Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study

Michel Segondy (1, 2) , Helen Kelly (3) , Mahlape Magooa (4) , Florencia Djigma , Jean Ngou (1, 2) , Clare Gilham (3) , Tanvier Omar (5) , Olga Goumbri-Lompo (6) , Pamela Michelow (5) , Sylviane Doutre (1, 2) , Omar Clavero , Admire Chikandiwa (5) , Bernard Sawadogo (6) , Marie-Noelle Didelot (1, 2) , Valérie Costes (1, 2) , Nicolas Meda (6) , Sinead Delany-Moretlwe (5) , Philippe Mayaud (3, 5)

1 Service de Biopathologie [CHRU Montpellier]
2 Pathogénèse et contrôle des infections chroniques (PCCI)
3 LSHTM - London School of Hygiene and Tropical Medicine
4 NICD - National Institute for Communicable Diseases [Johannesburg]
5 WITS - University of the Witwatersrand [Johannesburg]
6 CRIS - Centre de Recherche Internationale pour la Sante

BACKGROUND: The careHPV assay is a test for high-risk (HR) human papillomaviruses (HPV) detection designed to be affordable in resource-poor settings. We evaluated the performance of careHPV screening among 1052 women living with HIV/AIDS included in the HARP (HPV in Africa Research Partnership) study in Burkina Faso (BF) and South Africa (SA). METHODS: Cervical samples were tested for HR-HPV by the careHPV and the INNO-LiPA HPV genotyping Extra assays. All women had Pap smear testing, visual inspection with acetic acid/Lugol's iodine (VIA/VILI) and colposcopy. Cervical biopsies were obtained for participants who were HR-HPV DNA positive by careHPV or who had abnormalities detected on cytology, VIA/VILI or colposcopy. RESULTS: Overall, 45.1% of women had a positive careHPV test (46.5% in BF, 43.8% in SA). The careHPV positivity rate increased with the grade of cytological lesions. Sensitivity and specificity of careHPV for the diagnosis of CIN2+ (n=60, both countries combined) were 93.3% (95% confidence interval (CI): 83.8-98.2) and 57.9% (95% CI: 54.5-61.2), respectively. Specificity increased with CD4 count. careHPV had a similar clinical sensitivity but higher specificity than the INNO-LiPA assay for detection of CIN2+. CONCLUSIONS: Our results suggest that careHPV testing is a reliable tool for cervical cancer screening in HIV-1-infected women in sub-Saharan Africa.

Domaines: Cancer

Michel Segondy, Helen Kelly, Mahlape Magooa, Florencia Djigma, Jean Ngou, et al.. Performance of careHPV for detecting high-grade cervical intraepithelial neoplasia among women living with HIV-1 in Burkina Faso and South Africa: HARP study. British Journal of Cancer, 2016, 115 (4), pp.425 - 430. ⟨10.1038/bjc.2016.207⟩. ⟨hal-01844576⟩