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

Columbia University, New York, New York, United States
Journal of Clinical Microbiology (Impact Factor: 3.99). 07/2007; 45(6):1679-83. DOI: 10.1128/JCM.02369-06
Source: PubMed


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.

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    • "HPV and Human Immunodeficiency Virus (HIV) work synergistically to increase the malignant potential of dysplastic cervical lesions [2], [3], [4]. South Africa has more HIV-positive citizens than any country in the world, with nearly 3 million women ages 15 and older currently living with HIV [5], and up to two-thirds have concomitant oncogenic HPV infections [6], [7], [8]. HIV-positive women are nearly five times more likely to have high-risk HPV-infection compared to HIV-negative women, leading to ICC becoming the most common cancer-killer among South African women [9], [10], [11], [12]. "
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    • "It has been reported that more LR types are likely to be detected in specimens from the vagina than in samples from the cervix (Jones et al., 2007). The risk of HPV infection was found to decrease with increasing age in women and men. "
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