Detection Of Human Papillomavirus Infection Research Articles

Towards the detection of human papillomavirus infection by a reagentless electrochemical peptide biosensor

In the present work, we report first results about a technology using a conjugated copolymer poly(5-hydroxy-1,4-naphthoquinone-co-5-hydroxy-2-carboxyethyl-1,4-naphthoquinone) acting both as immobilizing and transducing element for reagentless immunosensor, and its application for the detection of HPV infection. It was shown that the reagentless immunosensor was able to detect the interaction between antigenic peptide L1 from HPV-16 major capsid protein, a dominant epitope involved in viral infection as well as in prophylactic vaccine, and the relevant antibody.

Rapid Rise in Detection of Human Papillomavirus (HPV) Infection Soon After Incident HIV Infection Among South African Women

It is well established that the prevalence of human papillomavirus (HPV) infection is increased among human immunodeficiency virus (HIV)-positive individuals, but the temporal relationships between these infections are unclear. During a South African cervical cancer screening trial, 5595 women 35-65 years of age were followed up for 36 months; 577 women were HIV positive at enrollment, HIV seroconversion occurred in 123 women, and 4895 women remained HIV negative throughout. Tests for high-risk HPV DNA and cytology were performed on cervical samples, and a colposcopy/biopsy was performed at each visit. The effects of early HIV infection on the risk of HPV infection and HPV-related disease were evaluated. Among seroconverters, HPV infection prevalence was 20.3% before seroconversion, 23.6% at seroconversion (P = .4), and 49.1% after seroconversion (P = .01). Seroconverters had significantly lower HPV infection prevalence than women with prevalent HIV infection before and at seroconversion (41.8% and 45.9%, respectively) but had similar HPV infection prevalence to women with prevalent HIV infection after seroconversion (49.4%). HIV seroconversion was associated with newly detected HPV infection (adjusted hazard ratio [AHR], 4.02; 95% confidence interval [CI], 2.26-7.13) and increased risk of low-grade cytological abnormalities (AHR, 2.53; 95% CI, 1.16-5.51) compared with HIV-negative women. Detection of HPV infection increases rapidly within the first years after HIV seroconversion, suggesting that mucosal immune dysfunction occurring at an early stage of HIV infection may influence HPV-related diseases.

E6 Oncoprotein Expression in Non-Small Cell Lung Cancer Patients

Background: Lung cancer is the leading cause of cancer deaths in the world. Human papillomavirus (HPV) infection and E6 oncoprotein expression are known risk factors for the development of non-small cell lung cancer (NSCLC). This study was performed to evaluate the prevalence of HPV 16/18 E6 oncoprotein expression in patients with NSCLC. Methods: Immunohistochemical stains of the HPV 16/18 E6 oncoprotein were performed in tumor tissues from 68 patients with NSCLC who underwent curative surgery from March 2006 to November 2008. Results: The E6 oncoprotein was expressed in 29.4% of patients with NSCLC and a statistical analysis revealed that E6 oncoprotein expression was significantly higher in females (p=0.028), never smokers (p=0.045), and patients with adenocarcinoma (p=0.022) than that in other patients. Conclusion: The E6 oncoprotein was expressed in 29.4% of patients with NSCLC. Further studies detecting HPV infection and E6 oncoprotein expression in never smoking patients with NSCLC are needed.

Development of Genital Warts after Incident Detection of Human Papillomavirus Infection in Young Men

Determining the rate at which men develop genital warts after infection with alpha genus human papillomavirus (HPV) types will provide important information for the design of prevention strategies. We conducted a cohort study of 18-21-year-old men who underwent triannual genital examinations. The 24-month cumulative genital wart incidence was 57.9% (95% confidence interval [CI], 38.1%-79.1%) among 46 men with incident detection of HPV-6 or HPV-11 infection, 2.0% (95% CI, 0.5%-7.9%) among 161 men with incident detection of infection with other HPV types, and 0.7% (95% CI, 0.2%-2.8%) among 331 men who tested negative for HPV. Our results suggest that genital warts are common after HPV-6 or HPV-11 infection in young men.

