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Cervical CancerNCT05247853

HPV Vaccine Effectiveness Study in Rwandan Women Living With HIV

An observational study of Cervical Cancer and Human Papilloma Virus, run by Montefiore Medical Center at 1 site in Rwanda.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Our study will assess and measure population effectiveness of prophylactic HPV vaccine in reducing cervical, anal, and/or oral prevalent and 6-month persistent infections among HPV-vaccinated and 757 HPV-unvaccinated Rwandan WLWH aged 18-26 years. Read more about this study

Who is it for?
Ages 18 to 28 years, women onlyHealthy volunteers can take part
What is being tested?
Blood collection, Oral, cervicovaginal and anal specimen collection and Anoscopy & Biopsy of Acetowhite Lesions
How many people
3,127 participants
Where
1 siteRwanda
Study dates
3 Nov 2021to 12 Dec 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 28 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Study population: This study will recruit women attending collaborating clinics and women from the communities surrounding those clinics into three groups: HPV-vaccinated WLWH (Group 1); HPV-unvaccinated WLWH (Group 2); and HIV[-] women who are HPV-vaccinated (Group 3). The number of doses of HPV vaccination received is dictated by introduction of HPV vaccination in Rwanda. In general, most Rwandan women born in 2003 or later will have been vaccinated with two doses of Gardasil®, women born between 1996 and 2002 will have been vaccinated with three doses of Gardasil®, and women born in 1995 or earlier will be unvaccinated. Therefore, we will recruit by age, which will serve as a useful and very good proxy for HPV vaccination status, which otherwise would be difficult to confirm in real time at enrollment.

Who may be able to join

  • Female
  • 18-28 years. The age of inclusion criteria will likely be restricted as age-specific enrollment goals are met.
  • Physically and mentally able and willing to participate in the study.
  • Willing to provide written and signed or thumb printed, informed consent.
  • Known to be living with HIV (i.e., enrolled in a treatment program), or consent to HIV testing to confirm HIV status.

Who cannot join

  • Have positive pregnancy test or report to be pregnant at the time of visit or less than 6 weeks post-partum (will be asked to make an appointment 6 or more weeks post-partum)
  • Report to be menstruating at the time of visit (will be asked to make new appointment)
  • History of hysterectomy and no longer have a cervix
  • History of treatment for cervical abnormalities after cervical screening
  • History of cervical cancer
  • Report no previous sexual activity
  • HIV status is unknown, and date of birth is 12/31/1995 or earlier
  • Because this study has age-specific enrollment goals for WLWH and HIV[-] women, once those enrollment goals are met for each study group, the respective cohorts will be closed and other eligible women will be excluded.

Trial locations and contacts

1 site in 1 country.

Rwanda1 site
  • Rwanda Military Hospital

    Kigali

Other trials in Rwanda

About this study

Official title: Long-Term Human Papillomavirus Vaccination Effectiveness and Immunity in Rwandan Women Living With and Without Human Immunodeficiency Virus

Our study will assess and measure population effectiveness of prophylactic HPV vaccine in reducing cervical, anal, and/or oral prevalent and 6-month persistent infections among HPV-vaccinated and 757 HPV-unvaccinated Rwandan WLWH aged 18-26 years. Additional objectives include the quantification \& examination of long-term antibody (into young adulthood) responses to HPV vaccination and to validate the performance (e.g., sensitivity and specificity) of a low-cost, POC (point-of-care) anti-HPV16 antibody test to determine/confirm HPV vaccination status. The findings for this study will provide necessary evidence regarding the long-term protection afforded by HPV vaccination in WLWH living in SSA, who are at the greatest risk of HPV-related cancers.

Read the detailed description

Cervical cancer is the 4th most common cancer and cause of cancer-related death in women globally; in many lower-resource settings, especially sub-Saharan Africa (SSA), it is the most common. Virtually all cervical cancer and precancer are caused by 12-15 high-risk human papillomavirus (HPV) types. HPV16 causes approximately 55-60% and HPV18 causes approximately 10-15% of cervical cancer while the remaining 12 HPV types cause the remaining 25-30% of cervical cancer. High-risk HPV, predominately HPV16, also causes most anal, vulvar, vaginal, and penile cancers and a significant proportion of oropharyngeal cancers. Prophylactic HPV vaccines have been developed and have been shown to be nearly 100% protective against incident HPV infection and related abnormalities in the general population. However, the evidence for the effectiveness of prophylactic HPV vaccines in women living with human immunodeficiency virus (HIV) (WLWH) is less clear. HIV infection increases the risk of cervical cancer due to an impaired immune response to HPV.

