1. Visual inspection with acetic acid screening for cervical cancer among women receiving anti‐retroviral therapy for human immunodeficiency virus infection in northern Tanzania.
- Author
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Chinn, Justine O., Runge, Ava S., Dinicu, Andreea I., Chang, Jenny, Maher, Justine A., Crawford, Elizabeth W., Naaseh, Ariana, Cooper, Emma C., Zezoff, Danielle C., White, Kayla M., Lucas, Alexa N., Bera, Kevin R., Bernstein, Megan, Hari, Anjali, Ziogas, Argyrios, Tewari, Sujata E., Pearre, Diana C., and Tewari, Krishnansu S.
- Subjects
HIV infection epidemiology ,HIV-positive persons ,COLD therapy ,EARLY detection of cancer ,FISHER exact test ,HIGHLY active antiretroviral therapy ,ACETIC acid ,CHI-squared test ,DESCRIPTIVE statistics ,CERVIX uteri tumors - Abstract
Aim: To evaluate visual inspection with acetic acid (VIA) screening for cervical cancer among human immunodeficiency virus (HIV)‐positive patients in an East African community. Methods: During a July 2018 cervical cancer screen‐and‐treat in Mwanza, Tanzania, participants were offered free cervical VIA screening, cryotherapy when indicated, and HIV testing. Acetowhite lesions and/or abnormal vascularity were designated VIA positive in accordance with current guidelines. The association between VIA results and HIV status was compared using Chi‐square and Fisher exact tests. Results: Eight hundred and twenty‐four of 921 consented participants underwent VIA screening and 25.0% (n = 206) were VIA positive. VIA‐positive nonpregnant women (n = 147) received cryotherapy and 15 (1.8%) with cancerous‐appearing lesions were referred to Bugando Hospital. Sixty‐six women were HIV‐positive and included 25 diagnosed with HIV at the cervical cancer VIA screening and 41 with a prior diagnosis of HIV who were receiving antiretroviral therapy (ART) at the time of cervical cancer VIA screening. Sixty‐four of these 66 patients, were screened with VIA. HIV infection was not associated with VIA findings. Abnormal VIA positive screening was observed in 20.3% (n = 13) of HIV‐positive patients and in 24.4% (n = 145) of HIV‐negative patients (p = 0.508). A nonsignificant trend of higher VIA positive screens among newly diagnosed HIV patients of 26.1% (n = 6) versus patients with preexisting HIV on ART of 17.1% (n = 7) was observed (p = 0.580). Conclusion: The unexpected lack of correlation between HIV infection and VIA positivity in a community with access to ART warrants additional research regarding the previously described role of ART in attenuating HPV‐mediated neoplasia. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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