1
|
Saidu R, Kuhn L, Tergas A, Boa R, Moodley J, Svanholm-Barrie C, Persing D, Campbell S, Tsai WY, Wright TC, Denny L. Performance of Xpert HPV on Self-collected Vaginal Samples for Cervical Cancer Screening Among Women in South Africa. J Low Genit Tract Dis 2021; 25:15-21. [PMID: 33105451 PMCID: PMC7748046 DOI: 10.1097/lgt.0000000000000575] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Self-sampling may increase access to cervical cancer screening in low-resource settings. Using Xpert HPV, we compared test performance of self- and clinician-collected samples in HIV-positive and HIV-negative women in South Africa. MATERIALS AND METHODS Three hundred thirty HIV-positive and 375 HIV-negative women in the screening group and 202 HIV-negative and 200 HIV-positive women in the referral group, aged 30-65 years, participated in the study. All women self-collected a vaginal sample, and then, a cervical sample was collected by a clinician (both tested using Xpert HPV), followed by colposcopic examination and collection of histologic specimens. RESULTS There was good agreement between self- and clinician-collected samples for detection of any high-risk human papillomavirus (HPV, κ = 0.72 [95% CI = 0.669-0.771]). Prevalence of HPV and sensitivity of the test to detect cervical intraepithelial neoplasia 2+ was similar in self- and clinician-collected samples. Specificity was lower in self-collected than in clinician-collected samples in both HIV-negative (self: 77.5% [95% CI = 72.8-81.8] vs clinician: 86.9% [95% CI = 82.9-90.2]) and HIV-positive (self: 44.0% [95% CI = 38.0-50.1] vs clinician: 59.7% [95% CI = 53.6-65.6]) women. Restricting the definition of screen-positive to 3 of 5 channels on HPV Xpert improved specificity in both HIV-negative (self: 83.2% [95% CI = 78.8-87.0] vs clinician: 89.7% [95% CI = 86.1-92.7]) and HIV-positive (self: 54.2% [95% CI = 48.1-60.2] vs clinician: 67.4% [95% CI = 61.5-72.9]) women. CONCLUSIONS The self-collected sample had good agreement with the clinician-collected sample for the detection of HPV, and restricting the HPV types may improve the specificity in HIV-positive women.
Collapse
Affiliation(s)
- Rakiya Saidu
- Department of Obstetrics and Gynaecology, Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Gynaecologic Cancer Research Centre (SAMRC GCRC), Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
| | - Louise Kuhn
- Gertrude H. Sergievsky Centre, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Centre, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Centre, New York, NY
| | - Ana Tergas
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Centre, New York, NY
- Department of Obstetrics and Gynaecology, Vangelos College of Physicians and Surgeons, Columbia University Irving Medical Centre, New York, NY
| | - Rosalind Boa
- Department of Obstetrics and Gynaecology, Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
| | - Jennifer Moodley
- South African Medical Research Council Gynaecologic Cancer Research Centre (SAMRC GCRC), Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
- Department of Public Health, University of Cape Town, Cape Town, South Africa
| | | | | | | | - Wei-Yann Tsai
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Centre, New York, NY
| | - Thomas C. Wright
- Department of Pathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Centre, New York, NY
| | - Lynette Denny
- Department of Obstetrics and Gynaecology, Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Gynaecologic Cancer Research Centre (SAMRC GCRC), Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
2
|
de Pokomandy A, Burchell AN, Salters K, Ding E, O'Brien N, Bakombo DM, Proulx-Boucher K, Boucoiran I, Pick N, Ogilvie G, Loutfy M, Kaida A. Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). CMAJ Open 2019; 7:E217-E226. [PMID: 30979726 PMCID: PMC6461544 DOI: 10.9778/cmajo.20180151] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cisgender women with HIV experience an elevated risk of cervical cancer compared with HIV-negative women, but this cancer can be prevented through regular cervical cancer screening. Our study objective was to measure adherence to current national cervical cancer screening guidelines among women with HIV in 3 Canadian provinces and identify factors associated with delays. METHODS We conducted a cross-sectional study using the baseline questionnaire of the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). Participants were recruited through clinics, peers and community organizations in British Columbia, Ontario and Quebec. Women were eligible for inclusion if they were cisgender female with HIV, aged 21-70 years, and never had cervicectomy/hysterectomy. RESULTS Of 1189 eligible participants, 815 (68.5%) had received cervical cancer screening less than 1 year ago (i.e., as recommended), 211 (17.7%) 1-3 years ago (i.e., moderate delay) and 163 (13.7%) at least 3 years ago or never (i.e., long delay). Overall, 309 (26.0%) had never discussed the need for a Papanicolaou smear with a nurse/doctor. Factors associated with a long delay were living in Ontario (adjusted odds ratio [OR] 2.51, 95% confidence interval [CI] 1.29-4.88) or Quebec (adjusted OR 3.70, 95% CI 1.79-7.67) (v. BC), being sexually inactive in the past 6 months (adjusted OR 2.02, 95% CI 1.25-3.25), having unknown or < 200 cells/mm3 CD4 counts (adjusted OR 1.78, 95% CI 1.11-2.85) and having a male HIV care provider (adjusted OR 2.15, 95% CI 1.36-3.42). INTERPRETATION Over one-third of women reported cervical cancer screening delays, and one-quarter had never discussed cervical cancer screening recommendations with a health care provider. Additional efforts are needed to improve women's and health care providers' awareness of cervical cancer screening recommendations, particularly among women who are sexually inactive, who are immunosuppressed and who have male HIV care providers.