Rwanda is a high-burden cervical cancer country where the prevalence of HIV is 3.7% among adult women, with higher HIV prevalence among young women (1). In 2011, Rwanda implemented a national HPV vaccination program with Gardasil®, which protects against HPV16 and HPV18, the two HPV types that cause ~70% of cervical cancer, and HPV6 and HPV11, the two types that cause ~90% of anogenital warts (HPV6/11/16/18). Their program has achieved >90% coverage of the target population, primarily girls aged 12 years, annually. The implementation of a highly successful HPV vaccination program and the high prevalence of HIV, in addition to the research and medical capacity that Albert Einstein College of Medicine (Einstein) has helped to build at the Rwanda Military Hospital (RMH) and University of Rwanda (UR), makes Rwanda the ideal locale to study the long-term effects of HPV vaccination in WLWH.

To answer questions about HPV vaccine effectiveness and immunity in Rwandan WLWH, collaborators at Einstein, RMH, and UR will conduct an observational study of WLWH and HIV-negative (HIV[-]) women who did (birth cohorts 1997 and later) and WLWH who did not (birth cohorts before 1997) receive HPV vaccination through the national vaccination program. The investigators will compare cervicovaginal, anal, and oral prevalent and 6-month persistent HPV6/11/16/18 infections in 757 HPV-vaccinated WLWH to those in 757 unvaccinated WLWH and 757 HPV-vaccinated HIV[-] women. The investigators will also compare the HPV immune response in 548 HPV-vaccinated WLWH to 548 HPV-vaccinated HIV[-] women and the impact of switching from 3 doses to 2 doses of Gardasil® in 2015. Finally, the investigators will investigate the risk factors, including the cervicovaginal microbiome, for prevalent and 6-month persistent HPV infection in young WLWH and HIV[-] women. The long-term goal is to establish a cohort of WLWH in whom we can examine the long-term effectiveness of HPV vaccination in WLWH now and in the future. This contribution is significant as it will establish the population effectiveness of HPV vaccination in WLWH living in SSA, the group of women at the highest risk of cervical cancer, for which there is a dearth of evidence. The proposed research is innovative as it leverages and expands the local research and medical capacity in Rwanda to examine one of the critically unanswered questions about HPV vaccine effectiveness in the context of the World Health Organization's (WHO) call for the elimination of cervical cancer.

Being tested
Blood collection, Oral, cervicovaginal and anal specimen collection, Anoscopy & Biopsy of Acetowhite Lesions, Colposcopy & Biopsy of Acetowhite Lesions, Ablative Treatment
Medical subject headings
Uterine Cervical Neoplasms, Acquired Immunodeficiency Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood collectionProcedure or surgery

    Blood collection at enrollment visit

  • Oral, cervicovaginal and anal specimen collectionProcedure or surgery

    Oral, cervicovaginal and anal specimen collection at enrollment and follow-up visits

  • Anoscopy & Biopsy of Acetowhite LesionsProcedure or surgery

    Used for management in follow-up visits of persistent anal HPV16/18+ in WLWH

  • Colposcopy & Biopsy of Acetowhite LesionsProcedure or surgery

    Used for management in follow-up visits of persistent type-specific high-risk HPV cervicovaginal HPV

  • Ablative TreatmentProcedure or surgery

    Use for management in follow-up visits of persistent cervicovaginal HPV 16/18+ in WLWH, as identified in colposcopy and biopsy

  • LEEP (Loop Electrosurgical Excision Procedure)Procedure or surgery

    Use for management in follow-up visits of persistent cervicovaginal HPV 16/18+ in WLWH, as identified in colposcopy and biopsy that ablation ineligible

