Loading...
Publication: Performance of Xpert HPV on self-collected vaginal samples for cervical cancer screening among women in South Africa
Saidu, R. Kuhn, L. Tergas, A. Boa, R. Moodley, J. Svanholm-Barrie, C. Persing, D. Campbell, S Tsai, W-Y Wright, T.C
Saidu, R.
Kuhn, L.
Tergas, A.
Boa, R.
Moodley, J.
Svanholm-Barrie, C.
Persing, D.
Campbell, S
Tsai, W-Y
Wright, T.C
Citations
Altmetric:
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.
Description
Date
2021-01-01
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer Health
Collections
Research Projects
Organizational Units
Journal Issue
Keywords
Self-collected vaginal samples,Cervical cancer screening,Women,South Africa
Citation
Saidu R, Kuhn L, Tergas A, Boa R, Moodley J, Svanholm-Barrie C, Persing D, Campbell S, Tsai WY, Wright TC, Denny L. Performance of Xpert HPV on Self-collected Vaginal Samples for Cervical Cancer Screening Among Women in South Africa. J Low Genit Tract Dis. 2021 Jan 1;25(1):15-21. doi: 10.1097/LGT.0000000000000575.