Collapse
Affiliation(s)
- Alexandra de Pokomandy
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont.
| | - Ann N Burchell
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Kate Salters
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Erin Ding
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Nadia O'Brien
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Dada Mamvula Bakombo
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Karène Proulx-Boucher
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Isabelle Boucoiran
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Neora Pick
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Gina Ogilvie
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Mona Loutfy
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| | - Angela Kaida
- Chronic Viral Illness Service (de Pokomandy, Bakombo, Proulx-Boucher), McGill University Health Centre; Department of Family Medicine (de Pokomandy, O'Brien), McGill University, Montréal, Que.; Department of Family and Community Medicine (Burchell), St. Michael's Hospital; Department of Family and Community Medicine (Burchell), University of Toronto, Toronto, Ont.; Faculty of Health Sciences (Salters, Kaida), Simon Fraser University, Burnaby, BC; BC Centre for Excellence in HIV/AIDS (Salters, Ding, Kaida), Vancouver, BC; Department of Obstetrics and Gynecology (Boucoiran), Hôpital Sainte-Justine and Université de Montréal, Montréal, Que.; Oak Tree Clinic (Pick), BC Women's Hospital; Department of Family Practice (Ogilvie), School of Population and Public Health, University of British Columbia, Vancouver, BC; Women's College Research Institute (Loutfy), Women's College Hospital; Faculty of Medicine (Loutfy), University of Toronto, Toronto, Ont
| |
Collapse
|
3
|
Coorevits L, Traen A, Bingé L, Van Dorpe J, Praet M, Boelens J, Padalko E. Are vaginal swabs comparable to cervical smears for human papillomavirus DNA testing? J Gynecol Oncol 2018; 29:e8. [PMID: 29185266 PMCID: PMC5709534 DOI: 10.3802/jgo.2018.29.e8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/18/2017] [Accepted: 10/12/2017] [Indexed: 11/30/2022] Open
Abstract
Objective Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). Methods Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. Results The overall prevalence of high-risk (HR)-HPV was 51%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HR-HPV was 100% and 70% and for probable HR-HPV 100% and 91%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95% confidence interval [CI]=2.8–4.2) was significantly higher than in cervical smear samples (mean=2.6; 95% CI=2.1–3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. Conclusion As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.
Collapse
Affiliation(s)
- Liselotte Coorevits
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium.
| | | | | | - Jo Van Dorpe
- Department of Pathology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Marleen Praet
- Department of Pathology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Jerina Boelens
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium
| | - Elizaveta Padalko
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium.,School of Life Sciences, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
4
|
Lagier JC, Diagne N, Fenollar F, Tamalet C, Sokhna C, Raoult D. Vaginal self-sampling as a diagnosis tool in low-income countries and potential applications for exploring the infectious causes of miscarriage. Future Microbiol 2017; 12:609-620. [PMID: 28604063 DOI: 10.2217/fmb-2016-0179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gynecological health is a challenge in low-income countries. Personal opposition to perineal examination has been overcome by the use of vaginal self-sampling. Here, we review the use of this procedure notably in low-income countries and the main infectious causes of miscarriage. Vaginal self-sampling was mainly used for human papillomavirus detection but also to detect microorganisms causing sexually transmitted infections or bacterial vaginosis. 58 studies have been performed in low-resource countries, mainly studies performed to detect human papillomavirus in urban and peri-urban areas and demonstrating excellent acceptability. Several infectious causes of miscarriage could be tested using self-vaginal samples. In the future, such strategies coupled with a rapid-identification point-of-care method could allow the development of screening and treatment programs in rural areas in low-resource countries.
Collapse
Affiliation(s)
- Jean-Christophe Lagier
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Nafissatou Diagne
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Florence Fenollar
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Catherine Tamalet
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Cheikh Sokhna
- Aix-Marseille Université, URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, Inserm U1095, Campus International UCAD-IRD, BP 1386, CP 18524, Dakar, Senegal
| | - Didier Raoult
- Aix-Marseille Université URMITE, IHU Méditerranée-Infection, UM63, CNRS 7278, IRD 198, INSERM 1095, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| |
Collapse
|
5
|
Mitchell SM, Pedersen HN, Eng Stime E, Sekikubo M, Moses E, Mwesigwa D, Biryabarema C, Christilaw J, Byamugisha JK, Money DM, Ogilvie GS. Self-collection based HPV testing for cervical cancer screening among women living with HIV in Uganda: a descriptive analysis of knowledge, intentions to screen and factors associated with HPV positivity. BMC WOMENS HEALTH 2017; 17:4. [PMID: 28086933 PMCID: PMC5237237 DOI: 10.1186/s12905-016-0360-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/29/2016] [Indexed: 01/23/2023]
Abstract
Background Women living with HIV (WHIV) are disproportionately impacted by cervical dysplasia and cancer. The burden is greatest in low-income countries where limited or no access to screening exists. The goal of this study was to describe knowledge and intentions of WHIV towards HPV self-collection for cervical cancer screening, and to report on factors related to HPV positivity among women who participated in testing. Methods A validated survey was administered to 87 HIV positive women attending the Kisenyi Health Unit aged 30–69 years old, and data was abstracted from chart review. At a later date, self-collection based HPV testing was offered to all women. Specimens were tested for high risk HPV genotypes, and women were contacted with results and referred for care. Descriptive statistics, Chi Square and Fischer-exact statistical tests were performed. Results The vast majority of WHIV (98.9%) women did not think it necessary to be screened for cervical cancer and the majority of women had never heard of HPV (96.4%). However, almost all WHIV found self-collection for cervical cancer screening to be acceptable. Of the 87 WHIV offered self-collection, 40 women agreed to provide a sample at the HIV clinic. Among women tested, 45% were oncogenic HPV positive, where HPV 16 or 18 positivity was 15% overall. Conclusions In this group of WHIV engaged in HIV care, there was a high prevalence of oncogenic HPV, a large proportion of which were HPV genotypes 16 or 18, in addition to low knowledge of HPV and cervical cancer screening. Improved education and cervical cancer screening for WHIV are sorely needed; self-collection based screening has the potential to be integrated with routine HIV care in this setting.
