Performance of the Swede score to predict cervical intraepithelial neoplasia in women with HIV‐1 in Johannesburg, South Africa
| Autor: | Philippe Mayaud, Clare Gilham, Yasmin Adam, Admire Chikandiwa, Helen Kelly, Vusumuzi David Maringa, Sinead Delany-Moretlwe, Langanani Mbodi |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Biopsy Human immunodeficiency virus (HIV) Uterine Cervical Neoplasms Cervical intraepithelial neoplasia medicine.disease_cause Sensitivity and Specificity Cohort Studies South Africa 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Internal medicine Histological diagnosis HIV Seropositivity medicine Humans 030212 general & internal medicine Colposcopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics and Gynecology Secondary data General Medicine Uterine Cervical Dysplasia medicine.disease Cross-Sectional Studies Cohort HIV-1 Female business |
| Zdroj: | International Journal of Gynecology & Obstetrics. 152:188-195 |
| ISSN: | 1879-3479 0020-7292 |
| DOI: | 10.1002/ijgo.13392 |
| Popis: | OBJECTIVE To evaluate the performance of the Swede score to detect cervical intraepithelial neoplasia (CIN) in women with HIV-1 in Johannesburg, South Africa. METHODS A cross-sectional study using secondary data analysis from the HPV in Africa Research Partnership (HARP) study that compared the performance of three different screening tests to detect CIN. Colposcopy was performed on any woman who screened positive and findings were recorded using the Swede score. A biopsy of any lesion and a four-quadrant biopsy was taken. The score was evaluated against a histological diagnosis of >CIN1. The sensistivity, specificity, PPV and NPV for each score was calculated. RESULTS Median age and CD4+ count of the 576 women eligible from the Johannesburg cohort was 34 years (IQR, 30-39) and 427 cells/mm3 (IQR, 323-579), respectively. Almost two-thirds (64%) were on ART and about 21% had CIN 2+ on histology. A Swede score of 5 or greater had the best combination of sensitivity and specificity for CIN 2+ with an AUC of 0.72 (95% CI, 0.68-0.76) corresponding to a sensitivity of 72.1 (95% CI, 63.5-79.6) and specificity of 71.8 (95% CI, 67.4-75.9). CONCLUSION The Swede score can assist in determining whether women with HIV/AIDS should have treatment at the first colposcopy visit versus those who may be followed up, thereby individualizing treatment. |
| Databáze: | OpenAIRE |
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