2024-03-28T16:15:49Zhttp://digital.csic.es/dspace-oai/requestoai:digital.csic.es:10261/2128412020-12-10T07:43:36Zcom_10261_11773com_10261_1col_10261_11774
DIGITAL.CSIC
author
Viciana, Pompeyo
author
Milanés-Guisado, Yusnelkis
author
Fontillón, María
author
Domínguez Castaño, Ana
author
Sotomayor, César
author
Espinosa, Nuria
author
López-Cortés, Luis F.
author
Neukam, Karin
funder
Instituto de Salud Carlos III
funder
European Commission
funder
Red Española de Investigación en SIDA
2020-06-01T09:32:14Z
2020-06-01T09:32:14Z
2019
Clinical Infectious Diseases 69(12): 2185-2192 (2019)
http://hdl.handle.net/10261/212841
10.1093/cid/ciz144
http://dx.doi.org/10.13039/501100004587http://dx.doi.org/10.13039/501100000780
[Background]: Screening methods for anal squamous intraepithelial lesions (SILs) are suboptimal. We aimed to determine the diagnostic performance of a composite endpoint comprising anal liquid-based cytology (aLBC) and high-risk human papillomavirus (HR-HPV) testing to predict histological high-grade SILs (hHSILs).
[Methods]: From the SeVIHanal cohort, human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) who had an aLBC with concomitant HR-HPV testing were included. hHSILs were determined by high-resolution anoscopy (HRA)-guided biopsy.
[Results]: A total of 705 visits obtained from 426 patients were included. The prevalence of HR-HPV among aLBC results were 51.9% (133/215) normal, 87.9% (20/232) low-grade SILs (LSILs), and 90.9% (149/164) high-grade SILs; P (linear association) <. 001. Low prevalence of hHSILs was only observed for the composite aLBC/HR-HPV testing endpoint >normal/noHR-HPV> (10%) and >LSIL/noHR-HPV> (4%). The prognostic values (95% confidence interval) for HR-HPV to predict hHSILs in normal cytology were positive predictive value (PPV), 29.3% (25.6%-33.3%); negative predictive value (NPV), 90.2% (82.8%-94.7%); sensitivity, 83% (69.2%-92.4%); and specificity, 44.1% (36.4%-51.9%). Corresponding figures for cytologic LSILs were PPV, 39.2% (37.4%-41.1%); NPV, 96.4% (78.9%-99.5%); sensitivity, 98.8% (93.3%-99.9%); and specificity, 17.9% (12.1%-24.9%). A positive interaction and a synergistic effect for the composite endpoint were observed (relative excess risk = 1.50, attributable proportion of histological results to interaction = 0.17, synergy index = 1.24).
[Conclusions]: HRA should not be indicated in the setting of LSILs/noHR-HPV following aLBC-based screening. In contrast, HIV-infected MSM with normal aLBC/HR-HPV infection should be considered for HRA. Clinical Trials Registration: NCT03713229.
closedAccess
Anal liquid-based cytology
Human papillomavirus
Diagnostic performance
Squamous intraepithelial lesions
HIV-infected men who have sex with men
High-risk human papilloma vrus testing improves diagnostic performance to predict moderate-to high-grade anal Intraepithelial neoplasia in human immunodeficiency virus-infected men who have xex with men in low-to-absent cytological abnormalities
artículo
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URL
https://digital.csic.es/bitstream/10261/212841/1/accesoRestringido.pdf
File
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42637ae8545636bc41605c1740a9a84e
15753
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accesoRestringido.pdf