Epidemiological Study of Anti-HPV16/18 Seropositivity and Subsequent Risk of HPV16 and -18 Infections

Infection with human papillomavirus (HPV) 16 or HPV18 elicits an antibody response, but whether the elicited antibodies protect women against subsequent infection by a homologous HPV type compared with seronegative women is unknown. Study participants were women aged 18-25 years at enrollment in the control group of the ongoing National Cancer Institute-sponsored, community-based, randomized HPV16/18 Costa Rica Vaccine Trial. At enrollment, 2813 participants were negative for cervical HPV16 DNA and 2950 for HPV18 DNA. Women were interviewed regarding sociodemographic data and medical and health history. Medical and pelvic examinations were conducted for all consenting sexually experienced women. Serum samples taken at enrollment were tested for total HPV16/18 antibodies with a polyclonal enzyme-linked immunosorbent assay, and cervical specimens were tested for type-specific HPV DNA over 4 years of follow-up. Using Poisson regression, we compared rate ratios of newly detected cervical HPV16 or HPV18 infection among homologous HPV-seropositive and HPV-seronegative women, adjusting for age, education, marital status, lifetime number of sexual partners, and smoking. There were 231 newly detected HPV16 infections during 5886 person-years among HPV16-seronegative women compared with 12 newly detected HPV16 infections during 581 person-years among HPV16-seropositive women with the highest HPV16 sero-levels. There were 136 newly detected HPV18 infections during 6352 person-years among HPV18-seronegative women compared with six new infections detected during 675 person-years among HPV18 seropositives with the highest sero-levels. After controlling for risk factors associated with newly detected HPV infection, having high HPV16 antibody titer at enrollment was associated with a reduced risk of subsequent HPV16 infection (women in the highest tertile of HPV16 antibody titers, adjusted rate ratio = 0.50, 95% confidence interval = 0.26 to 0.86 vs HPV16-seronegative women). Similarly, having high HPV18 antibody titer at enrollment was associated with a reduced risk of subsequent HPV18 infection (women in the highest tertile of HPV18 antibody titers, adjusted rate ratio = 0.36, 95% confidence interval = 0.14 to 0.76 vs HPV18-seronegative women). In this study population, having high antibody levels against HPV16 and HPV18 following natural infection was associated with reduced risk of subsequent HPV16 and HPV18 infections.

E‐cadherin expression in male urethral smears and correlation with PCR‐based detection of human papillomavirus infection

We performed cytological examination of urethral brushing to study aberrant E-Cadherin expression as a possible marker for papillomavirus in cytological samples. A total of 30 cytobrush male urethral smears were examined E-cadherin expression and human papillomavirus (hpv) was confirmed using PCR-DNA. The age range was 19-36 years (mean: 27 years), 17 (56.7%) cases corresponded to low-risk HPV and 13 (43.3%) cases were high-risk HPV. The mean age ranges were 25.77 +/- 5.90 years for high-risk HPV and 26.77 +/- 4.31 years for low-risk HPV. Pap smears showed dyskeratosis in 23 (76.7%) cases, koilocytes in 13 (43.3%) cases, infection or bacterial background in 14 (43.7%) cases, suggestive changes of Gardnerella infection in 7 (23.3%) cases, and Chlamydia in 3 (10%) cases. Immunohistochemistry was positive for membrane E-Cadherin; there was weak expression in 13 (43.3%) cases, moderate expression in 11 (36.7%) cases (P = 0.109) (Figs. 3a and b), and strong expression in 6 (20%) cases. There were a statistically significant correlations between E-Cadherin expression and koilocytes (P = 0.007), individual cell dyskeratosis (P = 0.041), and HPV risk (P = 0.000). We concluded that the loss of E-Cadherin membrane expression was greater in high-risk HPV cases and was associated with individual cell dyskeratosis features and koilocytes. There were statistically significant correlations between E-Cadherin expression and dyskeratosis (P = 0.043), koilocytes (P = 0.007), and type of HPV (P = 0.000). Using male urethral smears to test for the loss of E-Cadherin membrane expression is simple, rapid, specific and more sensitive than conventional morphologic observations. We concluded that E-Cadherin can be used to discriminate between high- and low-risk papillomavirus in urethral cytologic specimens.

