Contribution of human papillomavirus second-generation hybrid capture test for the diagnosis of cervical pathology in HIV-infected outpatients

BACKGROUND AND OBJECTIVE: The causal relationship between human papillomavirus (HPV) and cervical cancer is well established. The initial diagnosis of HPV-related cervical infection is currently performed by HPV-associated changes in cervical cytology. We aimed to study the accuracy and concordance between HPV ADN detection by second-generation hybrid capture (HC-2) and cervical cytological changes for the diagnosis of HPV cervical infection in human immunodeficiency virus (HIV+) outpatients. PATIENTS AND METHOD: From March 1999 to August 2002, 139 HIV+ patients were included. HPV infection was determined by cytology and HC-2. The accuracy and level of concordance between both techniques was analyzed. RESULTS: The applicability of the HC-2 test was 96%. Sixty-eight (49%) patients were diagnosed with HPV infection by HC-2. High-oncogenetic- risk HPV genotypes were detected in 64 (46%) patients. The sensitivity, specificity and positive and negative predictive values of HC-2 in HPV detection were 78%, 69%, 61% and 83%, respectively. The concordance was K = 0.44 (95% confidence interval, 0.29-0.60); p < 0.001. CONCLUSIONS: The HC-2 diagnostic technique for HPV-related cervical infection in HIV+ patients is a sensitive and specific test. The combined use of both tests might increase the diagnostic efficacy, and hence have positive repercussions on cervical pathology screening on an outpatient basis.