Details:

Alternative Title:
BMC Infect Dis
Personal Author:
Lin, Carol Y. ; Li, Ling
Lin, Carol Y. ; Li, Ling Less -
Description:
Background

HPV DNA diagnostic tests for epidemiology monitoring (research purpose) or cervical cancer screening (clinical purpose) have often been considered separately. Women with positive Linear Array (LA) polymerase chain reaction (PCR) research test results typically are neither informed nor referred for colposcopy. Recently, a sequential testing by using Hybrid Capture 2 (HC2) HPV clinical test as a triage before genotype by LA has been adopted for monitoring HPV infections. Also, HC2 has been reported as a more feasible screening approach for cervical cancer in low-resource countries. Thus, knowing the performance of testing strategies incorporating HPV clinical test (i.e., HC2-only or using HC2 as a triage before genotype by LA) compared with LA-only testing in measuring HPV prevalence will be informative for public health practice.

Method

We conducted a Monte Carlo simulation study. Data were generated using mathematical algorithms. We designated the reported HPV infection prevalence in the U.S. and Latin America as the “true” underlying type-specific HPV prevalence. Analytical sensitivity of HC2 for detecting 14 high-risk (oncogenic) types was considered to be less than LA. Estimated-to-true prevalence ratios and percentage reductions were calculated.

Results

When the “true” HPV prevalence was designated as the reported prevalence in the U.S., with LA genotyping sensitivity and specificity of (0.95, 0.95), estimated-to-true prevalence ratios of 14 high-risk types were 2.132, 1.056, 0.958 for LA-only, HC2-only, and sequential testing, respectively. Estimated-to-true prevalence ratios of two vaccine-associated high-risk types were 2.359 and 1.063 for LA-only and sequential testing, respectively. When designated type-specific prevalence of HPV16 and 18 were reduced by 50 %, using either LA-only or sequential testing, prevalence estimates were reduced by 18 %.

Conclusion

Estimated-to-true HPV infection prevalence ratios using LA-only testing strategy are generally higher than using HC2-only or using HC2 as a triage before genotype by LA. HPV clinical testing can be incorporated to monitor HPV prevalence or vaccine effectiveness. Caution is needed when comparing apparent prevalence from different testing strategies.


Subjects:
[+]
Algorithms Computer Simulation DNA, Viral Female Genotype Human Papillomavirus 16 Humans Molecular Diagnostic Techniques Papillomavirus Infections Polymerase Chain Reaction Prevalence Sensitivity And Specificity Uterine Cervical Neoplasms
Source:
BMC Infect Dis. 16.
Pubmed ID:
27821079
Pubmed Central ID:
PMC5100169
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:83fdeb09a00b4754a3d86d9d5bdd3c1be12ebff2d9efcf51dde6ab6e9f7ebabf
Download URL:
https://stacks.cdc.gov/view/cdc/43036/cdc_43036_DS1.pdf
File Type:

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