Cervical Intraepithelial Neoplasia Clinical Trial
— VICAR2Official title:
Validation of Implementation of Cervical Dysplasia Treatment Modalities in HIV-Seropositive Women
To compare the efficacy of cryotherapy and large loop excision of the transformation zone
(LLETZ) procedures for the treatment of high-grade cervical intra-epithelial neoplasia
(CIN2/3) among HIV-seropositive women by follow-up VIA, cytology and Human Papillomavirus.
Hypothesis: LEEP will be more effective than cryotherapy in removing CIN 2/3 lesions in HIV
positive women in South Africa
Status | Completed |
Enrollment | 166 |
Est. completion date | August 2014 |
Est. primary completion date | August 2014 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years to 65 Years |
Eligibility |
Inclusion Criteria: - Women 18-65 years of age - Not menstruating (if menstruating, the patient can be screened at another date) - Able to sign consent - Able to follow the study protocol - HIV positive (by two different criteria; either 2 different rapid HPV tests of different manufacturers, a HIV viral load =5,000,ELISA, Western blot documented in VICAR 1) - Participant with histology-proven CIN 2 or 3 disease Exclusion Criteria: - Pregnant - Clinically active sexually transmitted disease determined by clinical history and/or physical exam (may participate after adequate treatment by syndromic treatment management) - Known and previous treatment for high grade squamouse intraepithelial lesion by any method (cryotherapy, LLETZ or cone biopsy) - Previous hysterectomy with removal of the cervix - Significant medical illness/mental illness that the investigator feels would prevent the participant from complying with the protocol or place the participant at medical risk - Cervical dysplastic lesions that are not appropriate for cryotherapy, defined as the following: 1. Lesion is greater than =75% cervix 2. Lesion entering into the cervical canal and the complete lesion cannot be visualized 3. Presence of abnormal vasculature 4. Lesion bigger that the cryotherapy probe |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
South Africa | Helen Joseph Hospital | Johannesburg | Gauteng |
Lead Sponsor | Collaborator |
---|---|
University of Witwatersrand, South Africa |
South Africa,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Compare efficacy of cryotherapy and LEEP | To compare the efficacy of cryotherapy and large loop excision of the transformation zone (LLETZ) procedures for the treatment of high-grade cervical intra-epithelial neoplasia (CIN2/3) among HIV-seropositive women by follow-up VIA, cytology and HPV. | 1 year | No |
Secondary | The ability to use Human Papillomavirus as the measure of treatment success | To determine the utility of subsequent HPV DNA testing as a marker of effective treatment following the treatment of CIN 2/3 among HIV-seropositive women. | 1 year | No |
Secondary | To compare the safety of cryotherapy versus LLETZ in HIV seropositive women | To compare the safety of cryotherapy versus LLETZ in HIV seropositive women by evaluating adverse events as measured by the Division of AIDS toxicity table 2004 (revised August 2010) | 1 month, 6 months and 12 months | Yes |
Secondary | Describe factors associated with successful treatment of CIN 2/3 | To describe HIV disease status (CD4, HIV viral load), demographics, tissue margins and sexual behavior in each treatment arm (LLETZ and cryotherapy) in HIV seropositive women. | 1 year | No |
Secondary | To determine the cervical disease recurrence rates with cryotherapy and LLETZ. | To determine the cervical disease recurrence rates with cryotherapy and LLETZ at 6 months and 12 months by colposcopy | 6 months and 12 months | No |
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