Completed Research Cervical Cancer Prevention among HIV infected Women (2011 – 2012)

Cervical Cancer Prevention among HIV infected Women (2011 – 2012)

Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI) and Prayas; in collaboration and guidance from the International Agency for Research on Cancer (WHO) have completed a research project to prevent cervical cancer in HIV infected women. This project received funding from the Union for Cervical Cancer Control (UICC), Geneva, Switzerland.

Invasive cervical cancer is an AIDS defining illness. Observational studies in different regions of the world indicate that HIV infected women are at higher risk for oncogenic Human Papilloma virus (HPV) infection and at 5 to 10 fold increased risk of developing cervical cancer. 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. This study intended to comprehensively address early detection and prevention of cervical cancer in HIV-infected women in low and medium resourced settings.

The study assessed the clinical utility of different screening tests (Cytology, VIA, VILI and HPV DNA test) and effectiveness of different treatment methods, cold coagulation in particular, for preventing the progression of high-grade cervical lesions to invasive cancer in 1153 HIV infected women between the age group of 21-60 years.   

Women were counseled by trained counselors and demographic and medical information was obtained following a written informed consent. Women were screened using visual inspection with 5% acetic acid (VIA), visual inspection with Lugol’s iodine (VILI), cytology and HPV DNA testing using hybrid capture 2 (HC2) tests. All screened women underwent colposcopy, directed biopsy and treatment using cold coagulation for precancerous lesions during a single visit. Women with precancerous lesions not suitable for ablative treatment with cold coagulation were referred for excisional treatment using loop electrosurgical excision procedure (LEEP). Those women with cancers were referred for appropriate cancer directed treatment.

All women are being followed regularly for continued cervical cancer screening every year and we plan a long term follow up of this HIV infected women’s cohort.


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