{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T04:43:10Z","timestamp":1789879390166,"version":"4.0.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003Although human immunodeficiency virus (HIV)-infected women are at high risk for anal cancer, few data have been published on prevalence of and risk factors for anal precancer and potential screening strategies in this risk group.<\/jats:p>\n               <jats:p>Methods. \u2003A cross-sectional anal screening study was nested in a gynecological cohort of HIV-infected women. Anal swab specimens were collected for cytology and human papillomavirus (HPV) testing. High-resolution anoscopy, with biopsy when indicated, was systematically performed.<\/jats:p>\n               <jats:p>Results. \u2003Among the 171 enrolled women, median age was 47.3 years and 98% were receiving combination antiretroviral therapy. Median CD4+ count was 655 cells\/\u00b5L and HIV load was &amp;lt;50 copies\/mL in 89% of subjects. High-grade anal intraepithelial neoplasia or worse (HG-AIN+) was diagnosed in 12.9% (n = 21). In multivariable analysis, a history of cervical squamous intraepithelial lesion (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.1\u201316.4) and anal HPV-16 infection (OR, 16.1; 95% CI, 5.4\u201348.3) was associated with increased risk of HG-AIN+. Abnormal anal cytology and HPV-16 infection performed best as a screening strategy for HG-AIN+ histology, with positive likelihood ratios of 3.4 (95% CI, 2.3\u20135.1) and 4.7 (95% CI, 2.5\u20138.7) and negative likelihood ratios of 0.2 (95% CI, .07\u2013.8) and 0.4 (95% CI, .2\u2013.9), respectively.<\/jats:p>\n               <jats:p>Conclusions. \u2003HIV-infected women with a history of HPV-associated cervical disease are at increased risk for HG-AIN+ and should be offered anal cancer screening. Anal cytology and HPV-16 genotyping had the best screening performance. Anal cytology is easy to perform routinely; it may be the best candidate for screening for HG-AIN among HIV-infected women.<\/jats:p>","DOI":"10.1093\/cid\/civ049","type":"journal-article","created":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T05:27:49Z","timestamp":1422941269000},"page":"1559-1568","source":"Crossref","is-referenced-by-count":24,"title":["High Prevalence of Anal Human Papillomavirus\u2013Associated Cancer Precursors in a Contemporary Cohort of Asymptomatic HIV-Infected Women"],"prefix":"10.1093","volume":"60","author":[{"given":"Isabelle","family":"Heard","sequence":"first","affiliation":[{"name":"Institut Pasteur 1 French Human Papillomavirus Reference Laboratory ,"},{"name":"Assistance Publique, H\u00f4pitaux de Paris (AP-HP) 2 Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Etienney","sequence":"additional","affiliation":[{"name":"Diaconesses-Croix Saint-Simon Group Hospitals 3 Department of Proctology ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Potard","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9s, UPMC Univ Paris 06, UMR_S 1136 4"},{"name":"INSERM, UMR_S 1136 5"},{"name":"INSERM Transfert 6 , Paris"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Poizot-Martin","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, Assistance Publique, H\u00f4pitaux de Marseille, Sainte-Marguerite, Service d'Immuno-h\u00e9matologie clinique, INSERM U912 (SESSTIM) 7 ,","place":["Marseille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Moore","sequence":"additional","affiliation":[{"name":"Scottish Human Papillomavirus Reference Laboratory 8 , Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Carole","family":"Lesage","sequence":"additional","affiliation":[{"name":"Diaconesses-Croix Saint-Simon Group Hospitals 3 Department of Proctology ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Ressiot","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, Assistance Publique, H\u00f4pitaux de Marseille, Sainte-Marguerite, Service d'Immuno-h\u00e9matologie clinique, INSERM U912 (SESSTIM) 7 ,","place":["Marseille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Crenn-Hebert","sequence":"additional","affiliation":[{"name":"AP-HP\u2013H\u00f4pitaux Universitaires Paris Nord Val de Seine, H\u00f4pital Mourier 9 , Colombes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Fl\u00e9jou","sequence":"additional","affiliation":[{"name":"AP-HP\u2013H\u00f4pitaux Universitaires de l'Est Parisien, H\u00f4pital Saint-Antoine 10 Department of Pathology , , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Cubie","sequence":"additional","affiliation":[{"name":"Scottish Human Papillomavirus Reference Laboratory 8 , Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9s, UPMC Univ Paris 06, UMR_S 1136 4"},{"name":"INSERM, UMR_S 1136 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa M.","family":"Darragh","sequence":"additional","affiliation":[{"name":"University of San Francisco 11 Department of Pathology , , California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ANRS-C017 VIHGY Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Franceschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Palefsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Heard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Costagliola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Cubie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bergeron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Carcelain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Foulot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Crenn-H\u00e9bert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Tubiana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Poizot-Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Isabelle Richet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Lefebvre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Rousset Jablonski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Viard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Sastre