Management of women with a positive HPV test result – Triage with VIA
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In settings where high-quality cytology is not available, HPV-positive women may be triaged with VIA. Women who are HPV-positive but VIA-negative (i.e. triage-negative) are advised to repeat the HPV test after 1 year for women living with HIV and after 2 years for women in the general population. Women who are both HPV-positive and VIA-positive (i.e. triage-positive) are immediately assessed for eligibility for ablative treatment in a screen, triage, and treat setting. If eligible, they are treated with thermal ablation or cryotherapy. HPV-positive and VIA-positive women who are ineligible for ablative treatment or are suspected to have invasive cancer should be appropriately referred and managed. The details of the various techniques to treat cervical precancers are described later. To learn more about the techniques of VIA, please consult the Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment.
Women who are known to be positive for HPV16 or HPV18 may be directly assessed for eligibility for ablative treatment, whereas those who test positive for other high-risk HPV types undergo VIA for triage.