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Evaluation of direct visual inspection of the cervix in detecting cytology diagnosed squamous intraepithelial lesion in women of known HIV status. A randomized trial (CANHIV study)

Ezechi, Oliver LU ; Odberg Pettersson, Karen LU ; Gbajabiamila, Titilola A.; Idigbe, Ifeoma Eugenia; Gab-Okafor, Chidinma Vivian; Okolo, Clement Abu; Ujah, Innocent Achaya Otobo and Ostergren, Per Olof LU (2016) In African journal of reproductive health 20(4). p.77-88
Abstract

A two-arm, open label, randomized study, evaluated the test characteristics of visual inspection of cervix with Acetic acid (VIA) and Lugol’s Iodine (VILI) in detecting cytology diagnosed squamous intraepithelial lesion (SIL) in 1160 women of known HIV status in southwestern Nigerian. Using SIL as reference standard and the HIV status masked, VIA and VILI had similar test characteristics except for the positive predictive value in which VIA value of 91.5% was significantly higher than 77.7% for VILI (p=0.01). Among HIV positive women, VILI performed poorly across all the 4 test characteristics compared to VIA. Among severely immuno-compromised HIV positive participants VILI performance was consistently below 80% across all test... (More)

A two-arm, open label, randomized study, evaluated the test characteristics of visual inspection of cervix with Acetic acid (VIA) and Lugol’s Iodine (VILI) in detecting cytology diagnosed squamous intraepithelial lesion (SIL) in 1160 women of known HIV status in southwestern Nigerian. Using SIL as reference standard and the HIV status masked, VIA and VILI had similar test characteristics except for the positive predictive value in which VIA value of 91.5% was significantly higher than 77.7% for VILI (p=0.01). Among HIV positive women, VILI performed poorly across all the 4 test characteristics compared to VIA. Among severely immuno-compromised HIV positive participants VILI performance was consistently below 80% across all test characteristics (sensitivity-70.0%; specificity-66.9%; positive predictive value-46.7%; negative predictive value (NPV) -50.0%) compared to VIA (Senstivity-71.3%; specificity-88.2%; positive predictive value-83.3%; negative predictive value-88.2). Our study shows that VILI is insufficiently sensitive and specific in the presence of HIV infection especially in those with severe immunosuppression. Based on VIA’s acceptable sensitivity and NPV in all situations, it is recommended for cervical cancer screening in HIV positive women and in settings of high HIV burden.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cervical cancer, HIV, Squamous intraepithelial lesion, Visual inspection with Acetic acid and Lugol’s Iodine
in
African journal of reproductive health
volume
20
issue
4
pages
12 pages
publisher
Women's Health and Action Research Centre
external identifiers
  • scopus:85011094644
ISSN
1118-4841
language
English
LU publication?
yes
id
51d31718-eaa6-49ba-aaf1-4c1ceb81754d
alternative location
http://www.ajrh.info/index.php/ajrh/article/view/21
date added to LUP
2017-02-17 07:58:32
date last changed
2017-06-30 08:16:35
@article{51d31718-eaa6-49ba-aaf1-4c1ceb81754d,
  abstract     = {<p>A two-arm, open label, randomized study, evaluated the test characteristics of visual inspection of cervix with Acetic acid (VIA) and Lugol’s Iodine (VILI) in detecting cytology diagnosed squamous intraepithelial lesion (SIL) in 1160 women of known HIV status in southwestern Nigerian. Using SIL as reference standard and the HIV status masked, VIA and VILI had similar test characteristics except for the positive predictive value in which VIA value of 91.5% was significantly higher than 77.7% for VILI (p=0.01). Among HIV positive women, VILI performed poorly across all the 4 test characteristics compared to VIA. Among severely immuno-compromised HIV positive participants VILI performance was consistently below 80% across all test characteristics (sensitivity-70.0%; specificity-66.9%; positive predictive value-46.7%; negative predictive value (NPV) -50.0%) compared to VIA (Senstivity-71.3%; specificity-88.2%; positive predictive value-83.3%; negative predictive value-88.2). Our study shows that VILI is insufficiently sensitive and specific in the presence of HIV infection especially in those with severe immunosuppression. Based on VIA’s acceptable sensitivity and NPV in all situations, it is recommended for cervical cancer screening in HIV positive women and in settings of high HIV burden.</p>},
  author       = {Ezechi, Oliver and Odberg Pettersson, Karen and Gbajabiamila, Titilola A. and Idigbe, Ifeoma Eugenia and Gab-Okafor, Chidinma Vivian and Okolo, Clement Abu and Ujah, Innocent Achaya Otobo and Ostergren, Per Olof},
  issn         = {1118-4841},
  keyword      = {Cervical cancer,HIV,Squamous intraepithelial lesion,Visual inspection with Acetic acid and Lugol’s Iodine},
  language     = {eng},
  number       = {4},
  pages        = {77--88},
  publisher    = {Women's Health and Action Research Centre},
  series       = {African journal of reproductive health},
  title        = {Evaluation of direct visual inspection of the cervix in detecting cytology diagnosed squamous intraepithelial lesion in women of known HIV status. A randomized trial (CANHIV study)},
  volume       = {20},
  year         = {2016},
}