Evaluation of Transported Dry and Wet Cervical Exfoliated Samples for Detection of Human Papillomavirus Infection

We determined the feasibility of human papillomavirus (HPV) detection in cervical exfoliated cells collected as dry swab samples. Both dry cervical swab and specimen transport medium (STM) cervical swab samples were collected from 135 patients attending either colposcopy or women's clinics in Guayaquil, Ecuador, who had a cytology diagnosis within 6 months. HPV was detected by dot blot hybridization and genotyped by the liquid bead microarray assay (LBMA). Overall, 23.1% of dry samples were positive for any high-risk HPV types, and 24.6% of STM samples were positive for any high-risk HPV types. Of 125 paired samples, the type-specific high-risk HPV proportion positive agreement was 60.7% (kappa, 0.69; 95% confidence interval [CI], 0.53 to 0.82). Of six women with cytological evidence of invasive cervical cancer, high-risk HPV DNA was detected in three of their STM samples and in five of their dry samples. Dry samples were more likely to be insufficient for HPV testing than STM samples. Consistent with this observation, the amount of genomic DNA quantitated with the beta-actin gene was almost 20 times lower in dry samples than in STM samples when detected by the real-time TaqMan assay; however, HPV DNA viral loads in dry samples were only 1.6 times lower than those in matched STM samples. We concluded that exfoliated cervical cells could be collected as dry swab samples for HPV detection.

594 A novel form of cellular senescence induced by hyper-activation of the PI3K/Akt pathway

Periocular sebaceous carcinoma is an aggressive neoplasm with significant morbidity and mortality. Its pathogenesis is poorly understood. It is only rarely associated with Muir-Torre syndrome. Previous studies from Asian countries, have suggested that human papillomavirus (HPV) infection plays a role in the pathogenesis and overexpression of p16INK4a, a surrogate marker of HPV infection, have also been reported. However, data from western countries seem contradictory. In order to clarify and explore the molecular and epigenetic basis of HPV, CDKN2A status and role of microsatellite instability in the development of periocular sebaceous carcinoma, 24 cases of periocular sebaceous carcinoma were analyzed for the expression of p16INK4a and mismatch repair proteins (MLH1, MSH2, MSH6 and PMS2) via immunohistochemistry. Nested polymerase chain reaction (PCR) and genechip HPV typing were used to detect HPV infection and decide its genotype when present. PCR amplification using a consensus primer pair was also performed to detect β-HPV. The methylation status of CDKN2A promoter region was studied by methylation-specific polymerase chain reaction. HPV-positivity was demonstrated in only one of our cases (HPV 16), while another case showed p16INK4a overexpression. All cases showed preserved expression of mismatch repair proteins. CDKN2A promoter hypermethylation was noted in nearly half of our cases (11/24) and was associated with younger patient age (P = .013). Our results showed that periocular sebaceous carcinoma is rarely associated with HPV and microsatellite instability. Higher frequency of CDKN2A promoter hypermethylation in younger patients implies a significant epigenetic role in tumor development in this age group.

593 Stressor effect of zoledronic acide in rabbit heart tissue

Periocular sebaceous carcinoma is an aggressive neoplasm with significant morbidity and mortality. Its pathogenesis is poorly understood. It is only rarely associated with Muir-Torre syndrome. Previous studies from Asian countries, have suggested that human papillomavirus (HPV) infection plays a role in the pathogenesis and overexpression of p16INK4a, a surrogate marker of HPV infection, have also been reported. However, data from western countries seem contradictory. In order to clarify and explore the molecular and epigenetic basis of HPV, CDKN2A status and role of microsatellite instability in the development of periocular sebaceous carcinoma, 24 cases of periocular sebaceous carcinoma were analyzed for the expression of p16INK4a and mismatch repair proteins (MLH1, MSH2, MSH6 and PMS2) via immunohistochemistry. Nested polymerase chain reaction (PCR) and genechip HPV typing were used to detect HPV infection and decide its genotype when present. PCR amplification using a consensus primer pair was also performed to detect β-HPV. The methylation status of CDKN2A promoter region was studied by methylation-specific polymerase chain reaction. HPV-positivity was demonstrated in only one of our cases (HPV 16), while another case showed p16INK4a overexpression. All cases showed preserved expression of mismatch repair proteins. CDKN2A promoter hypermethylation was noted in nearly half of our cases (11/24) and was associated with younger patient age (P = .013). Our results showed that periocular sebaceous carcinoma is rarely associated with HPV and microsatellite instability. Higher frequency of CDKN2A promoter hypermethylation in younger patients implies a significant epigenetic role in tumor development in this age group.

