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

• Published in: Journal of Clinical Microbiology 2007-06, Vol.45 (6), p.1679-1683
• Main Authors: Jones, Heidi E, Allan, Bruce R, van de Wijgert, Janneke H.H.M, Altini, Lydia, Taylor, Sylvia M, de Kock, Alana, Coetzee, Nicol, Williamson, Anna-Lise
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; DNA, Viral - analysis; Female; Fundamental and applied biological sciences. Psychology; Human papillomavirus; Humans; Infectious diseases; Medical sciences; Menstrual Hygiene Products; Microbiology; Middle Aged; Miscellaneous; Nucleic Acid Amplification Techniques - methods; Papillomaviridae - classification; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnosis; Papillomavirus Infections - epidemiology; Papillomavirus Infections - pathology; Papillomavirus Infections - virology; Reproducibility of Results; Risk Factors; Self Care; Sensitivity and Specificity; South Africa - epidemiology; Specimen Handling - methods; Vaginal Smears; Virology
• ISSN: 0095-1137; 1098-660X; 1098-5530
• DOI: 10.1128/JCM.02369-06

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.