The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2018;22:16-23 - Vol. 22 Num.1 DOI: 10.1016/j.bjid.2017.10.007
Original article
Hybrid capture as a tool for cervical lesions screening in HIV-infected women: insights from a Brazilian cohort
Emilia Moreira Jalila,, , Paula M. Luza, Marcel Quintanaa,b, Ruth Khalili Friedmana, Rosa M. Domingues S. Madeiraa, Angela Cristina Andradea, Janice Chicarinoa, Ronaldo Ismerio Moreiraa, Monica Derricoa, José Eduardo Levib, Fabio Russomanoa, Valdilea Gonçalves Velosoa, Beatriz Grinsztejna
a Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI) Evandro Chagas, Rio de Janeiro, RJ, Brazil
b Universidade de São Paulo, São Paulo, SP, Brazil
Received 14 August 2017, Accepted 26 October 2017

Cervical cancer remains an important burden for HIV-infected women in the era of combination antiretroviral therapy. Recommendations for cervical screening in these women diverge and may include high-risk HPV (HRHPV) testing. We aimed to evaluate the clinical usefulness of a single HRHPV testing for cervical screening of HIV-infected women.


723 HIV-infected women from a Brazilian prospective cohort were included between 1996 and 2012. Inclusion criteria were: normal cervical cytology at baseline and having a HRHPV-test at baseline. We calculated incidence rates of any squamous intraepithelial lesion (SIL) and high grade SIL+ (HSIL+) and negative predictive values (NPV) within 12 and 36 months. Hazard Ratios were obtained using Cox proportional hazards regression models.


Incidence rate for both outcomes was low (9.9 cases per 100 PY [95% CI 8.8–11.0] for any SIL and 1.3 cases per 100 PY [95% IC 0.9–1.8] for HSIL+). Women with a HRHPV positive status at baseline had 1.7-fold (95% CI 1.3–2.2) and 3.2-fold (95% CI 1.5–7.1) increased risk of presenting any SIL and HSIL+, respectively, during follow-up. Negative-HRHPV test presented high NPV for both periods and outcomes (any SIL: 92.4% [95% CI 89.7–94.6] for 12 months and 80.9% [95% CI 77.2–84.3] for 36 months; and HSIL+: 99.8% [95% CI 98.9–100.0] for 12 months and 99.0 [95% CI 97.6–99.7] for 36 months).


Incidence of any and high grade cytological abnormality was significantly higher among HIV-infected women with positive-HRHPV test. A single negative-HRHPV test helped reassure follow-up free of cytological abnormalities through three years of follow-up in HIV-infected women with negative cytology.

HPV, HIV, Women, Cohort, Incidence
Braz J Infect Dis 2018;22:16-23 - Vol. 22 Num.1 DOI: 10.1016/j.bjid.2017.10.007