A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

Huchko, Megan J

Sneden, Jennifer

Zakaras, Jennifer M

Smith-McCune, Karen

Sawaya, George

Maloba, May

Bukusi, Elizabeth Ann

Cohen, Craig R

United States

2016-08-31T13:47:10Z

2015

Visual inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier and more specific screening test. VILI has not been well-validated as a stand-alone screening test, compared to VIA or validated for use in HIV-infected women. We carried out a randomized clinical trial to compare the diagnostic accuracy of VIA and VILI among HIV-infected women. Women attending the Family AIDS Care and Education Services (FACES) clinic in western Kenya were enrolled and randomized to undergo either VIA or VILI with colposcopy. Lesions suspicious for cervical intraepithelial neoplasia 2 or greater (CIN2+) were biopsied. Between October 2011 and June 2012, 654 were randomized to undergo VIA or VILI. The test positivity rates were 26.2% for VIA and 30.6% for VILI (p = 0.22). The rate of detection of CIN2+ was 7.7% in the VIA arm and 11.5% in the VILI arm (p = 0.10). There was no significant difference in the diagnostic performance of VIA and VILI for the detection of CIN2+. Sensitivity and specificity were 84.0% and 78.6%, respectively, for VIA and 84.2% and 76.4% for VILI. The positive and negative predictive values were 24.7% and 98.3% for VIA, and 31.7% and 97.4% for VILI. Among women with CD4+ count < 350, VILI had a significantly decreased specificity (66.2%) compared to VIA in the same group (83.9%, p = 0.02) and compared to VILI performed among women with CD4+ count ≥ 350 (79.7%, p = 0.02). VIA and VILI had similar diagnostic accuracy and rates of CIN2+ detection among HIV-infected women.

http://www.ncbi.nlm.nih.gov/pubmed/25849627

PONE-D-14-39517

1932-6203

https://hdl.handle.net/10161/12715

eng

Public Library of Science (PLoS)

PLoS One

10.1371/journal.pone.0118568

Acetic Acid

Adult

Cervical Intraepithelial Neoplasia

Coloring Agents

Colposcopy

Early Detection of Cancer

Female

HIV

HIV Infections

Humans

Iodides

Mass Screening

Uterine Cervical Dysplasia

Uterine Cervical Neoplasms

Vaginal Smears

A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

Journal article

Huchko, Megan J|0000-0002-4081-4768

http://www.ncbi.nlm.nih.gov/pubmed/25849627

e0118568

4

Duke

Global Health Institute

Institutes and Provost's Academic Units

School of Medicine

University Institutes and Centers

Published online

10