Follow-up Studies of Patients with High Risk Human Papillomavirus (HPV)-Positive, Cytology-Negative Cervical Screening Co-testing Results

2016 ◽  
Vol 5 (5) ◽  
pp. S41
Author(s):  
Yingchun Wang ◽  
Tomi Kuntzman ◽  
Christopher Dalton ◽  
Osama Alassi
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Cervical Screening ◽  
Positive Cytology ◽  
Follow Up Studies

scholarly journals A Study of Genotyping for Management of Human Papillomavirus-Positive, Cytology-Negative Cervical Screening Results

2014 ◽  
Vol 53 (1) ◽  
pp. 52-59 ◽  
Author(s):  
M. Schiffman ◽  
R. D. Burk ◽  
S. Boyle ◽  
T. Raine-Bennett ◽  
H. A. Katki ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Risk Stratification ◽  
Cervical Screening ◽  
Clinical Value ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Positive Cytology ◽  
Negative Results ◽  
Hpv Types ◽  
High Risk Hpv

The effective management of women with human papillomavirus (HPV)-positive, cytology-negative results is critical to the introduction of HPV testing into cervical screening. HPV typing has been recommended for colposcopy triage, but it is not clear which combinations of high-risk HPV types provide clinically useful information. This study included 18,810 women with Hybrid Capture 2 (HC2)-positive, cytology-negative results and who were age ≥30 years from Kaiser Permanente Northern California. The median follow-up was 475 days (interquartile range [IQR], 0 to 1,077 days; maximum, 2,217 days). The baseline specimens from 482 cases of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) and 3,517 random HC2-positive noncases were genotyped using 2 PCR-based methods. Using the case-control sampling fractions, the 3-year cumulative risks of CIN3+ were calculated for each individual high-risk HPV type. The 3-year cumulative risk of CIN3+ among all women with HC2-positive, cytology-negative results was 4.6%. HPV16 status conferred the greatest type-specific risk stratification; women with HC2-positive/HPV16-positive results had a 10.6% risk of CIN3+, while women with HC-2 positive/HPV16-negative results had a much lower risk of 2.4%. The next most informative HPV types and their risks in HPV-positive women were HPV33 (5.9%) and HPV18 (5.9%). With regard to the etiologic fraction, 20 of 71 cases of cervical adenocarcinomain situ(AIS) and adenocarcinoma in the cohort were positive for HPV18. HPV16 genotyping provides risk stratification useful for guiding clinical management; the risk among HPV16-positive women clearly exceeds the U.S. consensus risk threshold for immediate colposcopy referral. HPV18 is of particular interest because of its association with difficult-to-detect glandular lesions. There is a less clear clinical value of distinguishing the other high-risk HPV types.

scholarly journals Human Papillomavirus (HPV) 16 and 18/45 Genotyping-Directed Follow-up of Women With Messenger RNA HPV-Positive, Cytology-Negative Cervical Screening Test Results

2019 ◽  
Vol 153 (2) ◽  
pp. 243-250 ◽  
Author(s):  
Min Han ◽  
Juan Li ◽  
Marshall Austin ◽  
Kavita R Varma ◽  
Huina Zhang ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Screening Test ◽  
Messenger Rna ◽  
Cervical Screening ◽  
Test Results ◽  
Positive Cytology ◽  
Hpv 16 ◽  
Cervical Adenocarcinomas ◽  
High Risk Hpv

Abstract Objectives In this study, we sought to correlate genotype test results for human papillomavirus (HPV) types 16, 18, and 45 with histopathologic follow-up diagnoses in patients with messenger RNA (mRNA) high-risk HPV-positive, cytology-negative results. Methods We identified 1,157 patients with mRNA HPV-positive, cytology-negative cervical screening test results between June 2015 and June 2018. Reflex HPV 16/18/45 genotype results were documented in 1,018 women aged 30 years or older, 318 of whom had follow-up within 18 months. Results Histopathologic findings of cervical intraepithelial neoplasia 2 or worse (CIN2+) were diagnosed in 14 of 122 (11.5%) patients positive for HPV 16/18/45 vs in seven of 196 (3.6%) HPV 16/18/45–negative patients. Three patients with high-risk HPV–positive, cytology-negative cervical screening test results were diagnosed with stage I cervical adenocarcinomas following early colposcopic referral and biopsy after HPV 16/18/45–positive genotype results. Conclusions Immediate reflex HPV 16/18/45 genotyping of mRNA HPV-positive, cytology-negative patients led to early colposcopic referral and histopathologic diagnoses of three difficult-to-detect, low-stage, cervical adenocarcinomas and significantly increased overall early detection of CIN2+ lesions.

