Cervical Cancer, Coinfection, HIV, HIV Infections, HPV-Related Cervical Carcinoma
Conditions
Keywords
Cervical cancer screening, Self-sampling, Urine sample, Vaginal sample
Brief summary
This study assesses topics as Human Immunodeficiency Virus (HIV), Human Papilloma Virus (HPV), and cancer screening methods. The focus will be on evaluating feasibility of implementing novel cancer screening modalities in a low-resource setting in Guinea-Bissau and further to estimate the prevalence of the precancerous virus HPV amongst women living with HIV. In the study the investigators will collect urinary and vaginal self-samples for HPV testing, and further evaluate the feasibility of implementing the devices as screening modalities through questionnaires given to the women.
Detailed description
This pilot study will partly take place at the outpatient HIV clinic, based in the Hospital National Simão Mendes (HNSM) in the capital city Bissau, Guinea-Bissau. HNSM is the main hospital in Bissau, and the HIV clinic is the biggest HIV treatment center in Guinea-Bissau in terms of patients on follow-up. The Bissau Nationwide HIV Cohort is a clinical HIV Cohort started in 2007. As of today, the investigators collect data from 9 outpatient HIV clinics in the country, and samples will be collected from all 9 clinics. Study participants who present at the HIV clinic will be thoroughly instructed in correct usage of the vaginal and urine devices by trained healthcare workers. At the HIV clinics, facilities will be available for the women to conduct self-sampling in privacy, before handing in the samples. At the local laboratory, the dry brush head will be suspended in Thinprep medium and stored until shipment to Denmark. The urine samples will be stored at room temperature for up to 7 days before transferred to a -20º freezer until shipment to Denmark. Analyses: vaginal and urine samples will be analyzed at Randers Regional Hospital using the Cobas 4800 HPV DNA test. The Department is specialized in self-collected samples from previous studies. This procedure is considered feasible based on data showing that the dry brush is analytically stable for HPV DNA detection for up to 32 weeks at temperatures ranging from 4 ºC to 30 ºC. After HPV analyses, residual material from the self-collected samples will be stored in a biobank in Denmark at Aarhus University hospital and saved for future research.
Interventions
DIAGNOSTIC_TESTSelf-sampling for HPV infection
After informed consent has been provided, the woman will be asked to collect firstly a first-void urine sample using the Collipee device and secondly to collect a vaginal self-sample using the dry Evalyn® Brush device. Socioeconomic, demographic and clinical data will be collected in the Bissau HIV Cohort database and through study questionnaires to collect background information on risk factors for HPV persistence and development of cervical cancer (HIV genotype, immune status, parity). Questionnaires will collect additional information on the acceptance of cervical screening measures to better evaluate the feasibility of implementing self-collected screening among HIV infected women in Guinea-Bissau.
Sponsors
Aarhus University Hospital
Universiteit Antwerpen
Randers Regional Hospital
Bandim Health Project
University of Aarhus
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* HIV-positive (women with HIV-1, HIV-2 AND HIV1/2 are all eligible) * Age between 18 and 65 years
Exclusion criteria
* Current pregnancy * Pregnancy within the last 3 months * Prior hysterectomy * Women using other vaginal products than contraceptives and water based lubricants * Women who don't understand the extent of the study * Bleeding due to ongoing period
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of implementing HPV self sampling for cervical cancer screening | April 2023 - February 2024 | Among women meeting the inclusion criteria, the investigators want to estimate the prevalence of how many accepts the offer to collect self-samples, thereby gaining knowledge on the feasibility of implementing self-sampling as a cervical cancer screening method in Guinea-Bissau. |
| HPV-prevalence among HIV-infected women in Guinea-Bissau | April 2023 - February 2024 | The investigators want to estimate the prevalence of high risk HPV infection among HIV-infected women in the Nationwide HIV-cohort in Guinea-Bissau. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Experiences with self-collected vaginal and urine samples | April 2023 - February 2024 | Among the women accepting the invitation to enroll in the study, the investigators will through a questionnaire obtain data on the participants experiences with the two self-sampling devices. |
| HPV-genotype agreement between vaginal- and urine samples | April 2023 - February 2024 | Among HPV-positive women the investigators want to describe the genotype agreement among the two sample types |
Countries
Guinea-Bissau
Outcome results
None listed