Garau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Tubiana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bonmarchand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Cuccu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Lefebvre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Richet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Torchin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Carbonne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. F.","family":"Fl\u00e9jou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hoyeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Poizot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.J.","family":"Ducassou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ressiot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Figarella-Branger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Crenn-H\u00e9bert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gorbatchev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Rousset-Jablonski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Viard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Etienney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lesage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Potard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Taibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Costagliola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virology: H.","family":"Cubie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bergeron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,2,2]]},"reference":[{"key":"2024111411392398100_CIV049C1","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1002\/ijc.26115","article-title":"Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978\u20132008","volume":"130","author":"Nielsen","year":"2012","journal-title":"Int J Cancer"},{"key":"2024111411392398100_CIV049C2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/AOG.0b013e31829a2ace","article-title":"Risk factors for anal intraepithelial neoplasia in women with genital dysplasia","volume":"122","author":"ElNaggar","year":"2013","journal-title":"Obstet Gynecol"},{"key":"2024111411392398100_CIV049C3","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1093\/cid\/cir1012","article-title":"Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America","volume":"54","author":"Silverberg","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2024111411392398100_CIV049C4","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1093\/jnci\/djp205","article-title":"Risk of human papillomavirus-associated cancers among persons with AIDS","volume":"101","author":"Chaturvedi","year":"2009","journal-title":"J Natl Cancer Inst"},{"key":"2024111411392398100_CIV049C5","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1097\/QAD.0000000000000382","article-title":"Risk of non-AIDS-defining cancers among HIV-1-infected individuals in France between 1997 and 2009: results from a French cohort","volume":"28","author":"Hleyhel","year":"2014","journal-title":"AIDS"},{"key":"2024111411392398100_CIV049C6","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/CCO.0b013e3283094ed8","article-title":"Human papillomavirus-related diseases in HIV-infected individuals","volume":"20","author":"Stier","year":"2008","journal-title":"Curr Opin Oncol"},{"key":"2024111411392398100_CIV049C7","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/DCR.0b013e318207039a","article-title":"Prevalence of anal intraepithelial neoplasia defined by anal cytology screening and high-resolution anoscopy in a primary care population of HIV-infected men and women","volume":"54","author":"Weis","year":"2011","journal-title":"Dis Colon Rectum"},{"key":"2024111411392398100_CIV049C8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/QAD.0b013e32831cc101","article-title":"Anal intraepithelial neoplasia in a multisite study of HIV-infected and high-risk HIV-uninfected women","volume":"23","author":"Hessol","year":"2009","journal-title":"AIDS"},{"key":"2024111411392398100_CIV049C9","doi-asserted-by":"crossref","first-page":"21.e1","DOI":"10.1016\/j.ajog.2010.01.010","article-title":"Abnormal anal cytology in HIV-infected women","volume":"203","author":"Tandon","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"2024111411392398100_CIV049C10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/QAI.0b013e318251afd9","article-title":"High prevalence of high grade anal intraepithelial neoplasia in HIV-infected women screened for anal cancer","volume":"60","author":"Hou","year":"2012","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024111411392398100_CIV049C11","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1097\/QAD.0b013e3283601b09","article-title":"Concomitant anal and cervical human papillomavirus infections and intraepithelial neoplasia in HIV-infected and uninfected women","volume":"27","author":"Hessol","year":"2013","journal-title":"AIDS"},{"key":"2024111411392398100_CIV049C12","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/2046-4053-2-35","article-title":"Screening for cervical cancer: a systematic review and meta-analysis","volume":"2","author":"Peirson","year":"2013","journal-title":"Syst Rev"},{"key":"2024111411392398100_CIV049C13","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/CCO.0b013e328363e04a","article-title":"Screening guidelines for non-AIDS defining cancers in HIV-infected individuals","volume":"25","author":"Mani","year":"2013","journal-title":"Curr Opin Oncol"},{"key":"2024111411392398100_CIV049C14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/DCR.0b013e31819793d9","article-title":"Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia","volume":"52","author":"Berry","year":"2009","journal-title":"Dis Colon Rectum"},{"key":"2024111411392398100_CIV049C15","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/PGP.0b013e31826916c7","article-title":"The Lower Anogenital Squamous Terminology Standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology","volume":"32","author":"Darragh","year":"2013","journal-title":"Int J Gynecol