Accuracy of Portable Colposcopy and HPV Genotypes Among HIV+ Women

Duke University

Status: Terminated

Conditions: Human Immunodeficiency Virus; Human Papillomavirus; Cervical Cancer

Treatments: Device: Conventional colposcopy (Wallach Zoomscope); Device: Portable colposcopy (Cerviscope)

Study type: Interventional

Funder types: Other

Identifiers

NCT02338141

Pro00055627

Details and patient eligibility

About

This study will evaluate the effectiveness of portable colposcopy when compared to conventional colposcopy (25x magnification of the cervix, the gold standard) and Visualization Inspection with Acetic acid (VIA, with 1x magnification, the accepted low-resource method). Half the participants will be evaluated for cervical pathology by portable colposcopy after VIA assessment, while the other half will be evaluated by conventional colposcopy. This study also will use collected lab specimens for human papillomavirus (HPV)-positive women to determine those HPV genotypes most prevalent among higher grade disease cases (CIN II+) and among the sub-group of human immunodeficiency virus (HIV)-positive women.

Full description

This research is a randomized, prospective trial designed to evaluate the value of magnification in making a diagnosis of high grade intraepithelial lesions of the cervix. The overall goal is to evaluate a cervical cancer screening protocol that provides the highest level of care possible for low-resource communities and hard-to-reach areas. Currently, a national cervical cancer screening and diagnosis program does not exist within Haiti.

All women meeting inclusion criteria will be randomized to portable (8x magnification with the Cerviscope) or conventional (25x magnification) colposcopy. After application of acetic acid to the cervix, the physician will record naked eye observations of the cervix by: 1) recording the location of all white lesions; 2) describing the vascular pattern; and 3) stating his/her clinical impression of a diagnosis. The physician will then follow-up with use of either the portable or the conventional colposcope to: 1) record the location of all white lesions; 2) describe the vascular pattern; and 3) state a clinical impression of diagnosis. Women will have biopsies in all four quadrants of the cervix even if no cervical lesions are seen to evaluate the accuracy of the visualization techniques against the gold standard of biopsy pathologic results. Treatment options will be dictated by biopsy results.

Biopsy material will also be evaluated for specific HPV genotype using lab-based measures. Results of these genotypes will be compared between women with high-grade disease vs. low-grade disease and in the subset of women with HIV compared to the HIV-negative population.

Enrollment: 132 patients

Sex: Female

Ages: 25 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Female
• 25-60 years old
• Pre-tested as positive for human papillomavirus (HPV)

Exclusion criteria

• Pre-tested as negative for human papillomavirus (HPV)
• Pregnant at time of enrollment
• Prior hysterectomy
• < 25 or > 60 years old
• Male

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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132 participants in 2 patient groups

Portable colposcopy

Experimental group

Description:

Diagnostic evaluation with 8x magnification portable colposcopy after visual inspection with acetic acid

Treatment:

Device: Portable colposcopy (Cerviscope)

Conventional colposcopy

Active Comparator group

Description:

Diagnostic evaluation with standard 25x magnification conventional colposcopy after visual inspection with acetic acid

Treatment:

Device: Conventional colposcopy (Wallach Zoomscope)