[Contribution of human papillomavirus second-generation hybrid capture test for the diagnosis of cervical pathology in HIV-infected outpatients].
OBJECTIVE
The causal relationship between human papillomavirus (HPV) and cervical cancer is well established. The initial diagnosis of HPV-related cervical infection is currently performed by HPV-associated changes in cervical cytology. We aimed to study the accuracy and concordance between HPV ADN detection by second-generation hybrid capture (HC-2) and cervical cytological changes for the diagnosis of HPV cervical infection in human immunodeficiency virus (HIV+) outpatients.


METHODS
From March 1999 to August 2002, 139 HIV+ patients were included. HPV infection was determined by cytology and HC-2. The accuracy and level of concordance between both techniques was analyzed.


RESULTS
The applicability of the HC-2 test was 96%. Sixty-eight (49%) patients were diagnosed with HPV infection by HC-2. High-oncogenetic-risk HPV genotypes were detected in 64 (46%) patients. The sensitivity, specificity and positive and negative predictive values of HC-2 in HPV detection were 78%, 69%, 61% and 83%, respectively. The concordance was K = 0.44 (95% confidence interval, 0.29-0.60); p < 0.001.


CONCLUSIONS
The HC-2 diagnostic technique for HPV-related cervical infection in HIV+ patients is a sensitive and specific test. The combined use of both tests might increase the diagnostic efficacy, and hence have positive repercussions on cervical pathology screening on an outpatient basis.
Sirera
Guillem
G
Unidad VIH, Servicio de Medicina, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. de Canyet s/n, 08916 Badalona, Barcelona, Spain. gsirera@ns.hugtip.scs.es
Videla
Sebastián
S
Castellá
Eva
E
Cavallé
Lluís
L
Grané
Núria
N
Llatjos
Mariona
M
Tural
Cristina
C
Negredo
Eugenia
E
Fernández
Angela
A
Rey-Joly
Celestino
C
Clotet
Bonaventura
B
D000328:Adult; D015704:CD4 Antigens / Q000097:blood; D003127:Colposcopy; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009693:Nucleic Acid Hybridization / Q000379:methods; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*
D015704:CD4 Antigens; D004279:DNA, Viral