{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:20:46Z","timestamp":1791300046484,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1K08CA271949"],"award-info":[{"award-number":["1K08CA271949"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K43 TW012350\u201001"],"award-info":[{"award-number":["K43 TW012350\u201001"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the performance of HPV type restriction and cycle threshold (Ct)\u2010limit setting to optimize detection of cervical intraepithelial neoplasia (CIN) with primary HPV testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline cervical screening at time of entry into a prospective longitudinal cohort of women with and without HIV was conducted from February 2021 to July 2022 in Botswana. All women underwent HPV testing of 15 individual types using the AmpFire assay; all HPV\u2010positive and a random subset of HPV negative had histopathology collected. Performance parameters of HPV type restriction groupings were calculated, and sensitivity by individual HPV type Ct\u2010value limits were plotted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2964 women who underwent primary HPV screening, 1293 (43.6%) tested HPV\u2010positive. Among women with HIV (WWH), HPV types 16\/18\/33 were associated with the greatest burden of CIN2+\/CIN3+ (53%\/56%). In WWH, grouping by HPV types separately reported in commercial assays (16\/18\/45) had low sensitivity (44% [CI: 36%\u201352%]) but high specificity (86% [CI: 84%\u201388%]) for CIN2+; 8\u2010type HPV restriction (16\/18\/31\/33\/35\/45\/52\/58) improved sensitivity (79% [CI: 72%\u201386%]) and maintained reasonable specificity (67% [CI: 65%\u201370%]) for CIN2+. Similar results were seen in women without HIV. Ct\u2010limit setting for medium oncogenic HPV types (31,33,35,52,58) maintained a sensitivity of 72% in WWH while reducing over\u2010detection of non\u2010pathogenic HPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Eight\u2010type HPV restriction and Ct\u2010limit setting are promising strategies for improving the performance of primary HPV screening. A potential strategy to improve 8\u2010type HPV restriction would be to treat all with HPV 16\/18\/45; treat HPV 31\/33\/35\/52\/58 if below the type\u2010specific Ct limit and repeat HPV testing in 1\u2010year for other positive HPV results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70074","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T06:48:06Z","timestamp":1742366886000},"page":"882-892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improved cervical screening using\n                    <scp>HPV<\/scp>\n                    type restriction and cycle threshold limit setting with the\n                    <scp>AmpFire<\/scp>\n                    assay: A prospective screening cohort of women with and without\n                    <scp>HIV<\/scp>\n                    in Botswana"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1975-8837","authenticated-orcid":false,"given":"Rebecca","family":"Luckett","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Obstetrics and Gynecology Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Ramogola\u2010Masire","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Botswana  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sikhulile","family":"Moyo","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Harvard T.H. 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