A Systematic Review of the Effects of Visual Inspection With Acetic Acid, Cryotherapy, and Loop Electrosurgical Excision Procedures for Cervical Dysplasia in HIV-Infected Women in Low- and Middle-Income Countries

Forhan, Sara E.; Godfrey, Catherine; Watts, D. Heather; Langley, Carol

doi:10.1097/qai.0000000000000488

Cited by 29 publications

(34 citation statements)

References 23 publications

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“…220 These options are generally safe and effective for WLWH. [221][222][223][224][225][226] However, endocervical extension is more frequent among WLWH. 227 Therefore, loop excision is less effective and recurrence rates are higher in WLWH than in HIV-negative patients.…”

Section: Management Of Precancerous Cervical Lesions In Plwhmentioning

confidence: 99%

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Reid¹,

Suneja²,

Ambinder³

et al. 2018

J Natl Compr Canc Netw

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People living with HIV (PLWH) are diagnosed with cancer at an increased rate over the general population and generally have a higher mortality due to delayed diagnoses, advanced cancer stage, comorbidities, immunosuppression, and cancer treatment disparities. Lack of guidelines and provider education has led to substandard cancer care being offered to PLWH. To fill that gap, the NCCN Guidelines for Cancer in PLWH were developed; they provide treatment recommendations for PLWH who develop non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer. In addition, the NCCN Guidelines outline advice regarding HIV management during cancer therapy; drug-drug interactions between antiretroviral treatments and cancer therapies; and workup, radiation therapy, surgical management, and supportive care in PLWH who have cancer.

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Section: Management Of Precancerous Cervical Lesions In Plwhmentioning

confidence: 99%

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Reid¹,

Suneja²,

Ambinder³

et al. 2018

J Natl Compr Canc Netw

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“…23, 24 It is well accepted that human papillomavirus (HPV) infection is highly correlated with cervical cancer. 25, 26 Loss of GJIC and reduction of expression of Cx26, Cx30 and Cx43 were described in HPV-infected dysplastic cervical epithelial cells.…”

mentioning

confidence: 99%

Non-junctional Cx32 mediates anti-apoptotic and pro-tumor effects via epidermal growth factor receptor in human cervical cancer cells

Zhao

Lai

et al. 2017

Cell Death Dis

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The role of connexin proteins (Cx), which form gap junctions (GJ), in progression and chemotherapeutic sensitivity of cervical cancer (CaCx), is unclear. Using cervix specimens (313 CaCx, 78 controls) and CaCx cell lines, we explored relationships among Cx expression, prognostic variables and mechanisms that may link them. In CaCx specimens, Cx32 was upregulated and cytoplasmically localized, and three other Cx downregulated, relative to controls. Cx32 expression correlated with advanced FIGO staging, differentiation and increased tumor size. In CaCx cell lines, Cx32 expression suppressed streptonigrin/cisplatin-induced apoptosis in the absence of functional GJ. In CaCx specimens and cell lines, expression of Cx32 upregulated epidermal growth factor receptor (EGFR) expression. Inhibition of EGFR signaling abrogated the anti-apoptotic effect of Cx32 expression. In conclusion, upregulated Cx32 in CaCx cells produces anti-apoptotic, pro-tumorigenic effects in vivo and vitro. Abnormal Cx32 expression/localization in CaCx appears to be both a mechanism and biomarker of chemotherapeutic resistance.

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“…lesion size) explain these differences? A recent systematic review, and subsequent publications, suggest that HIV‐infected women are more likely to have treatment failures/recurrent disease, but the evidence for each treatment modality is very limited. The most likely explanation is that HIV‐infected women have larger lesions due to immune suppression and therefore the lesion margins are not clear, leading to failure/recurrence. Does the healed epithelium following ablation allow for effective monitoring and diagnosis of recurrent (untreated) disease?…”

Section: Future Research On Treatment Methodsmentioning

confidence: 99%

“…However, the goal of this visualization is only to determine what treatment/management is needed-that is, whether there are con- explain these differences? A recent systematic review, 30 and subsequent publications, 28,[31][32][33] suggest that HIV-infected women are more likely to have treatment failures/recurrent disease, but the evidence for each treatment modality is very limited. The most likely explanation is that HIV-infected women have larger lesions due to immune suppression 28 and therefore the lesion margins are not clear, 32 leading to failure/recurrence.…”

Section: Visualizing Lesions For Ablative Treatmentmentioning

confidence: 99%

Treatment of cervical intraepithelial lesions

Castle

Murokora²,

Pérez

et al. 2017

Intl J Gynecology & Obste

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Precancerous cervical lesions precede the development of invasive cervical cancer by 10-20 years, making cervical cancer preventable if these lesions are detected and effectively treated. Treatment has evolved in the last few decades and now includes ablative options that can be performed in lower-resource settings where surgical excision is not feasible or routinely available. Gas-based cryotherapy, which freezes cervical tissue to induce localized necrosis, is the most commonly used ablative treatment.However, its implementation in low-resource settings is difficult because the refrigerant gas can be difficult to procure and transport, and is expensive. New cryotherapy devices that do not require an external supply of gas appear promising. Thermal coagulation, which burns cervical tissue to induce necrosis, has become more widely available in the last few years owing to its portability and the feasibility of using battery-powered devices. These two ablative treatments successfully eradicate 75%-85% of high-grade cervical lesions and have minor adverse effects. K E Y W O R D SCervical precancer; Cryotherapy; Low-and middle-income country; Thermal coagulation; Treatment | INTRODUCTIONAlthough cervical cancer is preventable, more than half a million women around the world develop this disease every year, and around 270 000 die.1 The main reasons for these unnecessary deaths are the lack of screening, management, and treatment for women at the target age for secondary prevention in many low-and middle-income countries This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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A Systematic Review of the Effects of Visual Inspection With Acetic Acid, Cryotherapy, and Loop Electrosurgical Excision Procedures for Cervical Dysplasia in HIV-Infected Women in Low- and Middle-Income Countries

Cited by 29 publications

References 23 publications

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Non-junctional Cx32 mediates anti-apoptotic and pro-tumor effects via epidermal growth factor receptor in human cervical cancer cells

Treatment of cervical intraepithelial lesions

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