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 [κ] of 0.71; for tampons, 89% concordance,
with κ of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with κ higher for
swabs than for tampons (for swabs, 81% concordance, with κ of 0.61; for tampons, 82% concordance, with κ 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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Available from: Sylvia Taylor
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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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    ABSTRACT: In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV) may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto.
    Full-text · Article · Aug 2013 · PLoS ONE
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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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    ABSTRACT: This study investigated the impact of human immunodeficiency virus (HIV) infection on genital human papillomavirus (HPV) in heterosexual couples. More HIV-positive men and women had genital HPV compared with HIV-negative men (77 vs 49%; P<0.001) and women (74 vs 36%; P<0.001). More men and women with partners who were HPV positive had HPV genital infection compared with those with HPV-negative partners (for men, 72% compared with 40%; P<0.001). Men with HIV-positive female partners were at greater risk of high-risk HPV and low-risk HPV (LR HPV) infection compared with men with HIV-negative female partners. This risk increased with decreasing CD4 count { ≥ 350 ml⁻¹: odds ratio [OR ], 2.37 [95% confidence interval (CI), 1.47-3.83]; < 350 ml⁻¹: OR, 3.02 [95 % CI, 1.86-4.9]}. Conversely, the risk of HPV of any type was not found to differ between women with an HIV-positive or HIV-negative male partner. In men, HIV infection and female partner HIV-positive status were both associated with a higher risk of type-specific HPV concordance with their sexual partner, though the associations were not significant for LR HPV. In women, HIV infection and low CD4 count were significantly associated with increased risk of type-specific HPV concordance, but male partner HIV-positive status was not significantly associated with this concordance. In conclusion, male genital HPV prevalence and type-specific sharing were influenced by their own HIV-positive status and that of their female partner. In contrast, female genital HPV prevalence and HPV type-specific sharing were determined by their own HIV-positive status and not by that of their male partner.
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    ABSTRACT: We wanted to compare detection of a broad spectrum of human papillomavirus (HPV) types detected in cellular specimens from the vagina and cervix, which could provide information about the potential of each anatomical site for harboring infection. Previous studies have failed to present data on or detect a broad spectrum of HPV genotypes and/or have not carefully sampled the vagina, instead relying on self-collection that is likely contaminated with cervical cells. We conducted follow-up study of 353 women who had participated in study of HPV and cervical neoplasia in Costa Rica. We collected paired cervical and vaginal specimens; vaginal specimens were collected from the fornix to minimize cervical contamination. Specimens were tested in a masked fashion for >40 HPV types using a MY09/MY11 PCR method and type-specific dot blot hybridization. The prevalence for any carcinogenic HPV type in vaginal and cervical specimens was similar (P = 0.3). However, the prevalence for any HPV type in vaginal specimens was greater than in cervical specimens (P = 0.0002), primarily due to a twofold increased vaginal prevalence of HPV types of the alpha3/alpha15 phylogenetic species (e.g., HPV61) (P <0.00005). Carcinogenic HPV types appeared to have a similar affinity for vaginal and cervical epithelium, but noncarcinogenic HPV types of the alpha3/alpha15 phylogenetic species may have a tropism for vaginal epithelium.
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