Abnormalities and HPV presenceThe Papanicolau test gave abnormal cytological findings in 28.9 of the population (n = 56; 95 CI = 22.6?5.8), results being classified as follows: 10.3 (n = 20) had atypical squamous cells of undetermined significance (AS-CUS), 16.5 (n = 32) lowgrade squamous intraepithelial lesions (L-SIL) and 2.1 (n = 4) high-grade squamous intraepithelial lesions (H-SIL). The HPV infection results obtained from the two samples were classified according the cytological results; data are 1676428 shown in Table 2. The association between the presence of HPV-DNA in each MedChemExpress HIV-RT inhibitor 1 sample and the cytological findings (categorized as being normal/ abnormal) revealed that 20.4 (n = 12) of the women having abnormal cytological findings had a negative result for HPV infection in the cervical sample while 78.6 gave a positive result (n = 44). Such difference was not statistically significant (x2(1) = 2.69; p = 0.101). On the other hand, it was found that 19.6 (n = 11) of the samples having abnormal cytological findings had negative test for HPV-DNA in the urine sample,HPV in HIV-Infected Women MedChemExpress Fruquintinib Paired SamplesFigure 1. Prevalence of HPV types in cervical and urine samples for 204 HIV-infected Colombian women. doi:10.1371/journal.pone.0056509.gTable 2. HPV detection in both sample sources according to the cytological results.HPV detection n ( ) Both positive Normal ASC-US L-SIL H-SIL 57 (41.3) 12 (60.0) 24 (75.0) 2 (50.0) Cytology only 35 (25.4) 4 (20.0) 1 (3.1) 1 (25.0) Both Urine only negative 22 (15.9) 3 (15.0) 3 (9.4) 1 (25.0) 24 (17.4) 1 (5.0) 4 (12.5) 0 (0.0) Total (194) 138 20 32Figure 2. Number of HPV types in cervical and urine samples for 204 HIV-infected Colombian women. doi:10.1371/journal.pone.0056509.gThe percentages show the frequency of women that tested positive with respect to the total per row. AS-CUS: Atypical squamous cells of undetermined significance. H-SIL: high-grade squamous intraepithelial lesions. L-SIL: Lowgrade squamous intraepithelial lesions. doi:10.1371/journal.pone.0056509.tHPV in HIV-Infected Women Paired Samplescompared to 80.4 (n = 45) where viral DNA was detected; this trend was statistically significant (x2(1) = 9.22; p = 0.002).Agreement between both samples and clinical performanceThe results obtained for infection (generic and type-specific) in both samples (cervical and urine) were compared to cytological findings, categorizing the population as normal or abnormal (Tables 3-A and 3-B, respectively), where the generic identification of HPV-DNA, showed the greatest percentage agreement. Agreement between paired samples showed that generic viral detection had greater than 50 agreement in the results obtained for the three sets of primers used, while greater agreement was found for HPV-33 and HPV-45 types for type-specific identification (even though these were the least prevalent in the 
population being studied). However, the k values gave poor correlation in all 
cases (Figure 3). The urine sample’s diagnostic performance revealed 68.8 sensitivity (60.5?6.2 95 CI), 50 specificity (36.8?3.2 95 CI), 76.7 positive predictive value (PPV) (68.5?3.7 95 CI), 40 negative predictive value (NPV) (28.9?2 95 CI) and a 0.59 ROC area (0.52?.67 95 CI).DiscussionDeveloping cervical cancer has been related to factors determining its progression, including the type of HPV infection, viral load and persistence of the infection [35]. Nevertheless, as most women have an efficient immune system they can manage to rid the.Abnormalities and HPV presenceThe Papanicolau test gave abnormal cytological findings in 28.9 of the population (n = 56; 95 CI = 22.6?5.8), results being classified as follows: 10.3 (n = 20) had atypical squamous cells of undetermined significance (AS-CUS), 16.5 (n = 32) lowgrade squamous intraepithelial lesions (L-SIL) and 2.1 (n = 4) high-grade squamous intraepithelial lesions (H-SIL). The HPV infection results obtained from the two samples were classified according the cytological results; data are 1676428 shown in Table 2. The association between the presence of HPV-DNA in each sample and the cytological findings (categorized as being normal/ abnormal) revealed that 20.4 (n = 12) of the women having abnormal cytological findings had a negative result for HPV infection in the cervical sample while 78.6 gave a positive result (n = 44). Such difference was not statistically significant (x2(1) = 2.69; p = 0.101). On the other hand, it was found that 19.6 (n = 11) of the samples having abnormal cytological findings had negative test for HPV-DNA in the urine sample,HPV in HIV-Infected Women Paired SamplesFigure 1. Prevalence of HPV types in cervical and urine samples for 204 HIV-infected Colombian women. doi:10.1371/journal.pone.0056509.gTable 2. HPV detection in both sample sources according to the cytological results.HPV detection n ( ) Both positive Normal ASC-US L-SIL H-SIL 57 (41.3) 12 (60.0) 24 (75.0) 2 (50.0) Cytology only 35 (25.4) 4 (20.0) 1 (3.1) 1 (25.0) Both Urine only negative 22 (15.9) 3 (15.0) 3 (9.4) 1 (25.0) 24 (17.4) 1 (5.0) 4 (12.5) 0 (0.0) Total (194) 138 20 32Figure 2. Number of HPV types in cervical and urine samples for 204 HIV-infected Colombian women. doi:10.1371/journal.pone.0056509.gThe percentages show the frequency of women that tested positive with respect to the total per row. AS-CUS: Atypical squamous cells of undetermined significance. H-SIL: high-grade squamous intraepithelial lesions. L-SIL: Lowgrade squamous intraepithelial lesions. doi:10.1371/journal.pone.0056509.tHPV in HIV-Infected Women Paired Samplescompared to 80.4 (n = 45) where viral DNA was detected; this trend was statistically significant (x2(1) = 9.22; p = 0.002).Agreement between both samples and clinical performanceThe results obtained for infection (generic and type-specific) in both samples (cervical and urine) were compared to cytological findings, categorizing the population as normal or abnormal (Tables 3-A and 3-B, respectively), where the generic identification of HPV-DNA, showed the greatest percentage agreement. Agreement between paired samples showed that generic viral detection had greater than 50 agreement in the results obtained for the three sets of primers used, while greater agreement was found for HPV-33 and HPV-45 types for type-specific identification (even though these were the least prevalent in the population being studied). However, the k values gave poor correlation in all cases (Figure 3). The urine sample’s diagnostic performance revealed 68.8 sensitivity (60.5?6.2 95 CI), 50 specificity (36.8?3.2 95 CI), 76.7 positive predictive value (PPV) (68.5?3.7 95 CI), 40 negative predictive value (NPV) (28.9?2 95 CI) and a 0.59 ROC area (0.52?.67 95 CI).DiscussionDeveloping cervical cancer has been related to factors determining its progression, including the type of HPV infection, viral load and persistence of the infection [35]. Nevertheless, as most women have an efficient immune system they can manage to rid the.
