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Multicenter Study
. 2025 Feb 1;156(3):598-607.
doi: 10.1002/ijc.35190. Epub 2024 Sep 25.

Performance of visual inspection, partial genotyping, and their combination for the triage of women living with HIV who are screen positive for human papillomavirus: Results from the AIMA-CC ANRS 12375 multicentric screening study

Pierre Debeaudrap  1 , Firmin Nongodo Kabore  2 , Limsreng Setha  3 , Joseph Tegbe  4 , Brahima Doukoure  5 , Moeung Sotheara  6 , Olivier Segeral  7 , Korn Aun  3 , Eugène Messou  8 , Pauline Bitolog  9 , Kim Sothea  6 , Pierre Vassilakos  10 , Armel Poda  11   12 , Evelyn Kasilé Poda  13 , Antoine Jaquet  14 , Adolphe Some  9 , Patrick Petignat  15 , Gary Clifford  16 , Apollinaire Horo  13
Affiliations
Multicenter Study

Performance of visual inspection, partial genotyping, and their combination for the triage of women living with HIV who are screen positive for human papillomavirus: Results from the AIMA-CC ANRS 12375 multicentric screening study

Pierre Debeaudrap et al. Int J Cancer. .

Abstract

The WHO recommends the use of human papillomavirus (HPV) testing for primary cervical cancer (CC) screening because of its high sensitivity. However, triage is desirable to correctly identify HPV+ women who have high-grade lesions (CIN2+) and require treatment. The ANRS-12375 study was conducted in Côte d'Ivoire, Burkina Faso and Cambodia to assess the performance, feasibility and benefits of different triage options for detecting CIN2+ lesions: partial (HPV16 and HPV16/18/45) and extended genotyping, visual inspection (VIA) alone and VIA combined with partial genotyping. VIA was performed by gynecologists. The sensitivity, specificity, and diagnostic likelihood ratio (DLR) of each triage option for detecting CIN2+ lesions with histology as a reference standard were calculated. Of the 2253 women living with HIV (WLHIV) included, 932 (41%) were HPV+. A CIN2+ lesion was identified in 105 (13%) of the 777 participants with histopathology results. The sensitivity of VIA as a triage test for CIN2+ patients was 89%, while that for extended genotyping was 89%, that for HPV16/18/45 partial genotyping was 51%, and that for HPV16 partial genotyping was 36%. The specificities for these tests were 45%, 29%, 72%., and 85%, respectively. Combining VIA and/or partial genotyping positivity slightly increased the sensitivity (94%) at the cost of lower specificity (28%). There was significant intersite heterogeneity (p = .04). Among the three triage tests with a sensitivity ≥85%, the VIA had the highest specificity and positive likelihood ratio (p < .001). VIA and extended genotyping, whether independent or combined, are good triage options with high sensitivity for identifying WLHIV needing treatment for CIN2+.

Keywords: HIV; HPV; cervical cancer; resource‐limited countries; screening.

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Conflict of interest statement

The authors declare no conflicts of interest.

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