BACKGROUND: Cervical cancer is the most common cancer in Sub-Saharan Africa. There are little of HIV-infected women one-year after screening using visual inspection with acetic acid (VIA), HPV or cytology in sub-Saharan Africa.
METHODS: HIV-infected women in Johannesburg South Africa were screened one year later by Pap smear, VIA and human papillomavirus (HPV) testing. Women qualified for the 12 month follow-up visit if they had a negative or cervical intra-epithelial neoplasia (CIN) 1 results at the baseline visit. Modified Poisson regression was used to analyse associations between patient baseline characteristics and progression.
RESULTS: A total of 688 of 1,202 enrolled at baseline study who were CIN-2+ negative and qualified for a 12 month follow-up visit. Progression to CIN-2+ was higher in women with positive VIA results (12.6\%; 24/191) than those VIA-negative (4.4\%; 19/432). HPV-positive women at baseline were more likely to progress to CIN-2+ (12.3\%; 36/293) than those HPV-negative (2.1\%; 7/329). Cytology-positive women at baseline were more likely to progress to CIN-2+ (9.6\%; 37/384) than cytology-negative women (2.5\%; 6/237). Approximately 10\% (10.4\%; 39/376) of women with CIN 1 at baseline progressed to CIN 2+. Women who were VIA or HPV positive at baseline were more likely to progress aIRR 1.85, CI 95\% (1.46 to 2.36), aIRR 1.41 CI 95\% (1.14 to 1.75) respectively.
CONCLUSION: Progression to CIN-2+ in HIV-infected women is significant when measured by baseline positive VIA, HPV or Pap and yearly screening by any method should be considered in this population if possible.
}, year = {2016}, journal = {PloS one}, volume = {11}, pages = {e0144905}, month = {12/2016}, issn = {1932-6203}, doi = {10.1371/journal.pone.0144905}, language = {eng}, }