AI Article Synopsis

  • - The WHO recommends HPV testing for cervical cancer screening due to its high sensitivity, but further triage is needed to identify women with high-grade lesions (CIN2+) who need treatment.
  • - The ANRS-12375 study evaluated various triage methods like visual inspection (VIA) and different genotyping options in Côte d'Ivoire, Burkina Faso, and Cambodia to detect CIN2+ lesions among women living with HIV.
  • - Results showed that VIA and extended genotyping had high sensitivity (89%), with VIA also exhibiting the best specificity among the tests, making them effective options for identifying women who require treatment for CIN2+.

Article Abstract

The WHO recommends the use of human papillomavirus (HPV) testing for primary cervical cancer (CC) screening because of its high sensitivity. However, triage is desirable to correctly identify HPV+ women who have high-grade lesions (CIN2+) and require treatment. The ANRS-12375 study was conducted in Côte d'Ivoire, Burkina Faso and Cambodia to assess the performance, feasibility and benefits of different triage options for detecting CIN2+ lesions: partial (HPV16 and HPV16/18/45) and extended genotyping, visual inspection (VIA) alone and VIA combined with partial genotyping. VIA was performed by gynecologists. The sensitivity, specificity, and diagnostic likelihood ratio (DLR) of each triage option for detecting CIN2+ lesions with histology as a reference standard were calculated. Of the 2253 women living with HIV (WLHIV) included, 932 (41%) were HPV+. A CIN2+ lesion was identified in 105 (13%) of the 777 participants with histopathology results. The sensitivity of VIA as a triage test for CIN2+ patients was 89%, while that for extended genotyping was 89%, that for HPV16/18/45 partial genotyping was 51%, and that for HPV16 partial genotyping was 36%. The specificities for these tests were 45%, 29%, 72%., and 85%, respectively. Combining VIA and/or partial genotyping positivity slightly increased the sensitivity (94%) at the cost of lower specificity (28%). There was significant intersite heterogeneity (p = .04). Among the three triage tests with a sensitivity ≥85%, the VIA had the highest specificity and positive likelihood ratio (p < .001). VIA and extended genotyping, whether independent or combined, are good triage options with high sensitivity for identifying WLHIV needing treatment for CIN2+.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621995PMC
http://dx.doi.org/10.1002/ijc.35190DOI Listing

Publication Analysis

Top Keywords

partial genotyping
20
visual inspection
8
women living
8
living hiv
8
human papillomavirus
8
sensitivity triage
8
detecting cin2+
8
cin2+ lesions
8
extended genotyping
8
likelihood ratio
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!