Collapse
Affiliation(s)
| | | | | | | | - Erin Moses
- Women's Health Research Institute, Vancouver, BC, Canada
| | | | | | - Jan Christilaw
- BC Women's Hospital and Health Centre, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3 N1, Canada
| | | | | | - Gina S Ogilvie
- University of British Columbia, Vancouver, BC, Canada. .,Women's Health Research Institute, Vancouver, BC, Canada. .,BC Women's Hospital and Health Centre, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3 N1, Canada.
| |
Collapse
|
6
|
Comparison of DRY and WET vaginal swabs with cervical specimens in Roche Cobas 4800 HPV and Abbott RealTime High Risk HPV tests. J Clin Virol 2016; 79:80-84. [PMID: 27111579 DOI: 10.1016/j.jcv.2016.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 02/18/2016] [Accepted: 04/14/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Self-collected vaginal swab samples have been proposed as an alternative specimen collection method for human papillomavirus (HPV) DNA detection. OBJECTIVES Two vaginal swabs (a cone-shaped flocked swab (DRY) and a L-shape FLOQSwab with 2mL eNAT transport medium (WET)) were compared to standard cervical samples for HPV DNA testing. Additionally, they were also compared by using Roche Cobas 4800 HPV (Roche_HPV) and Abbott Real-time High Risk HPV (Abbott_HPV) tests. STUDY DESIGN Ninety-six women were prospectively enrolled from the National Cancer Center in Korea between June and August 2015. WET and DRY vaginal swabs and cervical specimens were collected. Roche_HPV and Abbott_HPV tests were performed. The Roche_HPV test on cervical specimens was used as reference. RESULTS The observed agreements (kappa) of Roche_HPV and Abbott_HPV between WET and DRY swabs were 89.6% (0.790, 95% confidence interval (95% CI): 0.667-0.913) and 91.7% (0.833, 95%CI: 0.723-0.943), respectively. No statistical difference was observed between WET and DRY swabs (p>0.05 for all comparisons). For HPV16/18, the sensitivity/specificity of Roche_HPV on the DRY and WET samples presented 93.8%/96.3% and 87.5%/97.5%, respectively. For other High Risk HPV (hrHPV), the sensitivity/specificity of Roche_HPV on the DRY and WET swabs presented 91.9%/91.5% and 97.3%/98.3, respectively. The sensitivity/specificity of the Abbott_HPV on the DRY and WET swabs were 93.8%/98.8%, 87.5%/98.8% for HPV16/18, and 91.9%/93.2%, 100.0%/93.2% for other hrHPV, respectively. CONCLUSIONS HPV tests performed similarly when using vaginal DRY and WET swab samples. Using DRY and WET swabs to collect vaginal specimens could be an alternative to collecting cervical samples for HPV DNA testing.
Collapse
|
7
|
Evaluation of a new APTIMA specimen collection and transportation kit for high-risk human papillomavirus E6/E7 messenger RNA in cervical and vaginal samples. Sex Transm Dis 2015; 41:365-8. [PMID: 24825332 DOI: 10.1097/olq.0000000000000125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND An APTIMA specimen collection and transportation (SCT) kit was developed by Hologic/Gen-Probe. OBJECTIVES To compare cervical SCT samples to PreservCyt and SurePath samples and self-collected vaginal samples to physician-collected vaginal and cervical SCT samples. To determine ease and comfort of self-collection with the kit. STUDY DESIGN Each woman (n = 580) self-collected a vaginal SCT, then filled out a questionnaire (n = 563) to determine ease and comfort of self-collection. Colposcopy physicians collected a vaginal SCT and cervical PreservCyt, SCT, and SurePath samples. Samples were tested by APTIMA HPV (AHPV) assay. RESULTS Agreement between testing of cervical SCT and PreservCyt was 91.1% (κ = 0.82), and that of SurePath samples was 86.7% (κ = 0.72). Agreement of self-collected vaginal SCT to physician-collected SCT was 84.7% (κ = 0.68), and that of self-collected vaginal to cervical SCT was 82.0% (κ = 0.63). For 30 patients with CIN2+, AHPV testing of cervical SCT was 100% sensitive and 59.8% specific compared with PreservCyt (96.6% and 66.2%) and SurePath (93.3% and 70.9%). Vaginal SCT sensitivity was 86.7% for self-collection and 80.0% for physician collection. Most patients found that vaginal self-collection was easy, 5.3% reported some difficulty, and 87.6% expressed no discomfort. CONCLUSIONS Cervical samples collected with the new SCT kit compared well to traditional liquid-based samples tested by AHPV. Although there was good agreement between self-collected and physician-collected samples with the SCT, in a limited number of 30 women, vaginal sampling identified fewer with CIN2+ precancerous cervical lesions than cervical SCT sampling. Comfort, ease of use, and detection of high-risk HPV demonstrated that the kit could be used for cervical and vaginal sampling.
Collapse
|
8
|
Chaban B, Links MG, Jayaprakash TP, Wagner EC, Bourque DK, Lohn Z, Albert AYK, van Schalkwyk J, Reid G, Hemmingsen SM, Hill JE, Money DM. Characterization of the vaginal microbiota of healthy Canadian women through the menstrual cycle. MICROBIOME 2014; 2:23. [PMID: 25053998 PMCID: PMC4106219 DOI: 10.1186/2049-2618-2-23] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 03/31/2014] [Indexed: 05/11/2023]
Abstract
BACKGROUND The vaginal microbial community plays a vital role in maintaining women's health. Understanding the precise bacterial composition is challenging because of the diverse and difficult-to-culture nature of many bacterial constituents, necessitating culture-independent methodology. During a natural menstrual cycle, physiological changes could have an impact on bacterial growth, colonization, and community structure. The objective of this study was to assess the stability of the vaginal microbiome of healthy Canadian women throughout a menstrual cycle by using cpn60-based microbiota analysis. Vaginal swabs from 27 naturally cycling reproductive-age women were collected weekly through a single menstrual cycle. Polymerase chain reaction (PCR) was performed to amplify the universal target region of the cpn60 gene and generate amplicons representative of the microbial community. Amplicons were pyrosequenced, assembled into operational taxonomic units, and analyzed. Samples were also assayed for total 16S rRNA gene content and Gardnerella vaginalis by quantitative PCR and screened for the presence of Mollicutes by using family and genus-specific PCR. RESULTS Overall, the vaginal microbiome of most women remained relatively stable throughout the menstrual cycle, with little variation in diversity and only modest fluctuations in species richness. Microbiomes between women were more different than were those collected consecutively from individual women. Clustering of microbial profiles revealed the expected groupings dominated by Lactobacillus crispatus, Lactobacillus iners, and Lactobacillus jensenii. Interestingly, two additional clusters were dominated by either Bifidobacterium breve or a heterogeneous mixture of nonlactobacilli. Direct G. vaginalis quantification correlated strongly with its pyrosequencing-read abundance, and Mollicutes, including Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum, were detected in most samples. CONCLUSIONS Our cpn60-based investigation of the vaginal microbiome demonstrated that in healthy women most vaginal microbiomes remained stable through their menstrual cycle. Of interest in these findings was the presence of Bifidobacteriales beyond just Gardnerella species. Bifidobacteriales are frequently underrepresented in 16S rRNA gene-based studies, and their detection by cpn60-based investigation suggests that their significance in the vaginal community may be underappreciated.
