UICC Study

Short title

UICC study

 Title of the project:

Cervical cancer prevention in HIV-infected women

 Background:

Invasive cervical cancer is an AIDS defining illness. Observational studies in different regions of the world indicate that human immunodeficiency virus (HIV) infected women are at high risk for oncogenic human papillomavirus (HPV) infection and at 5- to 10-fold increased risk of developing cervical cancer. Thus, cervical cancer prevention among HIV-infected women assumes major priority, given the high risk of HPV infection, cervical precursor, and malignant lesions among them. In spite of large burden of both HIV infection and cervical cancer, there are very few studies in India that have addressed the association between them and the ways and means to control the disease.

In 2010, we initiated a study in collaboration with HCJMRI, Pune and with technical assistance from International Agency for Research on Cancer (WHO). Consecutive HIV-infected women were screened with visual screening tests, cytology and HPV testing.  All women underwent colposcopy and directed biopsy, treatment with cold coagulation or with LEEP if indicated.  They were called initially after 6 months and then every year thereafter. This large cohort of women is being followed with the following objectives. 

 Objectives of the project:

  • To evaluate incidence of CIN in the cohort of HIV infected women
  • To evaluate type specific incident CIN lesions in HIV-infected women
  • To evaluate the effectiveness of cold coagulation in curing and preventing recurrence of CIN 2-3 lesions in HIV-infected women
  • To evaluate HPV persistence, clearance, new infections in HIV infected women & incident CIN lesions in the cohort of HIV-infected women screened for cervical pre-cancerous lesions

 Study site: Prayas

 Type of research: Observational cohort study

 Investigators:

Dr. Smita Joshi (Principal Investigator)

Dr. Vinay Kulkarni (Co-Investigator)

Dr. Richard Muwonge (Co-Investigator)

 Funding: Currently being supported by research donations

  Start date: September 2010

 Study publications:

  1. Joshi SSankaranarayanan RMuwonge RKulkarni VSomanathan TDivate U. Screening of cervical neoplasia in HIV-infected women in India. AIDS. 2013 Feb 20;27(4):607-15. doi: 10.1097/QAD.0b013e32835b1041.
  2. Joshi SBabu JMJayalakshmi DKulkarni VDivate UMuwonge RGheit TTommasino MSankaranarayanan RPillai MR. Human papillomavirus infection among human immunodeficiency virus-infected women in Maharashtra, India. Vaccine. 2014 Jan 4. pii: S0264-410X(13)01803-3. doi: 10.1016/j.vaccine.2013.12.060.
 

Prayas-Amrita Clinic, Athawale Corner, Karve Road, Deccan Gymkhana, Pune - 411 004, Maharashtra, India.
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