Cervical Cancer Screening in HIV-Positive Women in India: Why, When and How?
Barriers
CIN
Cervical cancer
Colposcopy
HIV
Pap
Screening
VIA
Journal
Journal of obstetrics and gynaecology of India
ISSN: 0971-9202
Titre abrégé: J Obstet Gynaecol India
Pays: India
ID NLM: 0374763
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
22
06
2020
accepted:
10
12
2020
entrez:
19
8
2021
pubmed:
20
8
2021
medline:
20
8
2021
Statut:
ppublish
Résumé
Cervical cancer is an AIDS-defining illness, and HIV-positive women are at high risk. The present study aimed to determine the magnitude of the problem, compare the performance of screening tests and assess factors affecting participation. HIV-positive women aged 30-59 years attend the anti-retroviral therapy (ART) clinics were screened by conventional Pap, HPV testing (Hybrid Capture 2) and visual inspection with acetic acid (VIA). A cohort of HIV-negative women from the community matched for age and parity were screened similarly. Screen-positive women underwent colposcopy and biopsy. Factors affecting participation were assessed. Pap, VIA and HPV were positive in 48 (23.8%), 65 (32.2%) and 76 (37.6%) subjects, respectively, among HIV-positive women, and in 12 (5.9%), 10 (4.9%) and 12 (5.9%) subjects, respectively, among HIV-negative women There was higher prevalence of HPV infection and CIN2 + lesions in HIV-positive women. VIA showed equivalent sensitivity to Pap and could be a good substitute in low resource settings. Setting up cervical screening services in ART clinics and sensitising physicians can improve outcomes among these women.
Sections du résumé
BACKGROUND
BACKGROUND
Cervical cancer is an AIDS-defining illness, and HIV-positive women are at high risk. The present study aimed to determine the magnitude of the problem, compare the performance of screening tests and assess factors affecting participation.
METHODS
METHODS
HIV-positive women aged 30-59 years attend the anti-retroviral therapy (ART) clinics were screened by conventional Pap, HPV testing (Hybrid Capture 2) and visual inspection with acetic acid (VIA). A cohort of HIV-negative women from the community matched for age and parity were screened similarly. Screen-positive women underwent colposcopy and biopsy. Factors affecting participation were assessed.
RESULTS
RESULTS
Pap, VIA and HPV were positive in 48 (23.8%), 65 (32.2%) and 76 (37.6%) subjects, respectively, among HIV-positive women, and in 12 (5.9%), 10 (4.9%) and 12 (5.9%) subjects, respectively, among HIV-negative women
CONCLUSIONS
CONCLUSIONS
There was higher prevalence of HPV infection and CIN2 + lesions in HIV-positive women. VIA showed equivalent sensitivity to Pap and could be a good substitute in low resource settings. Setting up cervical screening services in ART clinics and sensitising physicians can improve outcomes among these women.
Identifiants
pubmed: 34408351
doi: 10.1007/s13224-020-01419-0
pii: 1419
pmc: PMC8310826
doi:
Types de publication
Journal Article
Langues
eng
Pagination
304-312Informations de copyright
© Federation of Obstetric & Gynecological Societies of India 2021.
Déclaration de conflit d'intérêts
Conflict of interestThe authors declare that they have no conflict of interest.
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