Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study.
Segondy, Michel;
Kelly, Helen;
Magooa, Mahlape P;
Djigma, Florencia;
Ngou, Jean;
Gilham, Clare;
Omar, Tanvier;
Goumbri-Lompo, Olga;
Michelow, Pamela;
Doutre, Sylviane;
+8 more...Clavero, Omar;
Chikandiwa, Admire;
Sawadogo, Bernard;
Didelot, Marie-Noelle;
Costes, Valérie;
Méda, Nicolas;
Delany-Moretlwe, Sinead;
Mayaud, Philippe;
(2016)
Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study.
British journal of cancer, 115 (4).
pp. 425-430.
ISSN 0007-0920
DOI: https://doi.org/10.1038/bjc.2016.207
(In Press)
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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.