Collapse
Affiliation(s)
- Bonnie Chaban
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada
| | - Matthew G Links
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada
- Agriculture and AgriFood Canada, 107 Science Place, Saskatoon, SK S7N 0X2, Canada
| | - Teenus Paramel Jayaprakash
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada
| | - Emily C Wagner
- Department of Obstetrics and Gynecology, University of British Columbia, 1190 Hornby Street, Vancouver, BC V6Z 2K5, Canada
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Danielle K Bourque
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Zoe Lohn
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Arianne YK Albert
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Julie van Schalkwyk
- Department of Obstetrics and Gynecology, University of British Columbia, 1190 Hornby Street, Vancouver, BC V6Z 2K5, Canada
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Gregor Reid
- Department of Microbiology and Immunology, University of Western Ontario and Lawson Health Research Institute, London, ON, Canada
| | - Sean M Hemmingsen
- National Research Council Canada, 110 Gymnasium Place, Saskatoon, SK S7N 0W9, Canada
- Department of Microbiology & Immunology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Janet E Hill
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada
| | - Deborah M Money
- Department of Obstetrics and Gynecology, University of British Columbia, 1190 Hornby Street, Vancouver, BC V6Z 2K5, Canada
- Women’s Health Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| |
Collapse
|
9
|
[Self-collection of test material. Supplement to cervical cancer screening]. DER PATHOLOGE 2013; 34:558-62. [PMID: 24051606 DOI: 10.1007/s00292-013-1857-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Recent studies have reported high sensitivity of human papillomavirus (HPV) testing from self-collected vaginal specimens. These results suggest the possibility of introducing self-collection of samples for cervical cancer screening to increase overall participation. The current study compared test results from self-collected and physician-collected specimens. PATIENTS AND METHODS Vaginal samples from patients (n = 102) of a colposcopy clinic were taken by both a physician and themselves. All cell samples were tested using cytological diagnostics with a PAP test and for carcinogenic HPV genotypes (Cervista®). Additionally, all patients had a colposcopy (86% with cervical biopsy) and in 40% of patients was carried out a conisation. RESULTS Of the patients tested 50 had the histological diagnosis of a cervical intraepithelial neoplasia grade 2 (CIN 2+ or 3). Sensitivity of HPV self-collected samples was much lower than that of physician-collected samples (72 % compared to 92 %). The sensitivity of self-collected PAP tests was only 52 % but the positive predictive value of self-collected PAP tests was very high. The cytological diagnosis of high-grade intraepithelial lesion (HSIL) correlated much better with the histological results of conisation (96 %) than with cervical biopsies (76 %). CONCLUSION The results of this study indicate that self-collection may not provide an adequate collection method for improving efficiency in cervical cancer screening in Germany.
Collapse
|
10
|
de Almeida FG, Machado AP, Fernandes CEDS, Ferreira AT, Padovani CTJ, Tozetti IA. Molecular epidemiology of the human papillomavirus infection in self-collected samples from young women. J Med Virol 2013; 86:266-71. [PMID: 24009072 DOI: 10.1002/jmv.23725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 11/12/2022]
Abstract
The prevalence of human papillomavirus (HPV) infection is the highest in young, sexually active women less than 35 years of age. Direct diagnosis of infection by enabling genotyping methods is important considering that the viral types are divided into high (HR-HPV) and low (LR-HPV) oncogenic risk. This study aimed to evaluate the epidemiological and molecular characteristics of HPV infection in self-collected samples from young women. A cross-sectional study of 245 sexually active students (18 to 35 years of age) was undertaken with self-collected samples. Extracted DNA was analyzed by polymerase chain reaction (PCR) with the PGMY 09/11 and PC04/GH20 primers for the detection of HPV DNA and the β-globin gene, respectively. Viral genotyping was performed by type-specific PCR (TS-PCR) and restriction fragment length polymorphism (RFLP). Of the 236 valid samples, 68 (28.9%) were positive for HPV DNA, as genotyped by TS-PCR and RFLP. The HR-HPV were most prevalent, especially HPV-16, -31, -33, and -45, and the most prevalent LR-HPV were HPV-6 and -83. Multi-type HPV infections were detected in 17 (25%) samples. HPV infection was statistically more prevalent among younger women with lower educational levels and who had more partners in the past 2 years. A high prevalence of HPV infection was found in the age group examined, especially HR-HPV types, as well as the presence of risk behaviors associated with HPV infection were observed. Considering these results, vaccinating females before the onset of sexual activity in Brazil should be emphasized.
Collapse
Affiliation(s)
- Flávia Gatto de Almeida
- Program of Infectious and Parasitary Diseases from Medicine School, Universidade Federal de MatoGrosso do Sul/UFMS, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | | | | |
Collapse
|
11
|
Human papillomavirus infection in women in Puerto Rico: agreement between physician-collected and self-collected anogenital specimens. J Low Genit Tract Dis 2013; 17:210-7. [PMID: 23422638 DOI: 10.1097/lgt.0b013e318260e312] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to describe the prevalence and concordance between cervical and anal human papillomavirus (HPV) infection and compare cervicovaginal and anal self-collection methods for HPV testing between physician and self-collected specimens in women in Puerto Rico. MATERIALS AND METHODS Specimens for HPV-DNA testing were obtained from 100 women aged 18 to 34 years attending a general gynecology clinic for a routine Pap smear. Human papillomavirus testing was performed using polymerase chain reaction MY09/MY11 primers. Positive samples were typed for 39 genotypes. Agreement between sampling methods was determined by percent agreement and the κ statistic. RESULTS For the 39 genotypes evaluated, 38.4% (38/99) of cervicovaginal and 33.7% (30/89) of anal physician-collected samples were HPV+, whereas 35.1% (34/97) of cervicovaginal and 32.0% (31/97) of anal self-collected samples were positive. Human papillomavirus type 16 was the most common type identified in the cervix (8.3%, 8/97) and the anus (5.6%, 5/89) of physician-collected samples, with similar prevalence in self-collected samples. Concordance between cervical and anal HPV infection was high (>90%) for all types evaluated. There was a strong percent agreement between physician- and self-collected cervicovaginal and anal samples (>95% for all HPV types) and good to excellent agreement (κ > 0.60) for most HPV types. CONCLUSIONS The clinic-based prevalence of anal and cervicovaginal HPV infection was high, with a strong concordance between cervical and anal infection and good to excellent agreement between physician- and self-collected samples. This study supports the feasibility of using cervical and anal self-sampling methods in future population-based studies of HPV infection in Puerto Rico and as an HPV screening method in women.
