hig h-grade cervical intraepithelial neoplasia (P=.0006), but they improved the sensitivity and negative predictive value of baseline screening only sligh tly when combined with cervical cytologic examination. Incident cervical in traepithelial neoplasia occurred frequently (20%) during 1 year of follow-u p and was more common among human papillomavirus-infected women. Repeated c ytologic examination identified 60% of women with new cervical intraepithel ial neoplasia. CONCLUSION: Human immunodeficiency virus-infected women with at least mild immunosuppression have a high incidence of cervical intraepithelial neoplas ia, which warrants close follow-up. Those with high baseline human papillom avirus deoxyribonucleic acid levels may be at the highest risk for incident cervical intraepithelial neoplasia.