Evidence map›Paper›PMID 34008294›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2021

Persistence and clearance of high-risk human papillomavirus and cervical dysplasia at 1 year in women living with human immunodeficiency virus: a prospective cohort study.

R Luckett, H Painter, M R Hacker, B Simon, A Seiphetlheng, A Erlinger, C Eakin, S Moyo, L T Kyokunda, K Esselen and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  5. Review
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  8. The role of HIV as an independent risk factor to cervical HSIL recurrence.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 4 countries.

R LuckettDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
H PainterBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
M R HackerDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
B SimonBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
A SeiphetlhengDepartment of Obstetrics and Gynaecology, Princess Marina Hospital, Gaborone, Botswana.
A ErlingerDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
C EakinBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
S MoyoBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
L T KyokundaDepartment of Pathology, University of Botswana, Gaborone, Botswana.
K EsselenDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
S FeldmanHarvard Medical School, Boston, MA, USA.
C MorroniBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
D Ramogola-MasireDepartment of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana.
Botswana Harvard AIDS Institute Partnership · BWHarvard University · USBeth Israel Deaconess Medical Center · USUniversity of Botswana · BWBrigham and Women's Hospital · USLiverpool School of Tropical Medicine · GBPrincess Margaret Hospital · HK

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Beth Israel Deaconess Medical CenterHarvard Catalyst UL 1TR002541Harvard University Center for AIDS Research NIH/NIAID 5P30AI060354-14NCATS NIH HHS UL1 TR002541NIAID NIH HHS P30 AI060354
6 · The paper itself

Abstract

objectiveEvaluate 1-year outcomes of cervical cancer screening and treatment using primary high-risk human papillomavirus (HPV) testing in women living with human immunodeficiency virus (HIV).

designProspective cohort study.

settingHIV treatment centre in Botswana. POPULATION: Women living with HIV.

methodsParticipants underwent cervical cancer screening with high-risk HPV testing and triage evaluation at baseline and 1-year follow up. Excisional treatment was offered as indicated. Histopathology was the reference standard.

main outcome measuresPersistence, clearance and incidence of high-risk HPV infection; and persistence, progression, regression, cure and incidence of cervical dysplasia.

resultsAmong 300 women screened at baseline, 237 attended follow up (79%). High-risk HPV positivity significantly decreased from 28% at baseline to 20% at 1 year (P = 0.02). High-risk HPV persistence was 46% and clearance was 54%; incidence was high at 9%. Prevalence of cervical intraepithelial neoplasia Grade 2 (CIN2) or higher was most common in participants with incident high-risk HPV (53%). CIN2 or higher was also common in those with persistent high-risk HPV (32%) and even in those who cleared high-risk HPV (30%). Of the high-risk HPV-positive participants at baseline with <CIN2, 40% progressed to CIN2 or higher at follow up.

conclusionThe high incidence of high-risk HPV and high-grade cervical dysplasia in women living with HIV after one round of high-risk HPV-based screening and treatment raises concern about the rate of progression of high-risk HPV infection to dysplasia. Persistent disease is common. Caution in spacing cervical cancer screening intervals using high-risk HPV testing in women living with HIV is warranted. TWEETABLE ABSTRACT: High incidence and persistence of HPV and CIN2+ in women living with HIV 1 year after screening and treatment.

Indexed as

AlphapapillomavirusAdultBotswanaCervix UteriEarly Detection of CancerFemaleFollow-Up StudiesHIVHIV InfectionsHumansIncidenceMiddle AgedPapillomavirus InfectionsPrevalenceProspective StudiesTime FactorsCervical cancer screeningdysplasiaHPV persistencehuman immunodeficiency virushuman papillomaviruslow- and middle-income countries

Identifiers

PMID34008294
PMCPMC8497414
OpenAlexW3161887188

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.