Study to look at preventing cervical cancer in HIV-infected women

The National AIDS Research Institute (NARI) and B J Medical College (BJMC) have undertaken a project to 'test-and-treat' HIV-infected women who have a higher risk of getting cervical cancer.

The study at both NARI and BJMC will look for a better way to prevent cervical cancer in women who have HIV and also high-risk Human Papilloma Virus (HPV) by comparing immediate cryotherapy to a Pap test-based strategy. This study will also see if these methods are safe and tolerable in HIV-infected women.

NARI Director Dr R S Paranjape told The Indian Express, "The test-and-treat programmes using visual inspection with acetic acid (VIA) linked to cryotherapy have been shown to be effective methods of cervical cancer prevention in several countries and now studies are also being taken up here."

Two separate projects under the same AIDS Clinical Trials group network and funded by the National Institutes of Health (NIH), USA will be part of a multi-centre study to compare different methods to prevent cervical cancer in HIV-infected women.

Worldwide, November is being observed as month to create awareness about prevention of cervical cancer which has emerged as the largest killer, surpassing breast cancer. Studies at NARI have also shown that there was an alarming increase in the prevalence of high-risk HPV among HIV-infected women and hence a need was felt to catch these women early to prevent cervical cancer.

Dr Sheela Godbole, principal investigator of the study at NARI, told The Indian Express that HPV is the virus that usually causes cervical cancer. Some types of HPV are more likely to cause cervical cancer than others. "We will screen over 200 HIV-infected women to check whether they have HPV and then try to get rid of it by using cryotherapy to freeze the cells," Godbole explained. NARI has tied up with Bharati Vidyapeeth's hospital to conduct the cryotherapy procedure.

Women with the high-risk types of HPV virus in their cervix will be randomly assigned to one of two different approaches to prevent cancer, test-and-treat, said Dr R Bhosale, principal investigator for the trial at B J Medical College.

During cryotherapy, cells in the cervix that have HPV high-risk virus will be frozen and killed. The standard approach involves two procedures to check for cancer cells in the cervix: Pap test and biopsy. For the Pap test a sample of cells is collected from the cervix and looked at under a microscope. If there are signs of abnormal cells, a small piece of cervical tissue (biopsy) is removed to be examined closely. If the biopsy shows abnormal cells, procedure LEEP will be done to remove abnormal cells, said scientists.

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