{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:42:52Z","timestamp":1760294572062,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,9,29]],"date-time":"2014-09-29T00:00:00Z","timestamp":1411948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Women who are infected with the human immunodeficiency virus (HIV) are at high risk of human papillomavirus\u2010persistent infections. Invasive cervical cancer is listed among the illnesses associated with the acquired immunodeficiency syndrome. The objective of the current study was to investigate whether, in South Africa, the accuracy of abnormal cytology confirmed by a histological diagnosis using loop electrosurgical excision procedure (LEEP) is affected by knowledge of the woman's HIV serostatus.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Of 7648 biopsy specimens, 941 were LEEPs indicated by a cytology report of low\u2010grade squamous intraepithelial lesion or high\u2010grade squamous intraepithelial lesion. A total of 618 specimens (65.7%) were from HIV\u2010uninfected women and 323 specimens (34.3%) were from HIV\u2010infected women. Those women with an unknown pre\u2010LEEP cytological diagnosis were excluded from the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The total prevalence of HIV infection among the 7648 patients was 18.6%, reflecting its prevalence in the general population of women aged 15 to 49 years. The rate of HIV infection among 3462 women with invasive cervical cancer was 10.7%. The overall prevalence of preinvasive lesions was 73.9% in HIV\u2010infected women compared with 50.3% in women not infected with HIV (<jats:italic>P<\/jats:italic>&lt;.0001). The concordance and discordance rates between cytology and histology were similar in uninfected and infected women (<jats:italic>P<\/jats:italic> =.93 and <jats:italic>P<\/jats:italic> =.18, respectively). Among HIV\u2010infected women, 79.1% of discordant results were due to cytological overdiagnosis; among HIV\u2010negative women, 86.5% of discordant results were due to underdiagnosis (<jats:italic>P<\/jats:italic>&lt;.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>It appears that the finding of a higher prevalence of preinvasive lesions combined with the knowledge of a patient's HIV\u2010positive serostatus prompts more cytological overdiagnosis, thereby resulting in avoidable LEEP interventions. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2014;122:909\u2013913.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21487","type":"journal-article","created":{"date-parts":[[2014,9,29]],"date-time":"2014-09-29T16:52:48Z","timestamp":1412009568000},"page":"909-913","source":"Crossref","is-referenced-by-count":2,"title":["Influence of knowledge of human immunodeficiency virus serostatus on accuracy of cervical cytologic diagnosis"],"prefix":"10.1002","volume":"122","author":[{"given":"Louis\u2010Jacques","family":"van Bogaert","sequence":"first","affiliation":[{"name":"Department of Pathology, National Health Laboratory Service University of Limpopo Polokwane Limpopo Province South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,29]]},"reference":[{"unstructured":"National Department of Health (South Africa). 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