{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:56:47Z","timestamp":1780988207803,"version":"3.54.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,2,16]],"date-time":"2019-02-16T00:00:00Z","timestamp":1550275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Red de Investigaci\u00f3n en SIDA","award":["RD16\/0025\/0020-ISCIII-FEDER"],"award-info":[{"award-number":["RD16\/0025\/0020-ISCIII-FEDER"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CPII18\/00033"],"award-info":[{"award-number":["CPII18\/00033"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Screening methods for anal squamous intraepithelial lesions (SILs) are suboptimal. We aimed to determine the diagnostic performance of a composite endpoint comprising anal liquid-based cytology (aLBC) and high-risk human papillomavirus (HR-HPV) testing to predict histological high-grade SILs (hHSILs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From the SeVIHanal cohort, human immunodeficiency virus (HIV)\u2013infected men who have sex with men (MSM) who had an aLBC with concomitant HR-HPV testing were included. hHSILs were determined by high-resolution anoscopy (HRA)\u2013guided biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 705 visits obtained from 426 patients were included. The prevalence of HR-HPV among aLBC results were 51.9% (133\/215) normal, 87.9% (20\/232) low-grade SILs (LSILs), and 90.9% (149\/164) high-grade SILs; P (linear association) &lt; .001. Low prevalence of hHSILs was only observed for the composite aLBC\/HR-HPV testing endpoint \u201cnormal\/noHR-HPV\u201d (10%) and \u201cLSIL\/noHR-HPV\u201d (4%). The prognostic values (95% confidence interval) for HR-HPV to predict hHSILs in normal cytology were positive predictive value (PPV), 29.3% (25.6%\u201333.3%); negative predictive value (NPV), 90.2% (82.8%\u201394.7%); sensitivity, 83% (69.2%\u201392.4%); and specificity, 44.1% (36.4%\u201351.9%). Corresponding figures for cytologic LSILs were PPV, 39.2% (37.4%\u201341.1%); NPV, 96.4% (78.9%\u201399.5%); sensitivity, 98.8% (93.3%\u201399.9%); and specificity, 17.9% (12.1%\u201324.9%). A positive interaction and a synergistic effect for the composite endpoint were observed (relative excess risk = 1.50, attributable proportion of histological results to interaction = 0.17, synergy index = 1.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HRA should not be indicated in the setting of LSILs\/noHR-HPV following aLBC-based screening. In contrast, HIV-infected MSM with normal aLBC\/HR-HPV infection should be considered for HRA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials Registration<\/jats:title><jats:p>NCT03713229.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciz144","type":"journal-article","created":{"date-parts":[[2019,2,16]],"date-time":"2019-02-16T08:20:03Z","timestamp":1550305203000},"page":"2185-2192","source":"Crossref","is-referenced-by-count":11,"title":["High-risk Human Papilloma Virus Testing Improves Diagnostic Performance to Predict Moderate- to High-grade Anal Intraepithelial Neoplasia in Human Immunodeficiency Virus\u2013infected Men Who Have Sex With Men in Low-to-Absent Cytological Abnormalities"],"prefix":"10.1093","volume":"69","author":[{"given":"Pompeyo","family":"Viciana","sequence":"first","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas y Medicina Preventiva, Hospital Universitario Virgen del Roc\u00edo, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusnelkis","family":"Milan\u00e9s-Guisado","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Enfermedades Infecciosas y Medicina Preventiva, Hospital Universitario Virgen del Roc\u00edo, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Fontill\u00f3n","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Dom\u00ednguez Casta\u00f1o","sequence":"additional","affiliation":[{"name":"Servicio de Anatom\u00eda Patol\u00f3gica. 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