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Downham L, Rol ML, Forestier M, Romero P, Mendoza L, Mongelós P, Picconi MA, Colucci MC, Padin VM, Flores AP, Zúñiga M, Ferrera A, Cabrera Y, Crispín MF, Ramirez AT, Cele L, Diop-Ndiaye H, Samaté D, Manga P, Thiam FB, Rodriguez MI, DSouza JP, Nyaga VN, Diop M, Sebitloane M, Sánchez GI, Teran C, Calderon A, Wiesner C, Murillo R, Herrero R, Baena A, Almonte M. Field experience with the 8-HPV-type oncoprotein test for cervical cancer screening among HPV-positive women living with and without HIV in LMICs. Int J Cancer 2024. [PMID: 38602045 DOI: 10.1002/ijc.34953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
Overexpression of HPV-oncoproteins E6 and E7 is necessary for HPV-driven cervical carcinogenesis. Hence, these oncoproteins are promising disease-specific biomarkers. We assessed the technical and operational characteristics of the 8-HPV-type OncoE6/E7 Cervical Test in different laboratories using cervical samples from HPV-positive women living with (WLWH) and without HIV. The 8-HPV-type OncoE6/E7 Test (for short: "OncoE6/E7 test") was performed in 2833 HIV-negative women and 241 WLWH attending multicentric studies in Latin America (ESTAMPA study), and in Africa (CESTA study). Oncoprotein positivity were evaluated at each testing site, according to HIV status as well as type-specific agreement with HPV-DNA results. A feedback questionnaire was given to the operators performing the oncoprotein test to evaluate their impression and acceptability regarding the test. The OncoE6/E7 test revealed a high positivity rate heterogeneity across all testing sites (I2: 95.8%, p < .01) with significant lower positivity in WLWH compared to HIV-negative women (12% vs 25%, p < .01). A similar HPV-type distribution was found between HPV DNA genotyping and oncoprotein testing except for HPV31 and 33 (moderate agreement, k = 0.57). Twenty-one laboratory technicians were trained on oncoprotein testing. Despite operators' concerns about the time-consuming procedure and perceived need for moderate laboratory experience, they reported the OncoE6/E7 test as easy to perform and user-friendly for deployment in resource-limited settings. The high positivity rate variability found across studies and subjectivity in test outcome interpretation could potentially results in oncoprotein false positive/negative, and thus the need for further refinements before implementation of the oncoprotein testing in screen-triage-and-treat approaches is warranted.
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Affiliation(s)
- Laura Downham
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Mary Luz Rol
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathilde Forestier
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Pilar Romero
- Instituto Nacional de Cancerología, Bogota, Colombia
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Pamela Mongelós
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | | | - María Celeste Colucci
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Dr Malbrán, Buenos Aires, Argentina
| | - Valeria Mariel Padin
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Dr Malbrán, Buenos Aires, Argentina
| | - Ana Paula Flores
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
| | - Michael Zúñiga
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
| | - Annabelle Ferrera
- Instituto de Investigaciones en Microbiología, Escuela de Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Yessy Cabrera
- Instituto de Investigaciones en Microbiología, Escuela de Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Marcela Farfan Crispín
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Arianis Tatiana Ramirez
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Londiwe Cele
- University of Kwazulu Natal, Durban, South Africa
| | | | - Dianke Samaté
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | - Pascaline Manga
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | | | - Maria Isabel Rodriguez
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Jyoshma P DSouza
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Victoria Nyawira Nyaga
- Department of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Mamadou Diop
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | | | | | - Carolina Teran
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | | | | | - Raul Murillo
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Caja Costarricense del Seguro Social, Puntarenas, Costa Rica
| | - Armando Baena
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Maribel Almonte
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
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