Abstract
BackgroundOver 85% of cervical cancer cases and deaths occur in developing countries. HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. However, the literature on cervical cancer prevention in seropositive women in developing countries has not been reviewed. The aim of this study is to systematically review cervical cancer prevention modalities available for HIV-seropositive women in developing countries.Methods/designThis protocol was developed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported in accordance with the PRISMA guidelines. Embase, MEDLINE, PubMed, CINAHL and Cochrane Library will be searched from inception up to date of final search, and additional studies will be located through citation and reference list tracking. Eligible studies will be randomised controlled trials, prospective and retrospective cohort studies, case-control and cross-sectional studies carried out in developing countries. Studies will be included if they are published in English and examine cervical cancer prevention modalities in HIV-seropositive women. Results will be summarised in tables and, where appropriate, combined using meta-analysis.DiscussionThis review will address the gap in evidence by systematically reviewing the published literature on the different prevention modalities being used to prevent cervical cancer in HIV-seropositive women in developing countries. The findings may be used to inform evidence-based guidelines for prevention of cervical cancer in seropositive women as well as future research.Systematic review registrationPROSPERO CRD42017054678.
Highlights
Over 85% of cervical cancer cases and deaths occur in developing countries
A systematic review on the cervical cancer screening and prevention indicated that about 88% of all cervical cancer worldwide occurs in developing countries where
1 to 2% of HIV-negative women develop cervical intraepithelial neoplasia (CIN) stages 2 and 3 annually whilst HIV-positive women are at 10% more
Summary
HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. The aim of this study is to systematically review cervical cancer prevention modalities available for HIV-seropositive women in developing countries. HIV-seropositive women have been found to be at higher risk of HPV infection due to their immune compromised status and that they are 2 to 12 times more likely to develop cervical precancerous lesions that lead to cervical cancer than HIV-negative women [5, 6]. In a case-control study in South Africa, HIV-seropositive women infected with HPV had a more than 40-fold higher risk of developing cervical squamous intraepithelial lesions compared to women who are both HIV and HPV negative [7]
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