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74 Hypermethylation for cervical cancer screening among hiv-positive women in south african
  1. C Visser1,
  2. W Kremer2,
  3. E Breytenbach1,
  4. C Meiijer2 and
  5. G Dreyer1
  1. 1University of Pretoria, Department of Obstetrics and Gynaecology, Pretoria, South Africa
  2. 2Free University Amsterdam, Department of Pathology, Amsterdam, The Netherlands


Objectives We investigated the role of molecular markers in cervical cancer screening for South African women living with HIV (WLHIV).

Methods South African WLHIV underwent cervical screening and colposcopy-directed biopsy with molecular screening. Data included cytology, HPV (high-risk), HPV (16/18) and histology. Detection of FAM19A4/miR124–2 hypermethylation was performed on DNA isolated from cervical scrapes. Diagnostic performance of cytology and HPV tests alone and combined with FAM19A4/miR124–2 hypermethylation was determined.

Results 285 women were included in the analyses. Cytology provided the highest specificity (91.6%), but lowest sensitivity (59.3%), HPV (high-risk) provided the highest sensitivity (83.1%), but lowest specificity (66.4%). Combining cytology with methylation did not improve the performance of cytology alone, but triage of HPV (high-risk) with methylation, increased specificity (76.1%) while maintaining an acceptable sensitivity (72.9%). Similar performance was observed for HPV (16/18) with methylation triage (sensitivity 79.7%, specificity 74.8%). Number referred per CIN3+ was lowest for cytology (1.5), but only slightly higher for HPV (high-risk) or HPV (16/18) with methylation triage (2.3 and 2.2).

Conclusions We report promising results using molecular triage of HPV positive WLHIV with methylation markers regarding sensitivity and specificity for CIN 3+.

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