Collapse
|
12
|
Adler DH, Laher F, Lazarus E, Grzesik K, Gray GE, Allan B, Williamson AL. A Viable and Simple Self-Sampling Method for Human Papillomavirus Detection among South African Adolescents. ACTA ACUST UNITED AC 2013; 2. [PMID: 24324979 DOI: 10.4172/2329-9541.1000113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Self-sampling for Human Papillomavirus (HPV) testing may offer improved patient acceptability, decreased cost, and greater practicality than clinician collection of specimens. HPV testing among adolescents is necessary to conduct vaccine surveillance and may play a role in cervical cancer screening among some populations. METHODS A cross-sectional prevalence study was conducted to compare the results of self-collected and clinician-collected specimens for Human papillomavirus (HPV) testing among South African adolescent females. All participants provided self-sampled vaginal swabs and underwent clinician-collection of cervical swabs for HPV DNA analysis. The level of agreement between HPV DNA results from the two specimen collection methods was measured. RESULTS The level of agreement between HPV DNA results from self-collected and clinician-collected specimens was high (κ=86.7; p<0.001). A high prevalence of HPV overall was found by both specimen collection methods (57%; 95% CI 0.37-0.75). Low-risk HPV (LR-HPV) types were found slightly more frequently in self-collected specimens. CONCLUSION There is a high level of agreement between the HPV DNA results from self-collected and clinician-collected specimens. Self-collection of specimens for HPV testing is a viable alternative among adolescents.
Collapse
Affiliation(s)
- David H Adler
- Department of Emergency Medicine, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | | | | | | | | | | | | |
Collapse
|
13
|
Adler DH, Almudevar A, Gray GE, Allan B, Williamson AL. High level of agreement between clinician-collected and self-collected samples for HPV detection among South African adolescents. J Pediatr Adolesc Gynecol 2012; 25:280-1. [PMID: 22840940 PMCID: PMC3690189 DOI: 10.1016/j.jpag.2012.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/06/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022]
|
14
|
Cerigo H, Coutlée F, Franco EL, Brassard P. Dry self-sampling versus provider-sampling of cervicovaginal specimens for human papillomavirus detection in the Inuit population of Nunavik, Quebec. J Med Screen 2012; 19:42-8. [PMID: 22438506 DOI: 10.1258/jms.2012.012011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the comparability of self-collected cervicovaginal samples and provider-collected cervical samples for the detection of human papillomavirus (HPV) DNA among Inuit women in Nunavik, Quebec, avoiding the use of liquid-based storage and transport of the self-collected samples. METHODS Ninety-three women aged 18-69 years were recruited from a previously formed cohort on the natural history of HPV to this cross-sectional measurement study. This study utilized HPV DNA test results from 89 paired specimens collected by study participant and health provider with Dacron swabs. Samples were tested for 36 HPV types with the PGMY-primer PCR protocol and genotyping with the linear array method. Unweighted kappa statistics and McNemar tests were used to measure the agreement between sampling techniques. RESULTS In the self-collected samples, 30 different HPV types were found, compared with 29 types found in the provider-collected samples. The prevalence of high-risk (HR) HPV was 38.2% in the self-collected samples and 28.1% in the provider-collected samples. The agreement between collection methods for the detection of HR-HPV DNA (85.4%) was good. HR-HPV and type-specific HPV 16/18 were as likely to be detected in the self-collected samples compared with the provider-obtained samples. CONCLUSIONS Women in this population were easily able to collect adequate cervicovaginal specimens for HPV testing. As self-sampling has a high recovery of HR-HPV and is comparable with provider-sampling, we conclude that self-sampling with dry storage and transport could be a good cervical cancer screening alternative for Inuit women in Nunavik who have traditionally avoided speculum examination.
Collapse
Affiliation(s)
- Helen Cerigo
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | | | | |
Collapse
|
15
|
Gustavsson I, Sanner K, Lindell M, Strand A, Olovsson M, Wikström I, Wilander E, Gyllensten U. Type-specific detection of high-risk human papillomavirus (HPV) in self-sampled cervicovaginal cells applied to FTA elute cartridge. J Clin Virol 2011; 51:255-8. [DOI: 10.1016/j.jcv.2011.05.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 04/18/2011] [Accepted: 05/03/2011] [Indexed: 11/29/2022]
|
16
|
Self-collected vaginal swabs for the quantitative real-time polymerase chain reaction assay of Atopobium vaginae and Gardnerella vaginalis and the diagnosis of bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2011; 31:513-8. [PMID: 21789604 DOI: 10.1007/s10096-011-1341-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 07/07/2011] [Indexed: 10/18/2022]
Abstract
The aim of this study was to assess the feasibility of using self-collected vaginal specimens for the quantitative real-time polymerase chain reaction (qPCR) assays of bacterial vaginosis (BV)-associated bacteria versus practitioner-collected swabs. A cross-sectional study included 190 pregnant women enrolled before 20 weeks' gestation from September 2008 to November 2009. Self- and practitioner-collected swabs were taken during the same prenatal visit for each woman, qPCR assays performed for each, and the results compared. The quantification of the human albumin gene was used as an internal control to ensure sampling quality and accurate comparisons. The level of agreement of the qPCR assays for each microorganism was calculated with the Spearman product moment correlation coefficient and the kappa statistic. In all, 370 vaginal samples (185 self- and 185 practitioner-collected swabs) had a narrow range of values for the number of albumin gene copies and a significant correlation coefficient (Spearman's rho = 0.532; p < 0.001). The agreement between both sampling methods was excellent (Spearman's rho was 0.748 for Atopobium vaginae, 0.918 for Lactobacillus species, 0.940 for Gardnerella vaginalis; p < 0.001), especially for high concentrations of A. vaginae (≥10(8) copies/mL; kappa value = 0.973; p < 0.001) and G. vaginalis (≥10(9) copies/mL; kappa value = 0.903; p < 0.001). This study demonstrates the validity and reliability of self- versus practitioner-collected swabs for the molecular quantification of Lactobacillus species, G. vaginalis, and A. vaginae.
