title: Human papillomavirus testing in primary screening for cervical cancer of human immunodeficiency virus-infected women, 1990-1998.
abstract: OBJECTIVE
  Women infected with the human immunodeficiency virus (HIV) have an increased risk of cervical neoplasia while the value of cytologic screening is limited due to a high prevalence of inflammatory disease. The study was conducted to determine whether testing for human papillomavirus (HPV) DNA could improve primary screening for cervical cancer of these patients.
  
  
  METHODS
  One hundred thirty-eight HIV-infected women were examined between 1990 and 1998. Ninety-four patients with a total of 279 women-years were eligible for incidence evaluation. Colposcopy, cytology, and HPV DNA testing with the hybrid capture I assay were performed at each visit.
  
  
  RESULTS
  Seventeen cases of high-grade cervical neoplasia were diagnosed at study entry and 13 developed CIN II or CIN III during follow-up. The hybrid capture I assay detected 94.1% of prevalent and 100% of incident high-grade neoplasia, while the corresponding sensitivity of Pap smears using CIN I or worse as the referral criteria was 82.3% for prevalent and 69.2% for incident high-grade neoplasia. Eleven of 13 patients who progressed to histologically confirmed CIN II/III tested positive for HPV DNA at study entry compared with 5/13 women presenting with any degree of cytologic atypia at recruitment. The Pap smears of 36/94 women remained normal throughout the study while 54/94 patients remained negative for high-risk HPV types.
  
  
  CONCLUSIONS
  Hybrid capture I identified high-grade cervical neoplasia more accurately than the Pap smear and appeared to be beneficial for primary cervical cancer screening in HIV-infected women.
authors.affiliation: Department of Gynecological Oncology, Medizinische Hochschule Hannover, Podbielskistrasse 380, Hannover, 30659, Germany.
authors.forename: K U
authors.initials: KU
authors.lastname: Petry
authors.forename: G
authors.initials: G
authors.lastname: Böhmer
authors.forename: T
authors.initials: T
authors.lastname: Iftner
authors.forename: P
authors.initials: P
authors.lastname: Flemming
authors.forename: M
authors.initials: M
authors.lastname: Stoll
authors.forename: R E
authors.initials: RE
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000821:virology*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
chemical_list: D004279:DNA, Viral