Abstract 824: Comparison of the high risk HPV detection methods (HC II, DNA Chip, and luminex-based assay) in cervical lesion of Korean women

Abstract The detection of human papillomavirus (HPV) of female genital tract is very important, several HPV DNA detection methods have been developed during the last decade. In previous report, we introduced luminex-based HPV genotyping assay that is combined PCR amplification. In this study, we compared performances to detect high risk HPV types in hybrid capture 2 (HC II), DNA Chip, and luminex-based assay. A total of 330 cervical swabs from Cervical Cancer Early Diagnostic Clinic, Seoul St. Mary's Hospital were investigated. DNA was extracted from a single sample and HPV DNA detection assays were performed on the same specimen with 3 strategies and confirmed by DNA sequencing. Among 330 cervical swabs, 230 were HPV positive, 100 were negative. HPV detection rates of Luminex, HC II and DNA Chip in 330 specimens were 65.2%, 61.2% and 68.8%, respectively. The results of DNA sequence analysis, accuracy of Luminex, HC II and DNA Chip was 91.2%, 82.7% and 80.9%, respectively. HPV DNA infection slightly increase with severity of disease in cytologic and histologic diagnosis, there is no correlation between HPV, because HPV DNAs were detected in many samples with normal in this study. Conclusively in HPV detection comparison, DNA Chip had relatively high detection rate than Luminex and HC II, but Luminex had the highest accuracy for HPV DNA detection. These results indicate that the Luminex-based assay has more accurate performance than DNA Chip and HC II assay in the detection of HPV infections. We suggest that Luminex-based assay may be useful method for detecting of HPV infection clinically. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 824.

Detection of human papillomavirus infection in women attending a colposcopy clinic

Background Infection by human papillomavirus (HPV) is the main cause of and a necessary factor for cervical cancer. There are more than 100 known HPV genotypes, although HPV genotypes do not all have the same risk of inducing cervical cancer. The main aim of this study is to know the distribution of different types of HPV in women attending a colposcopy clinic for cervical dysplasia. Methods We prospectively identified and enrolled a cohort of women followed for cervical dysplasia who were referred to the colposcopy clinic of University Hospital Sant Joan de Déu in Barcelona, Spain, from April 2003 to April 2007. Two cervical scrape samples from each patient were collected for routine cytology and for identification of HPV DNA. During the study period, 2 techniques (Line Probe assay and microarray assay) were used consecutively. Findings HPV DNA was detected in 68% of patients (338 of 496 women) with statistically significant differences in positive results according to the cytologic category. Overall, the type distribution showed a predominance of genotype HPV-16 (27% of the total patients) followed by HPV-53 (9.4%), HPV-51 (8%), and HPV-51 (8%). Multiple genotype detection was observed in 35.5% of the patients with HPV infection. HPV-16 was mainly associated with the probable high-risk genotypes: HPV-53 and HPV-66. Conclusion The higher prevalence of high-risk nonvaccine genotypes should be considered to increase vaccine efficiency.

High‐risk Human Papilloma Virus infection (HPV) among women attending Women's Hospital (HMC) in Qatar

Human papillomavirus (HPV) causes a variety of infections. Recent studies indicated that high‐risk types of HPV cause cervical neoplasia. This study aims to investigate the prevalence of high‐risk Human (HPV) genotype (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) infection and its characteristics in Qatar's female by using High Risk Screen Real‐TM SC" test. Ninety five cervical swabs from women attending the Gynae‐oncology clinic at HMC (August 2007‐ May 2008) were enrolled in this study. Cytology results indicated that 31.8% of women had normal smear and 64.28% of them were HPV DNA positive, Upon the whole study population with abnormal smear 46.6% of them had ASCUS {60.7% of them were HPV DNA positive}, 34.9% had LGSIL {85.9% of them were HPV DNA positive}, 13.5% had HGSIL {61.7% of them were HPV DNA positive}, the remaining 5% had squamous cell carcinoma {66.7% of them were HPV DNA positive}.Of the overall study population; 11 samples were found to be positive by Pap smear and RT‐ PCR and 33 samples were found to be negative in both tests. On the other hand, no samples have being positive by Pap smear and negative by RT‐PCR. However, 44 samples which have shown to be negative by Pap smear but they found to be positive with RT‐PCR. In conclusion, results of this study have proved that detection of HPV infection using molecular technique is more sensitive than the use of conventional methods. This project is supported by QU & UREP.

Anal human papillomavirus genotype diversity and co-infection in a community-based sample of homosexual men

Objectives: To determine the prevalence and risk factors for anal human papillomavirus (HPV) infection in community-based cohorts of homosexual men in Sydney, Australia. Methods: A cross-sectional study in consecutively presenting...

