Assessment of a new low-cost, PCR-based strategy for high-risk human papillomavirus DNA detection for cervical cancer prevention

• Published in: BMC infectious diseases 2019-10, Vol.19 (1), p.842-842, Article 842
• Main Authors: Surriabre, Pedro, Torrico, Andrea, Vargas, Tania, Ugarte, Fuantina, Rodriguez, Patricia, Fontaine, Véronique
• Format: Article
• Language: English
• Subjects: Administrative support; Cancer; Cancer screening; Cervical cancer; Cervix; Cervix Uteri - pathology; Collection devices; Deoxyribonucleic acid; Diagnosis; DNA; DNA, Viral - analysis; DNA, Viral - metabolism; Early Detection of Cancer; EIA; Female; Genomes; Genotype; HPV screening; Human papillomavirus; Humans; Hybrid systems; Infections; Infectious diseases; Low cost; Medical screening; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus infections; Papillomavirus Infections - diagnosis; Papillomavirus Infections - virology; PCR BSGP; Polymerase chain reaction; Polymerase Chain Reaction - economics; Polymerase Chain Reaction - methods; Prevention; Reagent Kits, Diagnostic; Risk; Risk factors; Sampling methods; Sensitivity and Specificity; Sequence Analysis, DNA; Strategy; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - prevention & control; Uterine Cervical Neoplasms - virology
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4527-9

HPV test implementation as a primary screening tool has the potential to decrease cervical cancer incidence as shown by several studies around the world. However, in many low-resource settings, the HPV test introduction has been backed down mainly due to its price. In this study, we present a novel low-cost strategy involving simple devices and techniques for high-risk human papillomavirus (HR-HPV) detection. The analytical performance to detect HR-HPV infections of this novel strategy was assessed by comparing it with the Hybrid Capture 2 system (HC2), which is used as gold standard. Paired-cervical samples were collected from 541 women assisting to gynecological services in an outpatient clinic. One sample was transported in the Hybrid Capture Standard Transport Medium for HR-HPV detection by the HC2. The second sample was transported on glass slide for detection by PCR-based techniques (GP-EIA, BSGP-EIA and pU 1 M-L/2R). The level of agreement between the PCR-based techniques and HC2 system was determined with the Cohen's kappa value. The kappa values between HC2 and GP-EIA, BSGP-EIA and pU 1 M-L/2R were 0.71 (CI 95% 0.63-0.78), 0.78 (CI 95% 0.71-0.84) and 0.63 (CI 95% 0.55-0.72), respectively. However, when the results from both BSGP-EIA and pU 1 M-L/2R were combined, the level of agreement with HC2 was increased to 0.82 (CI 95% 0.76-0.88), reflecting a very good agreement between the two HR-HPV detection strategies. Furthermore, the sensitivity of both techniques combined was also increased compared to the BSGP-EIA (88.7% vs 77.4%) and the pU (88.7 vs 60.9%) without penalizing the specificity obtained with the BSGP-EIA (95.1% vs 96.9%) and the pU (95.1% vs 96.5%). This novel strategy, combining two PCR-based techniques for HR-HPV detection, could be useful for cervical cancer screening in self-collected samples in low-income countries.