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DC Field | Value | Language |
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dc.contributor.author | Omenge Orang’o, Elkanah | - |
dc.contributor.author | Christoffersen-Deb, Astrid | - |
dc.contributor.author | Itsura, Peter | - |
dc.contributor.author | Oguda, John | - |
dc.contributor.author | Washington, Sierra | - |
dc.contributor.author | Chumba, David | - |
dc.contributor.author | Cu-Uvin g, Susan | - |
dc.contributor.author | F. Rositch h, Anne | - |
dc.date.accessioned | 2020-08-25T11:06:13Z | - |
dc.date.available | 2020-08-25T11:06:13Z | - |
dc.date.issued | 2017 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3446 | - |
dc.description.abstract | Objectives: Few studies have addressed optimal follow-up for HIV-infected women after cervical treatment. This study aimed to compare performance of three available tests to detect posttreatment cervical disease in HIV-infected women in Kenya. Design: This is a prospective cohort study. Methods: At least 6 months following cryotherapy, 517 HIV-infected women were evaluated concurrently with visual inspection with acetic acid (VIA), papanicolaou (Pap) smear, and high-risk human papillomavirus (HR-HPV) testing. Women positive by any test (≥low-grade squamous intraepithelial lesion for Pap) were scheduled for colposcopy and biopsy. Among 248 with histological confirmation [and 174 assumed to be truly negative for cervical intraepithelial neoplasia (CIN)2+ after testing negative by all three tests], the ability of each test alone, or in combination, to detect CIN2+ was calculated to determine their utility in posttreatment follow-up. Results: The median age of women was 35 years, 68% were WHO stage 1-2, with a median CD4 cell count of 410 cells/μl, and 87% were on combination antiretroviral therapy. At a median of 6.3 months posttreatment, 64% had an abnormal screen by VIA, Pap, and/or HR-HPV. Among women with histological confirmation, 72 (30%) had persistent/recurrent CIN2+. As single tests, Pap correctly classified the most cases (83%) and had the highest specificity [91% (88 and 95%); sensitivity 44% (35 and 53%)], whereas HR-HPV had the highest sensitivity [85% (75 and 96%); specificity 54% (49 and 58%)]. VIA was not sensitive [27% (18 and 36%)] for the detection of posttreatment CIN2+ [specificity 82% (79 and 86%)]. Conclusion: With the goal to minimize the number of false negatives (e.g. not miss CIN2+ posttreatment) in this population that is high-risk due to both prior cervical disease and HIV infection, HR-HPV-based algorithms are recommended. | en_US |
dc.language.iso | en | en_US |
dc.publisher | medical publication | en_US |
dc.subject | cryotherapy | en_US |
dc.subject | HIV | en_US |
dc.subject | HPV | en_US |
dc.subject | Pap smear | en_US |
dc.subject | posttreatment | en_US |
dc.subject | screening | en_US |
dc.subject | sensitivity | en_US |
dc.subject | visual inspection | en_US |
dc.title | Use of visual inspection with acetic acid, Pap smear, or high-risk human papillomavirus testing in women living with HIV/AIDS for posttreatment cervical cancer screening: same tests, different priorities | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
Files in This Item:
File | Description | Size | Format | |
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Elkanah Omenge Orang’o et al.pdf | 192.85 kB | Adobe PDF | View/Open |
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