Options in human papillomavirus (HPV) detection for cervical cancer screening : comparison between full genotyping and a rapid qualitative HPV-DNA assay in Ghana.

Obiri-Yeboah D, Adu-Sarkodie Y, Djigma F, Akakpo K, Aniakwa-Bonsu E, Amoako-Sakyi D, Simpore J, Mayaud P. Gynecol Oncol Res Pract. 2017 Mar 23 ;4:8. doi : 10.1186/s40661-017-0044-y. eCollection 2017.PMID : 28352472 ;

BACKGROUND : Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV, a semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL).
METHODS : A study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was conducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women attending clinics in the hospital. Cervical samples were tested for HPV by careHPV and Anyplex-II HPV28 genotyping assay, and by conventional cytology.
RESULTS : A total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were analyzed based on the ability of both tests to detect the 14 hr-HPV types included in the careHPV assay. The inter-assay concordance was 94.3% (95%CI : 89.7-97.2%, kappa = 0.88), similar by HIV serostatus. The careHPV assay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%, p = 0.50) and slightly more specific among HIV-seronegative women (85.0% vs. 93.1%, p = 0.10). careHPV had good sensitivity (87.5%) but low specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping (87.5 and 38.8%, respectively). Reproducibility of careHPV, tested on 97 samples by the same individual was 82.5% (95%CI : 73.4-89.4%).
CONCLUSIONS : The performance characteristics of careHPV compared to genotyping suggest that this simpler and cheaper HPV detection assay could offer a suitable alternative for HPV screening in Ghana.
KEYWORDS : Cervical cancer ; Genotyping ; Ghana ; HIV ; Human papillomavirus (HPV) ; Screening ; careHPV

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