Persistence and clearance of high-risk human papillomavirus and cervical dysplasia at one year in women living with human immunodeficiency virus: a prospective cohort study

• Published in: BJOG : an international journal of obstetrics and gynaecology 2021-06, Vol.128 (12), p.1986-1996
• Main Authors: Luckett, Rebecca, Painter, Helena, Hacker, Michele R, Simon, Boikhutso, Seiphetlheng, Alexander, Erlinger, Adrienne, Eakin, Cortney, Moyo, Sikhulile, Tumwine Kyokunda, Lynnette, Esselen, Katharine, Feldman, Sarah, Morroni, Chelsea, Ramogola-Masire, Doreen
• Format: Article
• Language: English
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.16758

Evaluate one-year outcomes of cervical cancer screening and treatment using primary high-risk human papillomavirus (HPV) testing in women living with human immunodeficiency virus (HIV). Prospective cohort study SETTING: HIV treatment center in Botswana POPULATION: Women living with HIV METHODS: Participants underwent cervical cancer screening with high-risk HPV testing and triage evaluation at baseline and one-year follow-up. Excisional treatment was offered as indicated. Histopathology was the gold standard. Persistence, clearance and incidence of high-risk HPV infection; and persistence, progression, regression, cure and incidence of cervical dysplasia. Among 300 women screened at baseline, 237 attended follow-up (79%). High-risk HPV positivity significantly reduced from 28% at baseline to 20% at one year (p=0.02). High-risk HPV persistence was 46% and clearance 54%; incidence was high at 9%. Prevalence of cervical intraepithelial neoplasia grade (CIN) 2 or higher was most common in participants with incident high-risk HPV (53%). CIN2 or higher was also common in those with persistent high-risk HPV (32%) and even in those who cleared high-risk HPV (30%). 40% of high-risk HPV positive participants at baseline with