Table 4. Estimated Unadjusted Hazard Ratios (95% CI) of Time-Updated Covariate Effects on State Transitions, by Misclassification Assumptions and by IAC-Exclusion Window (≤180 vs.≤30 days).
| Covariate | IAC exclusion window2 | Cytology Misclassification Assumptions (Sensitivity / Specificity) | <HSIL to HSIL | HSIL to <HSIL | HSIL to IAC3 |
| 1. IRC1 [reference: no IRC] | ≤180 days | 0.66/0.90 | 2.2 (0.6–7.9) | 4.2 (2.0–8.5) | 2.7 (0.6–11.7) |
| 0.89/0.96 | 2.1 (0.95–4.6) | 2.3 (1.3–4.0) | 3.2 (0.7–13.6) | ||
| ≤30 days | 0.66/0.90 | 2.2 (0.6–8.0) | 4.2 (2.0–8.6) | 1.8 (0.4–7.7) | |
| 0.89/0.96 | 2.1 (0.96–4.7) | 2.2 (1.3–3.9) | 2.1 (0.5–9.0) | ||
| 2. ART4 [reference: no ART] | ≤180 days | 0.66/0.90 | 0.4 (0.2–0.6) | 0.9 (0.4–2.1) | 2.2 (0.5–9.4) |
| 0.89/0.96 | 0.5 (0.4–0.8) | 0.9 (0.6–1.3) | 2.1 (0.5–9.1) | ||
| ≤30 days | 0.66/0.90 | 0.4 (0.2–0.6) | 0.9 (0.4–2.1) | 3.2 (0.8–13.7) | |
| 0.89/0.96 | 0.5 (0.4–0.7) | 0.8 (0.6–1.3) | 3.2 (0.8–13.4) | ||
| 3. HIV Viral load [reference: >400 copies/mm3] | ≤180 days | 0.66/0.90 | 0.3 (0.2–0.5) | 1.3 (0.7–2.3) | 1.6 (0.7–3.9) |
| 0.89/0.96 | 0.5 (0.4–0.7) | 1.1 (0.8–1.5) | 1.6 (0.6–3.8) | ||
| ≤30 days | 0.66/0.90 | 0.3 (0.2–0.5) | 1.3 (0.7–2.3) | 1.2 (0.6–2.5) | |
| 0.89/0.96 | 0.5 (0.4–0.7) | 1.1 (0.8–1.4) | 1.2 (0.6–2.5) | ||
| 4. CD4 Category [reference: <350/mm3] | ≤180 days | 0.66/0.90 | 0.3 (0.2–0.5) | 0.8 (0.5–1.3) | 1.4 (0.6–3.3) |
| 0.89/0.96 | 0.4 (0.3–0.6) | 0.9 (0.6–1.1) | 1.4 (0.6–3.2) | ||
| ≤30 days | 0.66/0.90 | 0.3 (0.2–0.5) | 0.8 (0.5–1.3) | 1.1 (0.5–2.2) | |
| 0.89/0.96 | 0.4 (0.3–0.6) | 0.8 (0.6–1.1) | 1.1 (0.5–2.1) | ||
| 5. Smoking [reference: not smoking] | ≤180 days | 0.66/0.90 | 1.1 (0.7–1.7) | 0.8 (0.5–1.4) | 1.2 (0.5–2.9) |
| 0.89/0.96 | 1.0 (0.7–1.4) | 0.9 (0.7–1.2) | 1.3 (0.6–3.0) | ||
| ≤30 days | 0.66/0.90 | 1.1 (0.7–1.7) | 0.9 (0.5–1.4) | 1.2 (0.6–2.5) | |
| 0.89/0.96 | 1.0 (0.7–1.4) | 0.9 (0.7–1.2) | 1.3 (0.6–2.6) |
1.
IRC: infrared coagulation.
2.
IAC exclusion window: Cases of invasive anal carcinoma (IAC) diagnosed within 180 or 30 days of the first cytology result, respectively, were considered prevalent cases and were therefore excluded from analysis.
3.
State Transitions: HSIL: high grade squamous intraepithelial lesion; IAC: invasive anal carcinoma.
4.
ART: antiretroviral therapy.