Pathol"},{"key":"2024111411392398100_CIV049C16","volume-title":"Practical statistics for medical research","author":"Altman","year":"1991"},{"key":"2024111411392398100_CIV049C17","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S1470-2045(09)70096-8","article-title":"A review of human carcinogens\u2014part B: biological agents","volume":"10","author":"Bouvard","year":"2009","journal-title":"Lancet Oncol"},{"key":"2024111411392398100_CIV049C18","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/QAI.0b013e3182a9b3d3","article-title":"Random biopsy during high-resolution anoscopy increases diagnosis of anal high-grade squamous intraepithelial lesions","volume":"65","author":"Silvera","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024111411392398100_CIV049C19","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/QAD.0000000000000062","article-title":"High rates of anal dysplasia in HIV-infected men who have sex with men, women, and heterosexual men","volume":"28","author":"Gaisa","year":"2014","journal-title":"AIDS"},{"key":"2024111411392398100_CIV049C20","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/OLQ.0b013e3181f70253","article-title":"Human papillomavirus infection and cytologic abnormalities of the anus and cervix among HIV-infected women in the study to understand the natural history of HIV\/AIDS in the era of effective therapy (the SUN study)","volume":"38","author":"Kojic","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2024111411392398100_CIV049C21","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S1470-2045(12)70080-3","article-title":"Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis","volume":"13","author":"Machalek","year":"2012","journal-title":"Lancet Oncol"},{"key":"2024111411392398100_CIV049C22","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1002\/cncy.21218","article-title":"Interrater agreement of anal cytology","volume":"121","author":"Darragh","year":"2013","journal-title":"Cancer Cytopathol"},{"key":"2024111411392398100_CIV049C23","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1002\/cncr.20927","article-title":"Interobserver agreement in the interpretation of anal intraepithelial neoplasia","volume":"103","author":"Lytwyn","year":"2005","journal-title":"Cancer"},{"key":"2024111411392398100_CIV049C24","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12176","article-title":"Interobserver variability of cervical cytology in HIV-infected women","author":"Heard","year":"2014","journal-title":"Cytopathology"},{"key":"2024111411392398100_CIV049C25","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2174\/1874613600701010011","article-title":"Early impact and performance characteristics of an established anal dysplasia screening program: program evaluation considerations","volume":"1","author":"Mathews","year":"2007","journal-title":"Open AIDS J"},{"key":"2024111411392398100_CIV049C26","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S1470-2045(07)70043-8","article-title":"Risk of anogenital cancer after diagnosis of cervical intraepithelial neoplasia: a prospective population-based study","volume":"8","author":"Edgren","year":"2007","journal-title":"Lancet Oncol"},{"key":"2024111411392398100_CIV049C27","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1158\/1055-9965.EPI-08-1141","article-title":"Screening for HIV-associated anal cancer: correlation of HPV genotypes, p16, and E6 transcripts with anal pathology","volume":"18","author":"Salit","year":"2009","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2024111411392398100_CIV049C28","doi-asserted-by":"crossref","first-page":"b2569","DOI":"10.1136\/bmj.b2569","article-title":"Short term persistence of human papillomavirus and risk of cervical precancer and cancer: population based cohort study","volume":"339","author":"Castle","year":"2009","journal-title":"BMJ"},{"key":"2024111411392398100_CIV049C29","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1093\/jnci\/93.11.843","article-title":"Prevalence and risk factors for anal squamous intraepithelial lesions in women","volume":"93","author":"Holly","year":"2001","journal-title":"J Natl Cancer Inst"},{"key":"2024111411392398100_CIV049C30","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1086\/318071","article-title":"Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women","volume":"183","author":"Palefsky","year":"2001","journal-title":"J Infect Dis"},{"key":"2024111411392398100_CIV049C31","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1002\/ijc.28431","article-title":"Progression of anal high-grade squamous intraepithelial lesions to invasive anal cancer among HIV-infected men who have sex with men","volume":"134","author":"Berry","year":"2014","journal-title":"Int J Cancer"},{"key":"2024111411392398100_CIV049C32","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1002\/dc.23050","article-title":"A six-year experience with anal cytology in women with HPV in the lower genital tract: utility, limitations, and clinical correlation","volume":"42","author":"Cardinal","year":"2014","journal-title":"Diagn Cytopathol"},{"key":"2024111411392398100_CIV049C33","article-title":"National cancer control programmes. Policies and managerial guidelines","author":"World Health Organization","year":"2002"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/60\/10\/1559\/966472\/civ049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/60\/10\/1559\/966472\/civ049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T11:45:57Z","timestamp":1731584757000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/60\/10\/1559\/337919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,2]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2015,2,2]]},"published-print":{"date-parts":[[2015,5,15]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/civ049","relation":{},"ISSN":["1537-6591","1058-4838"],"issn-type":[{"value":"1537-6591","type":"electronic"},{"value":"1058-4838","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,5,15]]},"published":{"date-parts":[[2015,2,2]]}}}