Collapse
|
17
|
Twu NF, Yen MS, Lau HY, Chen YJ, Yu BKJ, Lin CY. Type-specific human papillomavirus DNA testing with the genotyping array: a comparison of cervical and vaginal sampling. Eur J Obstet Gynecol Reprod Biol 2011; 156:96-100. [DOI: 10.1016/j.ejogrb.2010.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 10/28/2010] [Accepted: 12/26/2010] [Indexed: 10/18/2022]
|
18
|
Schmeink CE, Bekkers RLM, Massuger LFAG, Melchers WJG. The potential role of self-sampling for high-risk human papillomavirus detection in cervical cancer screening. Rev Med Virol 2011; 21:139-53. [DOI: 10.1002/rmv.686] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Channa E. Schmeink
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Ruud L. M. Bekkers
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Leon F. A. G. Massuger
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Willem J. G. Melchers
- Department of Medical Microbiology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| |
Collapse
|
19
|
Determinants of human papillomavirus infection among Inuit women of northern Quebec, Canada. Sex Transm Dis 2010; 37:377-81. [PMID: 20473246 DOI: 10.1097/olq.0b013e3181cc4d22] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We investigated risk factors for prevalent high-risk human papillomavirus (HR-HPV) in Inuit women from Quebec. Younger age and having 10 or more lifetime sexual partners were associated with HR-HPV. Findings suggest that for older women, markers of recent sexual activity are more predictive of HR-HPV status than markers of lifetime sexual history.
Collapse
|
20
|
Tamalet C, Richet H, Carcopino X, Henry M, Leretraite L, Heid P, Leandri FX, Sancho-Garnier H, Piana L. Testing for human papillomavirus and measurement of viral load of HPV 16 and 18 in self-collected vaginal swabs of women who do not undergo cervical cytological screening in Southern France. J Med Virol 2010; 82:1431-7. [DOI: 10.1002/jmv.21835] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
21
|
Sehgal A, Gupta S, Parashari A, Sodhani P, Singh V. Urine HPV-DNA detection for cervical cancer screening: prospects and prejudices. J OBSTET GYNAECOL 2009; 29:583-9. [PMID: 19757259 DOI: 10.1080/01443610903061736] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Oncogenic types of human papilloma viruses (HPVs) have been established to be the causative agents for cervical cancers and high-grade squamous intraepithelial lesions (HSILs). The clinical application of molecular tests for HPV detection for screening purposes has been of considerable interest. DNA amplification methods allow the use of self-collected samples (including urine) from material collected away from the original disease site. For screening of cervical pathology, detection of HPV-DNA in urine would be useful only if it represents cervical HPV infection and/or HPV-related cervical pathology. We conducted a review of the literature in order to ascertain: (1) if urine is an adequate sample for HPV-detection; (2) whether sensitive techniques are available for HPV-detection in urine and (3) if detection of HPV in urine truly represents cervical infection/pathology. The review process consisted of assembling facts and analysing the published literature on the following facts: anatomical considerations of the lower genital and the lower urinary tract, biological behaviour of HPV and its shedding behaviour, technical issues regarding sample collection, processing and HPV-DNA assay systems, concordance rates of HPV-DNA detection and their type specificity in the paired samples (urine and cervical scrapes) obtained in different clinico-epidemiological settings and comparative detection rates of HSILs in the paired samples.
Collapse
Affiliation(s)
- A Sehgal
- Division of Epidemiology and Biostatistics, Institute of Cytology and Preventive Oncology (ICMR), Noida, India.
| | | | | | | | | |
Collapse
|
22
|
Safaeian M, Kiddugavu M, Gravitt PE, Gange SJ, Ssekasanvu J, Murokora D, Sklar M, Serwadda D, Wawer MJ, Shah KV, Gray R. Determinants of incidence and clearance of high-risk human papillomavirus infections in rural Rakai, Uganda. Cancer Epidemiol Biomarkers Prev 2008; 17:1300-7. [PMID: 18559545 DOI: 10.1158/1055-9965.epi-07-2678] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND We used self-administered vaginal swabs to assess the incidence and clearance of carcinogenic human papillomavirus (HPV) infections in rural Rakai, Uganda. METHODS Women provided self-administered vaginal swab at annual home-based visits. Type-specific carcinogenic HPV incidence and clearance and risk factors were assessed. RESULTS Carcinogenic HPV incidence was 17.3 per 100 person-years among HIV-positive women compared with 7.0 per 100 person-years among HIV-negative women (P < 0.001). HPV-51 had the highest incidence followed by HPV-16 (1.8 per 100 and 1.5 per 100 person-years, respectively). In multivariate model, HIV-positive women were twice as likely to have incident infection compared with HIV-negative women. Younger women were at higher risk for incident infection, as were women with higher lifetime and recent sexual partners, and high perception of AIDS. Married women were less likely to have incident infection. Approximately half of all carcinogenic HPV infections cleared over the study follow-up of 3 years. HPV-31, HPV-35, and HPV-16 had the lowest clearance (16.7%, 27.9%, and 38.3%, respectively). In multivariate model, HIV-positive, women over 30 years with higher HPV viral, burden and more lifetime sex partners were less likely to clear infections. CONCLUSIONS Self-collected vaginal swabs provide accurate HPV exposure assessment for studying HPV exposure and epidemiology and can be an important tool for research in populations unwilling to undergo pelvic exam.