Study groups in NCT05247853
Study groupRoleWhat they receive
Group 1HPV-vaccinated women living with HIV
Receives: Procedure: Blood collection; Procedure: Oral, cervicovaginal and anal specimen collection; Procedure: Anoscopy & Biopsy of Acetowhite Lesions; Procedure: Colposcopy & Biopsy of Acetowhite Lesions; Procedure: Ablative Treatment; Procedure: LEEP (Loop Electrosurgical Excision Procedure)
Group 2HPV-unvaccinated women living with HIV
Receives: Procedure: Blood collection; Procedure: Oral, cervicovaginal and anal specimen collection; Procedure: Anoscopy & Biopsy of Acetowhite Lesions; Procedure: Colposcopy & Biopsy of Acetowhite Lesions; Procedure: Ablative Treatment; Procedure: LEEP (Loop Electrosurgical Excision Procedure)
Group 3HIV[-] women who are HPV-vaccinated
Receives: Procedure: Blood collection; Procedure: Oral, cervicovaginal and anal specimen collection; Procedure: Colposcopy & Biopsy of Acetowhite Lesions

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in vaccine effectiveness of prophylactic HPV vaccine

    To measure population effectiveness of prophylactic HPV vaccine in reducing cervicovaginal, anal, and/or oral prevalent and 6-12 month persistent infections by HPV6/11/16/18

    Measured: Baseline and up to 12 months

  2. Change in long-term antibody responses to HPV vaccination

    To quantify, and examine the determinants of, long-term antibody (into young adulthood) responses to HPV vaccination

    Measured: Baseline and up to 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Feb 2022
  2. Study start3 Nov 2021
  3. Primary completion12 Dec 2024
  4. Study completion12 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
3,127 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05247853
Sponsor's protocol ID
2021-13087
Other IDs
1U54CA254568-01
Status last verified
Oct 2025
First submitted
13 Jan 2022
Last updated
16 Oct 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kundrod KA, Jeronimo J, Vetter B, Maza M, Murenzi G, Phoolcharoen N, Castle PE. Toward 70% cervical cancer screening coverage: Technical challenges and opportunities to increase access to human papillomavirus (HPV) testing. PLOS Glob Public Health. 2023 Aug 16;3(8):e0001982. doi: 10.1371/journal.pgph.0001982. eCollection 2023.

    PubMed 37585432
  • Murenzi G, Mungo C. Impact of the human papillomavirus vaccine in low-resource settings. Lancet Glob Health. 2023 Jul;11(7):e997-e998. doi: 10.1016/S2214-109X(23)00203-6. Epub 2023 May 16. No abstract available.

    PubMed 37207682
  • Murangwa A, Desai KT, Gage JC, Murenzi G, Tuyisenge P, Kanyabwisha F, Musafili A, Kubwimana G, Mutesa L, Anastos K, Kim HY, Castle PE. Agreement between Xpert and AmpFire tests for high-risk human papillomavirus among HIV-positive women in Rwanda. Afr J Lab Med. 2022 Oct 19;11(1):1827. doi: 10.4102/ajlm.v11i1.1827. eCollection 2022.

    PubMed 36353194
  • Murenzi G, Shumbusho F, Hansen N, Munyaneza A, Gage JC, Muhoza B, Kanyabwisha F, Pierz A, Tuyisenge P, Anastos K, Castle PE. Long-term human papillomavirus vaccination effectiveness and immunity in Rwandan women living with and without HIV: a study protocol. BMJ Open. 2022 Aug 25;12(8):e061650. doi: 10.1136/bmjopen-2022-061650.

    PubMed 36008069
  • Mukherjee A, Ye Y, Wiener HW, Kuniholm MH, Minkoff H, Michel K, Palefsky J, D'Souza G, Rahangdale L, Butler KR, Kempf MC, Sudenga SL, Aouizerat BE, Ojesina AI, Shrestha S. Variations in Genes Encoding Human Papillomavirus Binding Receptors and Susceptibility to Cervical Precancer. Cancer Epidemiol Biomarkers Prev. 2023 Sep 1;32(9):1190-1197. doi: 10.1158/1055-9965.EPI-23-0300.

    PubMed 37410084

Questions about this trial

What is this clinical trial studying?

An observational study of Cervical Cancer and Human Papilloma Virus, run by Montefiore Medical Center at 1 site in Rwanda.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Rwanda. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in vaccine effectiveness of prophylactic HPV vaccine (time frame: Baseline and up to 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05247853, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2025.

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