Re‐valuation of annual cytology using HPV self‐sampling to upgrade prevention (REACH UP): A feasibility study in women living with HIV in the UK

Cicconi, Paola; Wells, Charlotte; McCarthy, Blanka; Wareing, Susan; Andersson, Monique; Fox, Julie; Lwanga, Julianne; Pal, Nisha; Burns, Fiona; Woodward, Clare; Malek, R; Sabin, Caroline; Dorrell, Lucy

doi:10.1111/hiv.13257

Cited by 3 publications

(3 citation statements)

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“…Accumulating evidence has provided strong and consistent data that HPV persistence is the main factor influencing the risk of developing HPV-related disease, including cervical dysplasia and cervical cancer (Casarin et al ., 2020; Falcaro et al ., 2021; Mix et al ., 2022; Di Donato et al ., 2023; Giannini et al ., 2023). Duration of HPV persistence, viral load, deregulation of HPV gene expression, and host epigenetic mechanisms (including methylation of imprinted gene control) are the main factor influencing the process of tissue transformation (Smith et al ., 2022; Cicconi et al ., 2022; Demarco et al ., 2022; Mix et al ., 2022). Although a high level of evidence highlighted that HPV persistence correlates with the risk of developing either primary or recurrent cervical dysplasia, no evidence regarding the impact of duration of HPV infection is still available.…”

Section: Discussionmentioning

confidence: 99%

“…The role of HPV in determining the occurrence of cervical dysplasia and cervical cancer is well established (Falcaro et al, 2021;Bukowski et al, 2022;Demarco et al, 2022;Mix et al, 2022;Smith et al, 2022). More interestingly, HPV persistence, as well as viral load, are considered two of the main risk factors impacting the risk of cervical dysplasia recurrence (Bogani et al, 2021b;Cicconi et al, 2022;Prétet et al, 2022). Other main risk factors influencing the risk of cervical dysplasia recurrence include patients' age, positive margin status, and severity of the lesions (Bogani et al, 2019(Bogani et al, , 2020a(Bogani et al, , 2021b.…”

Section: Introductionmentioning

confidence: 99%

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Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Bogani

Sopracordevole

Ciavattini

et al. 2023

European Journal of Cancer Prevention

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Objective To evaluate how the duration of human papillomavirus (HPV) persistence influences the risk of developing recurrent high-grade cervical dysplasia (CIN2+). Methods Data of patients with persistent HPV infection (at least at 6 months) after primary conization were extracted from a multi-institutional Italian database, retrospectively. Kaplan–Meier and Cox proportional hazards models were used to evaluate associations between duration of HPV persistence with the 5-year risk of developing recurrent CIN2+. Results Overall, 545 patients met the inclusion criteria. Positive margins were detected in 160 (29.3%) patients. Overall, 247 (45.3%) and 123 (22.6%) patients had a documented infection from HPV16/18, and other high-risk HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12, 18, and 24 months, respectively. Patients with HPV persistence at 6 months experienced a risk of recurrence of 7.46%. Twelve-month HPV persistence strongly correlates with the risk of developing the recurrent disease (risk of recurrence: 13.1%). While, having HPV persistence >12 months did not correlate with an increased risk of recurrence (hazard ratio: 1.34 (95% confidence interval: 0.78–2.32); P = 0.336, log-rank test). Conclusion HPV persistence is one of the most important factors predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased with the increase of HPV persistence for up to 1 year. The persistence of HPV after the first year does not appear as a risk factor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Bogani

Sopracordevole

Ciavattini

et al. 2023

European Journal of Cancer Prevention

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“…Only one study [40] mentioned self‐sampling for cervical HPV DNA, yet this method has been approved by the WHO and the ESGO as it has comparable sensitivity to physician‐collected samples and has shown improvement in reaching those who do not routinely attend cervical cancer screening [12, 13, 38]. Data on HPV self‐sampling among WLWH mainly come from outside Europe [41], and therefore Cicconi et al's finding that WLWH in England found self‐sampling acceptable is of value and could support expanding the use of this method in the WER, particularly for women who decline standard screening [40].…”

Section: Discussionmentioning

confidence: 99%

Screening and prevention of HPV‐related anogenital cancers in women living with HIV in Europe: Results from a systematic review

Krankowska,

Mazzitelli,

Ucak

et al. 2024

HIV Medicine

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BackgroundWomen living with HIV (WLWH) are at increased risk of human papillomavirus (HPV)‐related cancers. Throughout Europe, there is great heterogeneity among guidelines for screening programmes, access to HPV testing and HPV vaccination. The aim of this systematic review is to summarize available data on screening and prevention measures for HPV‐related anogenital cancers in WLWH across the WHO European Region (WER).MethodsThe systematic review followed the PRISMA guidelines and was registered on Prospero. PubMed, Embase and Web of Science databases were searched to identify available studies, written in English and published between 2011 and 2022. A metanalysis was conducted using random‐effects models to calculate pooled prevalence of HPV. Subgroup analyses were conducted according to country and HPV testing.ResultsThirty‐four articles involving 10 336 WLWH met the inclusion criteria. Studies were heterogenous in their methodology and presentation of results: 73.5% of studies focused on cervical cancer prevention, and only 4.4% on anal cancer; 76.5% of studies conducted HPV testing as a routine part of screening. The prevalence of high‐risk HPV was 30.5–33.9% depending on the detection method used. A total of 77% of WLWH had cervical cytology results reported. Six studies reported the positive association of CD4 cell count <200 cells/μL with HPV prevalence and cervical abnormalities. Anal HPV testing was conducted in <8% of participants. HPV vaccination was completed in 5.6% of women (106/1902) with known vaccination status. There was no information about the vaccination status of the majority of women in the analysed studies (8434/10336).ConclusionData about screening of HPV‐related anogenital cancer in WLWH in Europe are heterogenous and lacking, especially in relation to anal cancer. HPV DNA testing is not routinely done as part of screening for HPV‐related cancer; guidelines should include indications for when to use this test. Low CD4 count is a risk factor for HPV infection and cytological abnormalities. HPV vaccination data are poor and, when available, vaccination rates are very low among WLWH in Europe. This review concludes that significant improvements are required for data and also consistency on guidelines for HPV screening, prevention and vaccination in WLWH.

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Re‐valuation of annual cytology using HPV self‐sampling to upgrade prevention (REACH UP): A feasibility study in women living with HIV in the UK

et al. 2022

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Introduction: Current UK guidelines for cervical cancer screening are based on the assumption that most women living with HIV (WLWH) are also high-risk (HR) human papillomavirus (HPV)-positive. We aimed to provide data on prevalence of HR-HPV in WLWH in the UK and to assess feasibility and acceptability of HR-HPV self-sampling in this group.Methods: Women living with HIV attending six HIV services in London/south of England, with no history of cervical cancer, were enrolled. Participants selfcollected a vaginal swab for the detection of HR-HPV, completed a survey about sexual/gynaecological history, attitudes towards annual screening and perception of HR-HPV self-sampling, and were asked to have their annual cervical smear. University of Oxford) for providing assistance in the project management and Sunita Baniya and Kate Rabjohns (Slough Hospital) for helping with the study delivery.

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Re‐valuation of annual cytology using HPV self‐sampling to upgrade prevention (REACH UP): A feasibility study in women living with HIV in the UK

Cited by 3 publications

References 17 publications

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Screening and prevention of HPV‐related anogenital cancers in women living with HIV in Europe: Results from a systematic review

Re‐valuation of annual cytology using HPV self‐sampling to upgrade prevention (REACH UP): A feasibility study in women living with HIV in the UK

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