Persistence and clearance of high-risk human papillomavirus and cervical dysplasia at 1 year in women living with human immunodeficiency virus: A prospective cohort study
BJOG: An International Journal of Obstetrics and Gynaecology — Luckett R, Painter H, Hacker MR, et al. | June 16, 2021
This prospective cohort analysis was undertaken to assess 1-year results of cervical cancer screening and treatment employing primary high-risk human papillomavirus (HPV) testing in females living with human immunodeficiency virus (HIV). Participants received cervical cancer screening using high-risk HPV testing and triage assessment at baseline as well as at 1-year follow up. Participants were also provided excisional treatment as indicated. The reference standard was histopathology. A significant reduction in high-risk HPV positivity, from 28% at baseline to 20% at 1 year, was identified. High-risk HPV persistence was estimated to be 46% and clearance was noted to be 54%; incidence was high at 9%. Following one round of high-risk HPV-based screening and treatment in females living with HIV, findings revealed a high incidence of high-risk HPV and high-grade cervical dysplasia, which raises concern regarding progression rate of high-risk HPV infection to dysplasia. Presence of persistent disease was a common finding. Caution is warranted in spacing cervical cancer screening intervals employing high-risk HPV testing in females living with HIV.