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Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study.

Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study.
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Segondy M, Kelly H, Magooa MP, Djigma F, Ngou J, Gilham C, Omar T, Goumbri-Lompo O, Michelow P, Doutre S, Clavero O, Chikandiwa A, Sawadogo B, Didelot MN, Costes V, Méda N, Delany-Moretlwe S, Mayaud P,


Segondy M, Kelly H, Magooa MP, Djigma F, Ngou J, Gilham C, Omar T, Goumbri-Lompo O, Michelow P, Doutre S, Clavero O, Chikandiwa A, Sawadogo B, Didelot MN, Costes V, Méda N, Delany-Moretlwe S, Mayaud P, (click to view)

Segondy M, Kelly H, Magooa MP, Djigma F, Ngou J, Gilham C, Omar T, Goumbri-Lompo O, Michelow P, Doutre S, Clavero O, Chikandiwa A, Sawadogo B, Didelot MN, Costes V, Méda N, Delany-Moretlwe S, Mayaud P,

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British journal of cancer 2016 07 19115(4) 425-30 doi 10.1038/bjc.2016.207

Abstract
BACKGROUND
The careHPV assay is a test for high-risk (HR) human papillomaviruses (HPV) detection designed to be affordable in resource-poor settings. We evaluated the performance of careHPV screening among 1052 women living with HIV/AIDS included in the HARP (HPV in Africa Research Partnership) study in Burkina Faso (BF) and South Africa (SA).

METHODS
Cervical samples were tested for HR-HPV by the careHPV and the INNO-LiPA HPV genotyping Extra assays. All women had Pap smear testing, visual inspection with acetic acid/Lugol’s iodine (VIA/VILI) and colposcopy. Cervical biopsies were obtained for participants who were HR-HPV DNA positive by careHPV or who had abnormalities detected on cytology, VIA/VILI or colposcopy.

RESULTS
Overall, 45.1% of women had a positive careHPV test (46.5% in BF, 43.8% in SA). The careHPV positivity rate increased with the grade of cytological lesions. Sensitivity and specificity of careHPV for the diagnosis of CIN2+ (n=60, both countries combined) were 93.3% (95% confidence interval (CI): 83.8-98.2) and 57.9% (95% CI: 54.5-61.2), respectively. Specificity increased with CD4 count. careHPV had a similar clinical sensitivity but higher specificity than the INNO-LiPA assay for detection of CIN2+.

CONCLUSIONS
Our results suggest that careHPV testing is a reliable tool for cervical cancer screening in HIV-1-infected women in sub-Saharan Africa.

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