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

J Clin Microbiol. 2007 Jun;45(6):1679-83. doi: 10.1128/JCM.02369-06. Epub 2007 Apr 4.

Abstract

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 [kappa] of 0.71; for tampons, 89% concordance, with kappa of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with kappa higher for swabs than for tampons (for swabs, 81% concordance, with kappa of 0.61; for tampons, 82% concordance, with kappa 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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • DNA, Viral / analysis
  • Female
  • Humans
  • Menstrual Hygiene Products
  • Middle Aged
  • 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*
  • Uterine Cervical Dysplasia* / diagnosis
  • Uterine Cervical Dysplasia* / epidemiology
  • Uterine Cervical Dysplasia* / pathology
  • Uterine Cervical Dysplasia* / virology
  • Vaginal Smears

Substances

  • DNA, Viral