Rakiya Saidu, Louise Kuhn, Ana Tergas, Rosalind Boa1, Jennifer Moodley, Cecilia Svanholm-Barrie2, David Persing3, Scott Campbell3, Wei-Yann Tsai4, Thomas C Wright5, Lynette Denny. 1. Department of Obstetrics and Gynaecology, Old Main Building, Groote Schuur Hospital, Observatory, University of Cape Town, Cape Town, South Africa. 2. Cepheid, Inc, Solna, Sweden. 3. Cepheid, Inc, Sunnyvale, CA. 4. Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Centre, New York, NY. 5. Department of Pathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Centre, New York, NY.
Abstract
OBJECTIVES: Self-sampling may increase access to cervical cancer screening in low-resource settings. Using Xpert HPV, we compared test performance of self- and clinician-collected samples in HIV-positive and HIV-negative women in South Africa. MATERIALS AND METHODS: Three hundred thirty HIV-positive and 375 HIV-negative women in the screening group and 202 HIV-negative and 200 HIV-positive women in the referral group, aged 30-65 years, participated in the study. All women self-collected a vaginal sample, and then, a cervical sample was collected by a clinician (both tested using Xpert HPV), followed by colposcopic examination and collection of histologic specimens. RESULTS: There was good agreement between self- and clinician-collected samples for detection of any high-risk human papillomavirus (HPV, κ = 0.72 [95% CI = 0.669-0.771]). Prevalence of HPV and sensitivity of the test to detect cervical intraepithelial neoplasia 2+ was similar in self- and clinician-collected samples. Specificity was lower in self-collected than in clinician-collected samples in both HIV-negative (self: 77.5% [95% CI = 72.8-81.8] vs clinician: 86.9% [95% CI = 82.9-90.2]) and HIV-positive (self: 44.0% [95% CI = 38.0-50.1] vs clinician: 59.7% [95% CI = 53.6-65.6]) women. Restricting the definition of screen-positive to 3 of 5 channels on HPV Xpert improved specificity in both HIV-negative (self: 83.2% [95% CI = 78.8-87.0] vs clinician: 89.7% [95% CI = 86.1-92.7]) and HIV-positive (self: 54.2% [95% CI = 48.1-60.2] vs clinician: 67.4% [95% CI = 61.5-72.9]) women. CONCLUSIONS: The self-collected sample had good agreement with the clinician-collected sample for the detection of HPV, and restricting the HPV types may improve the specificity in HIV-positive women.
OBJECTIVES: Self-sampling may increase access to cervical cancer screening in low-resource settings. Using Xpert HPV, we compared test performance of self- and clinician-collected samples in HIV-positive and HIV-negative women in South Africa. MATERIALS AND METHODS: Three hundred thirty HIV-positive and 375 HIV-negative women in the screening group and 202 HIV-negative and 200 HIV-positive women in the referral group, aged 30-65 years, participated in the study. All women self-collected a vaginal sample, and then, a cervical sample was collected by a clinician (both tested using Xpert HPV), followed by colposcopic examination and collection of histologic specimens. RESULTS: There was good agreement between self- and clinician-collected samples for detection of any high-risk human papillomavirus (HPV, κ = 0.72 [95% CI = 0.669-0.771]). Prevalence of HPV and sensitivity of the test to detect cervical intraepithelial neoplasia 2+ was similar in self- and clinician-collected samples. Specificity was lower in self-collected than in clinician-collected samples in both HIV-negative (self: 77.5% [95% CI = 72.8-81.8] vs clinician: 86.9% [95% CI = 82.9-90.2]) and HIV-positive (self: 44.0% [95% CI = 38.0-50.1] vs clinician: 59.7% [95% CI = 53.6-65.6]) women. Restricting the definition of screen-positive to 3 of 5 channels on HPV Xpert improved specificity in both HIV-negative (self: 83.2% [95% CI = 78.8-87.0] vs clinician: 89.7% [95% CI = 86.1-92.7]) and HIV-positive (self: 54.2% [95% CI = 48.1-60.2] vs clinician: 67.4% [95% CI = 61.5-72.9]) women. CONCLUSIONS: The self-collected sample had good agreement with the clinician-collected sample for the detection of HPV, and restricting the HPV types may improve the specificity in HIV-positive women.
Authors: Patrick Petignat; Daniel L Faltin; Ilan Bruchim; Martin R Tramèr; Eduardo L Franco; François Coutlée Journal: Gynecol Oncol Date: 2007-02-28 Impact factor: 5.482
Authors: P J W Ketelaars; R P Bosgraaf; A G Siebers; L F A G Massuger; J C van der Linden; C A P Wauters; J C Rahamat-Langendoen; A J C van den Brule; J IntHout; W J G Melchers; R L M Bekkers Journal: Prev Med Date: 2017-06-01 Impact factor: 4.018
Authors: Louise Kuhn; Rakiya Saidu; Rosalind Boa; Ana Tergas; Jennifer Moodley; David Persing; Scott Campbell; Wei-Yann Tsai; Thomas C Wright; Lynette Denny Journal: Lancet Glob Health Date: 2020-02 Impact factor: 26.763
Authors: S Joshi; J M Babu; D Jayalakshmi; V Kulkarni; U Divate; R Muwonge; T Gheit; M Tommasino; R Sankaranarayanan; M R Pillai Journal: Vaccine Date: 2014-01-04 Impact factor: 3.641
Authors: Pooja Bansil; Scott Wittet; Jeanette L Lim; Jennifer L Winkler; Proma Paul; Jose Jeronimo Journal: BMC Public Health Date: 2014-06-12 Impact factor: 3.295
Authors: James M Kangethe; Aliza Monroe-Wise; Peter N Muiruri; James G Komu; Kenneth K Mutai; Mirriam M Nzivo; Jillian Pintye Journal: South Afr J HIV Med Date: 2022-04-25 Impact factor: 1.835
Authors: Rixongile R Rikhotso; Emma M Mitchell; Daniel T Wilson; Aubrey Doede; Nontokozo D Matume; Pascal O Bessong Journal: S Afr J Infect Dis Date: 2022-06-08