Molecular methods for the detection of human papillomavirus infection: new insights into their role in diagnostics and epidemiological surveillance

Human papillomaviruses (HPVs) comprise more than 180 genotypes. HPV infection is mainly diagnosed by molecular methods. The aim of our study was to review the main molecular methods used to diagnose HPV infection, underscoring their characteristics. Several methods have been developed for molecular diagnosis of Papilloma infection, such as those based on PCR technique. Another commercial non-PCR based diagnostic method is Hybrid Capture test; it is the only commercially available HPV DNA detection test approved by the FDA. Several Authors have suggested that viral load and E6/E7 transcripts could be used as surrogate markers of persistent HPV infection, being more specific predictors of progressive disease than the simple presence of HPV DNA. Validating clinical sensitivity and specificity of each technique and improving the interpretation of the results are essential; consequently, there is a clear need for well characterized international quality control panels to compare the various diagnostic methods. HPV DNA testing could be useful both as a primary screening test, alone or in combination with a Pap smear, for the early detection of cervical cancer precursors, and as triage test to select women with minor cytological abnormalities who will need further follow-up and to predict possible treatment failure in women with diagnosed high-grade intraepithelial lesions who have undergone excisional therapy. In the next future surveillance for HPV infections, based on these molecular methods, could represent an important step for the development of primary and secondary prophylactic interventions, such as new vaccines targeted to genotypes who might replace those previously prevalent.

Determinants of Newly Detected Human Papillomavirus Infection in HIV-Infected and HIV-Uninfected Injection Drug Using Women

We sought to identify factors associated with newly detected human papillomavirus (HPV) infection in a high-risk cohort of injection drug using women in Baltimore, MD. We studied 146 HIV-infected and 73 HIV-uninfected female participants in a 5-year prospective HIV natural history study. We examined the association of sexual and nonsexual risk factors and newly detected type-specific HPV infection as determined by consensus PCR between consecutive visits. Newly detected HPV was more common among HIV-infected versus HIV-uninfected women (30% and 6%, respectively; P <0.01). Among the entire cohort, recent crack use (OR, 1.7; 95% CI, 1.1-2.6) and HIV infection/CD4 cell count were independent predictors for new HPV detection (HIV-uninfected as reference, OR, 4.6; 95% CI, 2.3-8.9, OR, 5.4; 95% CI, 2.8-10.3, and OR, 10.9; 95% CI, 5.5-21.7 for HIV-infected CD4 >500, 200-500, and <200, respectively). Among HIV-uninfected women, recent marijuana use was an independent predictor of newly detected HPV infection (OR, 3.5; 95% CI, 1.3-9.5). Newly detected HPV clearly increased with greater immunosuppression in HIV-infected injection drug users. Larger studies of HIV-uninfected and infected high-risk individuals are needed to clarify the independent associations of crack and marijuana use with new (or reactivated) HPV infection.

Molecular diagnosis of human papillomavirus in the development of cervical cancer

Cervical cancer (CC) is a major public health problem in developing countries and its most significant etiological risk factor is infection by the human papillomavirus (HPV). The main approach to date for the prevention of CC has been through screening programs, using the cervical smear (PAP test) to detect precursory lesions. The sensitivity and specificity of the PAP smear depend on the skills of the observer to recognize and classify a variety of cellular abnormalities. The development of early diagnoses to detect HPV infection has been a problem as cytology and colposcopy identify the lesion at an advanced stage. Therefore, molecular approaches have become more successful for early CC diagnosis. These molecular techniques recognize HPV DNA sequences by DNA hybridization, PCR-RFLP, hybrid capture and reverse line blot systems. Unfortunately, these systems cannot determine whether the HPV infection is active, latent or persistent. Thus, immunological techniques such as Western blot and ELISA have been designed to follow the immune response against the virus, and they can also be used to identify the stage of the infection. Several companies have developed, manufactured and merchandised gene-based testing systems for the screening, monitoring and diagnosis of HPV. Our review and comments focus on the critical analysis of existing products and their use in clinical practice as well as on immunological systems used mainly in research, but that may be applied in large population screening programs.