Collapse
Affiliation(s)
- Mahboobeh Safaeian
- Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Ferreccio C, Corvalán A, Margozzini P, Viviani P, González C, Aguilera X, Gravitt PE. Baseline assessment of prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples. BMC Public Health 2008; 8:78. [PMID: 18304362 PMCID: PMC2291464 DOI: 10.1186/1471-2458-8-78] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Accepted: 02/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chile has broad variations in weather, economics and population from the far desert north (Region 1) to the cold, icy south (Region 12). A home-based self-collected vaginal sampling was nested in the 2003 Chilean population-based health survey in order to explore the possibility of a type-specific geographical variation for human papillomavirus METHODS The population was a national probability sample of people 17 years of age and over. Consenting women provided self-collected cervicovaginal swabs in universal collection media (UCM). DNA was extracted and typed to 37 HPV genotypes using PGMY consensus PCR and line blot assay. Weighted prevalence rates and adjusted OR were calculated. RESULTS Of the 1,883 women participating in the health survey, 1,219 (64.7%) provided a cervicovaginal sample and in 1,110 (56.2% of participants and 66.5% of those eligible) the samples were adequate for analysis. Refusal rate was 16.9%. HPV prevalence was 29.2% (15.1% high-risk HPV and 14.1% low-risk HPV). Predominant high-risk types were HPV 16, 52, 51, 56 and 58. Predominant low-risk HPVs were HPV 84, CP6108, 62, 53 and 61. High-risk and low-risk HPV rates were inversely correlated between the regions. High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age. CONCLUSION Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.
Collapse
|
24
|
Petignat P, Franco EL, Coutlée F. Response to Pretorius and Belinson. Gynecol Oncol 2007. [DOI: 10.1016/j.ygyno.2007.08.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
Coutlée F, Rouleau D, Ghattas G, Hankins C, Vézina S, Coté P, Macleod J, de Pokomandy A, Money D, Walmsley S, Voyer H, Brassard P, Franco E. Confirmatory real-time PCR assay for human papillomavirus (HPV) type 52 infection in anogenital specimens screened for HPV infection with the linear array HPV genotyping test. J Clin Microbiol 2007; 45:3821-3. [PMID: 17898159 PMCID: PMC2168527 DOI: 10.1128/jcm.01145-07] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel real-time PCR assay for detection of human papillomavirus type 52 (HPV-52) DNA (RT-52) was evaluated on 265 anogenital samples. RT-52 had a sensitivity of 98.4% and a specificity of 100% compared to conventional HPV-52 typing assays, including hybridization of PGMY products with an HPV-52-specific probe and PCR sequencing of HPV-52 E6.
Collapse
Affiliation(s)
- François Coutlée
- Département de Microbiologie et Infectiologie, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
|
27
|
Safaeian M, Kiddugavu M, Gravitt PE, Ssekasanvu J, Murokora D, Sklar M, Serwadda D, Wawer MJ, Shah KV, Gray R. Comparability of self-collected vaginal swabs and physician-collected cervical swabs for detection of human papillomavirus infections in Rakai, Uganda. Sex Transm Dis 2007; 34:429-36. [PMID: 17075437 DOI: 10.1097/01.olq.0000243623.67673.22] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective of this study was to compare human papillomavirus (HPV) DNA testing between self-administered vaginal swabs and physician-administered cervical swabs in women from rural Rakai District, Uganda. STUDY DESIGN Between 2002 and 2003, women from a population-based cohort participated in an HPV study. Women collected self-administered vaginal swabs and were also offered a pelvic examination, which included physician-collected cervical samples. METHODS Hybrid-capture 2 was used to determine carcinogenic HPV status. Polymerase chain reaction was used to determine HPV genotypes. Unweighted kappa statistics were used to determine agreement. RESULTS Compliance with self-collected swabs was > or =86%; however, only 51% accepted a pelvic examination. Carcinogenic HPV prevalence was 19% in self-collected and 19% in physician-collected samples. Agreement among paired observations was 92% with a kappa of 0.75. Kappa between self- and physician-collected samples was similar in HIV strata (k = 0.71 and 0.75 for HIV-positive and HIV-negative, respectively). DISCUSSION In this community-based setting, detection of carcinogenic HPV was comparable among self- and physician-administered samples. Self-collection is a feasible and accurate means of obtaining HPV samples from women in resource-poor settings or persons reluctant to undergo a pelvic examination.
Collapse
Affiliation(s)
- Mahboobeh Safaeian
- Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 20852, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Winer RL, Feng Q, Hughes JP, Yu M, Kiviat NB, O'Reilly S, Koutsky LA. Concordance of self-collected and clinician-collected swab samples for detecting human papillomavirus DNA in women 18 to 32 years of age. Sex Transm Dis 2007; 34:371-7. [PMID: 17065848 DOI: 10.1097/01.olq.0000240315.19652.59] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether self- and clinician-collected samples are comparable for human papillomavirus (HPV) detection. STUDY DESIGN Three hundred seventy-four women aged 23 to 32 (population 1) and 211 women aged 18 to 25 (population 2) contributed self-collected vaginal and clinician-collected cervical and vulvovaginal samples for HPV DNA testing. Eighty-six women mailed in self-collected samples. RESULTS Agreement between self-collected vaginal and clinician-collected combined cervical/vulvovaginal samples was excellent (population 1:92.0%, kappa = 0.81; population 2: 96.4%, kappa = 0.88), but self-collected samples were more concordant with clinician-collected cervical samples in population 2 (kappa = 0.84) than population 1 (kappa = 0.65) (P = 0.01). Age-adjusted HPV prevalence was slightly lower in mailed-in (21.5%) than in-clinic self-collected samples (26.8%). CONCLUSIONS The combined clinician-collected cervical/vulvovaginal sample is most sensitive for detecting all female genital tract HPV infections. HPV concordance between cervical and vaginal samples may be better for newer infections. Larger studies are needed to determine whether mailed-in self-samples are as effective as those collected in a clinical setting.
