[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.
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
Guillem
G
Sirera
Sebastián
S
Videla
Eva
E
Castellá
Lluís
L
Cavallé
Núria
N
Grané
Mariona
M
Llatjos
Cristina
C
Tural
Eugenia
E
Negredo
Angela
A
Fernández
Celestino
C
Rey-Joly
Bonaventura
B
Clotet
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