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Table 1 Natural history of oncogenic HPV in HIV- and HIV+ subpopulations input data

From: Cost-effectiveness analysis of human papillomavirus vaccination in South Africa accounting for human immunodeficiency virus prevalence

Natural history-related parameter

Annual probability

 

HIV- subpopulation

Source

HIV+ subpopulation

Source

HPV-Onc to CIN1

0.049

Adjusted from [60] (0.15 after 36 months and 0.21 after 60 months)

0.096

[49]

HPV-Onc to CIN2/3

0

Spontaneous progression from HPV-onc to CIN2/3 within 1 year; assumed to be 0

0

Assumption (same as HIV- subpopulation)

HPV-Onc clearance to normal

0.293–0.553

[29, 60–62]

0.212

[49]

CIN1 to CIN2/3

0.091

[61–63]

0.098

[49]

CIN2/3 cured

0.227

[61–63]

0.227

Assumption (same as HIV- subpopulation)

CIN2/3 to CIN1

0

Spontaneous regression from CIN2/3 to CIN1 within 1 year; assumed to be 0; all patients cured going to no HPV assumption

0

Assumption (same as HIV- subpopulation)

HIV- CIN2/3 to persistent CIN2/3

0.114

[62, 63]

0.114

Assumption (same as HIV- subpopulation)

Persistent CIN2/3 to cervical cancer

Age 15: 0.00 %

Based on estimated CIN2/3 and reported cervical cancer progression rates

Age 15: 0.00 %

Applied relative risk ratio of 2 for HIV+ based on the progression rate from LSIL to HSIL [64]

Age 35: 1.10 %

Age 35: 2.20 %

Age 45: 2.52 %

Age 45: 5.04 %

Age 60: 7.56 %a

Age 60: 15.12 %a

  1. aThe model calibration led to 0.12 % yearly increase from 20 years of age to 35 years, 0.2 % yearly increase from 36 years of age to 45 years, 0.3 % yearly increase from 45 years of age to 55 years, and 0.4 % yearly increase from 60 years of age onwards
  2. CIN, cervical intraepithelial neoplasia; CIN1, CIN grade 1; CIN2/3, CIN grade 2 or 3; HPV, human papillomavirus; HPV-Onc, oncogenic HPV types; HIV, human immunodeficiency virus; HIV-, HIV-negative; HIV+, HIV + positive; HSIL, high-grade squamous intraepithelial lesions; LSIL, low-grade squamous intraepithelial lesions