Selecting human papillomavirus genotypes to optimize the performance of screening tests among South African women

Human papillomavirus (HPV) testing is highly sensitive compared to cytology, with the trade ‐off of being less specific. Among South African women, we have shown that restricting the definition of screen‐positive to women with HPV genotypes 16/18/45/31/33/35/52/58 substantially improves the specificity of screening while producing only minor reductions in sensitivity compared to inclus ion of all 14 HPV genotypes conventionally included as high risk in HPV assays. AbstractHuman papillomavirus (HPV) testing is highly sensitive compared to cytology, with the trade ‐off of being less specific. We investigated whether select combinations of HPV genotypes, ascertained by Linear Array (LA) and Xpert HPV (GX), can optimize sensitivity/specificity trade‐offs to detect high‐grade cervical intraepithelial neoplasia (CIN2+). In a study in Cape Town, South Africa , 586 women living without and 535 living with HIV, aged 30‐65 years, were recruited. Each woman underwent a pelvic exam to collect cervical samples (tested by LA and GX for 14 high‐risk HPV genotypes) and underwent colposcopy with histological sampling to determine CIN2+. In multivariable logi stic regression of LA results, only HPV genotypes 16, 18, 31, 33, 35, 52, 58 were significantly associated with CIN2+ (P <  .05). Xpert includes these seven types along with HPV 45 within three of the test's five channels and we defined these eight types as restricted genotyping (ie 16, 18, 31, 33, 35, 45, 52, 58). Ful...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research