Detection of human papillomavirus infection in penile samples through liquid-based cytology and polymerase chain reaction

The human papillomavirus (HPV) is strongly related to cervical cancer and its precursor lesions. However, unlike in the case of women, there are limited data regarding HPV infection in men. Analysis of male HPV infection is frequently hindered by the lack of consistency in collection methods, sample adequacy, and low sensitivity of cytologic analysis. The objective of the current study was to compare the results of liquid-based cytology and HPV DNA testing through polymerase chain reaction in 99 penile samples collected from men presenting with condyloma acuminate or male partners of HPV-infected women who had attended a public health service in the city of Belo Horizonte, Minas Gerais, Brazil. Classic and nonclassic cytomorphologic signs were adopted to evaluate the presence of HPV infections in penile smears. HPV DNA was detected in 93 (93.9%) of the 99 samples analyzed. Koilocytosis was detected in 1 smear and nonclassic signs were detected in 23 smears, 22 of which were found to be positive for HPV DNA. The cytopathologic detection of HPV infection in penile samples collected for liquid-based cytology is low, even when cytologic nonclassic signs are applied, and does not appear to improve the diagnosis of HPV infection in men.

Cervical Dysplasia and Associated Risk Factors in a Juvenile Detainee Population

Background: Canada has recently licensed a new human papilloma virus (HPV) vaccine for use in adolescent females, aiming to decrease the incidence of oncogenic serotypes of HPV and associated cervical cancer. There are many known risk factors for cervical cancer, including infection with certain strains of HPV, a history of sexually transmitted infections, early age at first intercourse, multiple partners, and low socioeconomic status. The current screening method using the Papanicolaou (Pap) test is limited in detecting HPV infection and cervical cancer, with an overall sensitivity of only 70% when used routinely.

The biomarkers of human papillomavirus infection in tonsillar squamous cell carcinoma—molecular basis and predicting favorable outcome

Presence of human papillomavirus (HPV) in variable proportions in tonsillar squamous cell carcinoma tissues has been demonstrated by several worldwide studies. Some reports emphasized the significance of HPV in predicting a better prognosis, as well as ethnic differences between Chinese and Caucasians. In order to understand the biological role of HPV and find out clinically accessible methods to determine its prognostic significance in primary tonsillar squamous cell carcinoma, we collected 92 patients with primary tonsillar squamous cell carcinoma diagnosed or treated in National Taiwan University Hospital, for whom archival tumor tissue were available. Immunohistochemical stains of p16INK4A, high-risk HPV in situ hybridization, and nested polymerase chain reaction (PCR)-based genechips were performed to detect HPV infection and determine its genotype. Clinical data were compared with HPV infection detected by the different methods mentioned above. Real-time PCR was also performed on the HPV16-positive [HPV16(+)] lesions to understand viral integration status. The positive rates of nested PCR-based genechips, overexpression of p16INK4A, and high-risk HPV in situ hybridization were 75% (6 9/92), 53% (4 9/92), and 44% (4 0/92), respectively. Both overexpression of P16INK4A and high-risk HPV in situ hybridization positivity were associated with favorable prognoses (P=0.004 and 0.001, respectively) and also independent prognostic factors in multivariate analyses (P=0.01 and 0.01, respectively). The positivity of nested PCR-based genechips was not statistically significant. From our data, primary tonsillar squamous cell carcinoma with positive immunohistochemical stains of p16INK4A and/or high-risk HPV in situ hybridization is associated with a better outcome, and both methods may serve as clinically accessible markers.

Comparability of Self-Collected Vaginal Swabs and Physician-Collected Cervical Swabs for Detection of Human Papillomavirus Infections in Rakai, Uganda

The objective of this study was to compare human papillomavirus (HPV) DNA testing between self-administered vaginal swabs and physician-administered cervical swabs in women from rural Rakai District, Uganda. Between 2002 and 2003, women from a population-based cohort participated in an HPV study. Women collected self-administered vaginal swabs and were also offered a pelvic examination, which included physician-collected cervical samples. Hybrid-capture 2 was used to determine carcinogenic HPV status. Polymerase chain reaction was used to determine HPV genotypes. Unweighted kappa statistics were used to determine agreement. Compliance with self-collected swabs was > or =86%; however, only 51% accepted a pelvic examination. Carcinogenic HPV prevalence was 19% in self-collected and 19% in physician-collected samples. Agreement among paired observations was 92% with a kappa of 0.75. Kappa between self- and physician-collected samples was similar in HIV strata (k = 0.71 and 0.75 for HIV-positive and HIV-negative, respectively). In this community-based setting, detection of carcinogenic HPV was comparable among self- and physician-administered samples. Self-collection is a feasible and accurate means of obtaining HPV samples from women in resource-poor settings or persons reluctant to undergo a pelvic examination.