Comparison of visual inspection with acetic acid and cervical cytology to detect high-grade cervical neoplasia among HIV-infected women in India

Human immunodeficiency virus (HIV)‐infected women in India and other developing country settings are living longer on antiretroviral therapy, yet their risk for human papillomavirus (HPV)‐induced cervical cancer remains unabated because of lack of cost‐effective and accurate secondary prevention met...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cancer 2012-01, Vol.130 (1), p.234-240
Main Authors: Sahasrabuddhe, Vikrant V., Bhosale, Ramesh A., Kavatkar, Anita N., Nagwanshi, Chandraprabha A., Joshi, Smita N., Jenkins, Cathy A., Shepherd, Bryan E., Kelkar, Rohini S., Sahay, Seema, Risbud, Arun R., Vermund, Sten H., Mehendale, Sanjay M.
Format: Article
Language:English
Subjects:
Acetates
Adult
Biological and medical sciences
Cancer
cervical cancer
Cervical Intraepithelial Neoplasia - diagnosis
Cervical Intraepithelial Neoplasia - prevention & control
Cervical Intraepithelial Neoplasia - virology
Cervix Uteri - pathology
Colposcopy
Cross-Sectional Studies
Cytodiagnosis
cytology
DNA, Viral - genetics
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
HIV - genetics
HIV - pathogenicity
HIV Infections - complications
HIV Infections - virology
HIV/AIDS
Humans
India
Mass Screening
Medical research
Medical sciences
Papanicolaou Test
Polymerase Chain Reaction
Predictive Value of Tests
screening
Sensitivity and Specificity
Tumors
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - prevention & control
Uterine Cervical Neoplasms - virology
Vaginal Smears
visual inspection
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Human immunodeficiency virus (HIV)‐infected women in India and other developing country settings are living longer on antiretroviral therapy, yet their risk for human papillomavirus (HPV)‐induced cervical cancer remains unabated because of lack of cost‐effective and accurate secondary prevention methods. Visual inspection after application of dilute acetic acid on the cervix (VIA) has not been adequately studied against the current standard: conventional cervical cytology (Pap smears) among HIV‐infected women. We evaluated 303 nonpregnant HIV‐infected women in Pune, India, by simultaneous and independent screening with VIA and cervical cytology with disease ascertainment by colposcopy and histopathology. At the cervical intraepithelial neoplasia (CIN2+) disease threshold, the sensitivity, specificity and positive and negative predictive value estimates of VIA were 80, 82.6, 47.6 and 95.4% respectively, compared to 60.5, 59.6, 22.4 and 88.7% for the atypical squamous cells of undetermined significance or severe (ASCUS+) cutoff on cytology, 60.5, 64.6, 24.8 and 89.4% for the low‐grade squamous intraepithelial cells or severe (LSIL+) cutoff on cytology and 20.9, 96.0, 50.0 and 86.3% for high‐grade squamous intraepithelial lesion or severe (HSIL+) cutoff on cytology. A similar pattern of results was found for women with the presence of carcinogenic HPV‐positive CIN2+ disease, as well as for women with CD4+ cell counts
ISSN:0020-7136
1097-0215
DOI:10.1002/ijc.25971