Collapse
Affiliation(s)
- Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.
| | | | | | | | | | | | | |
Collapse
|
29
|
Jones HE, Allan BR, van de Wijgert JHHM, Altini L, Taylor SM, de Kock A, Coetzee N, Williamson AL. Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa. J Clin Microbiol 2007; 45:1679-83. [PMID: 17409209 PMCID: PMC1933028 DOI: 10.1128/jcm.02369-06] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had high agreement with clinician-obtained brushes when the Roche Reverse Line Blot Assay (RLBA) was used (for swabs, 86% concordance, with a kappa statistic [kappa] of 0.71; for tampons, 89% concordance, with kappa of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with kappa higher for swabs than for tampons (for swabs, 81% concordance, with kappa of 0.61; for tampons, 82% concordance, with kappa of 0.55). Low-risk HPV types were nearly two times more common in self-collected specimens than in clinician-collected specimens tested by RLBA. All 15 women diagnosed with high-grade lesions by cytology tested positive for high-risk HPV with clinician-collected specimens tested by RLBA and HC2, while 11 out of 15 tested positive with self-collected specimens by HC2 and 5 out of 6 tested positive by RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.
Collapse
|
30
|
Petignat P, Faltin DL, Bruchim I, Tramèr MR, Franco EL, Coutlée F. Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis. Gynecol Oncol 2007; 105:530-5. [PMID: 17335880 DOI: 10.1016/j.ygyno.2007.01.023] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Revised: 01/10/2007] [Accepted: 01/16/2007] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples. DESIGN Systematic review and meta-analysis. DATA SOURCES Studies published between 1966 and November 2005 identified through Medline and Embase that compared both sampling methods. MAIN OUTCOME MEASURES We calculated the concordance and kappa statistic between physician- and self-sampling and the difference between proportions of HPV positive samples. Weighted averages were reported with 95% confidence intervals (CI) using a random-effects model. RESULTS Eighteen studies (5441 participants) were included that evaluated broad HPV type categories, 10 (3688 patients) that of high-risk (HR) HPV and three (530) that of low-risk (LR) HPV. A high level of concordance of 0.87 (95%CI, 0.82 to 0.91) between self- and physician-sampling was obtained for detection of HPV DNA (kappa 0.66, 95%CI, 0.56 to 0.76). The prevalence difference of HPV DNA between sampling methods was -0.5 (95%CI, -2.8 to 1.8). Results were similar when restricting the analysis to HR-HPV but the prevalence of LR-HPV types was higher in self-collected samples. CONCLUSION Self-sampling was as sensitive as physician-obtained sampling to detect HR-HPV or HPV DNA. Self-sampling may be a suitable alternative method for studies on HPV transmission and vaccine trials.
Collapse
Affiliation(s)
- Patrick Petignat
- Senology and Gynaecologic Oncology Unit, Geneva University Hospitals, 1211 Geneva 14, Switzerland.
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
HPV infection of both the genital tract and oral cavity of HIV+ men and women is increased. HPV-related pathology is also increased in the HIV+ individuals, usually with further increases seen for those HIV+ individuals with lower CD4 cell counts. Fortunately, the rates of cervical cancer and anal cancer are relatively low and not related to CD4 cell count. Treatment of the HIV+ individual with HPV-related disease is challenging and requires close long-term follow-up to prevent recurrent disease. The mechanism of how HPV and HIV interact is still not known but is more likely to be linked to immune suppression rather than a direct interaction between viruses. The newly developed HPV vaccines will likely have a significant impact on HPV-related disease in immunocompetent individuals. It remains to be seen what impact these vaccine will have on the immune depressed.
Collapse
Affiliation(s)
- Jennifer E Cameron
- Tulane Health Sciences Center, Tulane Medical School, New Orleans, LA, USA
| | | |
Collapse
|
32
|
Coutlée F, Rouleau D, Petignat P, Ghattas G, Kornegay JR, Schlag P, Boyle S, Hankins C, Vézina S, Coté P, Macleod J, Voyer H, Forest P, Walmsley S, Franco E. Enhanced detection and typing of human papillomavirus (HPV) DNA in anogenital samples with PGMY primers and the Linear array HPV genotyping test. J Clin Microbiol 2006; 44:1998-2006. [PMID: 16757590 PMCID: PMC1489445 DOI: 10.1128/jcm.00104-06] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 03/07/2006] [Accepted: 03/17/2006] [Indexed: 11/20/2022] Open
Abstract
The Roche PGMY primer-based research prototype line blot assay (PGMY-LB) is a convenient tool in epidemiological studies for the detection and typing of human papillomavirus (HPV) DNA. This assay has been optimized and is being commercialized as the Linear Array HPV genotyping test (LA-HPV). We assessed the agreement between LA-HPV and PGMY-LB for detection and typing of 37 HPV genotypes in 528 anogenital samples (236 anal, 146 physician-collected cervical, and 146 self-collected cervicovaginal swabs) obtained from human immunodeficiency virus-seropositive individuals (236 men and 146 women). HPV DNA was detected in 433 (82.0%) and 458 (86.7%) samples with PGMY-LB and LA-HPV (P = 0.047), respectively, for an excellent agreement of 93.8% (kappa = 0.76). Of the 17,094 HPV typing results, 16,562 (1,743 positive and 14,819 negative results) were concordant between tests (agreement = 96.9%; kappa = 0.76). The mean agreement between tests for each type was 96.4% +/- 2.4% (95% confidence interval [CI], 95.6% to 97.2%; range, 86% to 100%), for an excellent mean kappa value of 0.85 +/- 0.10 (95% CI, 0.82 to 0.87). However, detection rates for most HPV types were greater with LA-HPV. The mean number of types per sample detected by LA-HPV (4.2 +/- 3.4; 95% CI, 3.9 to 4.5; median, 3.0) was greater than that for PGMY-LB (3.4 +/- 3.0; 95% CI, 3.1 to 3.6; median, 2.0) (P < 0.001). The number of types detected in excess by LA-HPV in anal samples correlated with the number of types per sample (r = 0.49 +/- 0.06; P = 0.001) but not with patient age (r = 0.03 +/- 0.06; P = 0.57), CD4 cell counts (r = 0.06 +/- 0.06; P = 0.13), or the grade of anal disease (r = -0.11 +/- 0.06; P = 0.07). LA-HPV compared favorably with PGMY-LB but yielded higher detection rates for newer and well-known HPV types.
Collapse
Affiliation(s)
- François Coutlée
- Laboratoire de Virologie Moléculaire du centre de Recherche, Département de Microbiologie et Infectiologie, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|