Efficacy of careHPV ™ human papillomavirus screening versus conventional cytology tests for the detection of precancerous and cancerous cervical lesions among women living with HIV‐1 in Lao People's Democratic Republic
Résumé
Abstract Background In the Lao People's Democratic Republic (Lao PDR), cervical cancer is the third leading cause of women cancer. Aims The objective of this cross‐sectional study was to compare the efficacy of careHPV ™ test versus conventional Pap smear or Siriraj liquid‐based cytology in the detection of cervical cancer in women living with human immunodeficiency virus type 1 (HIV‐1). Materials & Methods Overall, 631 women consented to participate. Four cervical specimens were taken for the purpose of conventional Pap smear, Siriraj liquid‐based cytology, careHPV ™ test, and HPV‐16 genotyping. The exact McNemar test was used to compare the efficacy and diagnostic performance of the tests. Results Of the 631 women with follow‐up, 331 were human papillomavirus (HPV) negative. High‐grade squamous intraepithelial lesions were found in 37 women, biopsy‐proven high‐grade cervical intraepithelial neoplasia in 50 women, and invasive carcinoma in seven women. The proportion of women with high‐grade cervical lesion or carcinoma detected after abnormal careHPV ™ test was higher (6.02%; 95% confidence interval [CI]: 4.4–8.1) than that detected by conventional Pap smear (4.59%; 95% CI: 3.2–6.5). careHPV ™ and HPV‐16 genotyping had, respectively, the highest sensitivity (80.8%; 95% CI: 67.4–89.5) and specificity (92.2%; 95% CI: 89.8–94.2). HPV‐16 was the most frequently detected genotype. Conclusions careHPV ™ test represents a screening option in Lao PDR, particularly in women living with HIV‐1 because of higher prevalence of chronic HPV in this population.