scholarly journals Long-term protective effect of high-risk human papillomavirus testing in population-based cervical screening

2005 ◽  
Vol 92 (9) ◽  
pp. 1800-1802 ◽  
Author(s):  
N W J Bulkmans ◽  
L Rozendaal ◽  
F J Voorhorst ◽  
P J F Snijders ◽  
C J L M Meijer
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Protective Effect ◽  
Cervical Screening ◽  
Population Based ◽  
Human Papillomavirus Testing

scholarly journals Genome-Wide Association Study of Prevalent and Persistent Cervical High-Risk Human Papillomavirus(HPV) Infection

2019 ◽  
Author(s):  
Sally N. Adebamowo ◽  
Adebowale A Adeyemo ◽  
Charles N Rotimi ◽  
Olayinka Olaniyan ◽  
Richard B. Offiong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Association Study ◽  
Genome Wide Association Study ◽  
Principal Component ◽  
Hpv Infection ◽  
Genome Wide Association ◽  
Replication Studies ◽  
Genome Wide

Abstract Background: Genetic factors may influence the susceptibility to high-risk human papillomavirus (hrHPV) infection and persistence. We conducted the first genome-wide association study (GWAS) to identify variants associated with cervical hrHPV infection and persistence. Methods: Participants were 517 Nigerian women evaluated at baseline and 6 months follow-up visits for HPV. HPV was characterized using SPF10/LiPA25. hrHPV infection was positive if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was done using the Illumina Multi-Ethnic Genotyping Array (MEGA) and imputation was done using the African Genome Resources Haplotype Reference Panel. Association analysis was done under additive genetic models adjusted for age, HIV status and the first principal component (PC) of the genotypes. Results: The mean (±SD) age of the study participants was 38 (±8) years, 48% were HIV negative, 24% were hrHPV positive and 10% had persistent hrHPV infections. The top three variants associated with hrHPV infections were intronic variants clustered in KLF12 (all OR: 7.06, p=1.43 x 10-6). The top variants associated with cervical hrHPV persistence were in DAP(OR: 6.86, p=7.15 x 10-8), NR5A2(OR: 3.65, p=2.03 x 10-7) and MIR365-2(OR: 7.71, p=2.63 x 10-7) gene regions. Conclusions: This exploratory GWAS yielded novel candidate risk loci for cervical hrHPV infection and persistence. The identified loci have biological annotation and functional data supporting their role in hrHPV infection and persistence. Given our limited sample size, larger discovery and replication studies are warranted to further characterize the reported associations.

scholarly journals Prevalence, incidence, and distribution of human papillomavirus types in female sex workers in Kenya

2020 ◽  
Vol 31 (2) ◽  
pp. 109-118
Author(s):  
Kristen Sweet ◽  
Claire Bosire ◽  
Busola Sanusi ◽  
Carly J Sherrod ◽  
Jessie Kwatampora ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Female Sex ◽  
Hpv Prevalence ◽  
Hiv Negative

Female sex workers (FSWs) have a notably high risk of acquiring human papillomavirus (HPV) infections. Relatively few studies address the type-specific prevalence and incidence of HPV among FSWs in sub-Saharan Africa. FSWs (n = 348) attending the Korogocho clinic in Nairobi, Kenya participated from August 2009 to March 2011. HPV DNA was detected using the SPF10-LiPA25 PCR assay. Baseline prevalence of HPV infection and cervical dysplasia were calculated, stratified by HIV-serostatus. Incidence rate (IR) of infection was calculated as number of new infections from baseline over person-months among 160 HPV-negative participants with complete 12-month follow-up. Baseline HPV prevalence was 23.6% for any HPV and 20.4% for high-risk HPV (hrHPV) types. Most prevalent types were HPV52 (10.1%), HPV35 (2.3%), and HPV51 (2.3%). A quarter (24%) of participants were HIV-positive. HPV prevalence was higher in HIV-positive (32.1%) than HIV-negative (20.8%) participants. hrHPV prevalence was higher in HIV-positive (27.4%) than HIV-negative (18.2%) women. During follow-up, HPV IR was 31.4 (95% CI: 23.8–41.5) for any HPV and 24.2 (95% CI: 17.9–32.8) for hrHPV types. HPV52 had the highest IR (6.0; 95% CI: 6.5–10.3). Overall HPV and hrHPV prevalence were lower than expected, but both prevalence and incidence were higher in HIV-positive than in HIV-negative women.

scholarly journals Clinical and Analytical Performance of the Onclarity HPV Assay Using the VALGENT Framework

2015 ◽  
Vol 53 (10) ◽  
pp. 3272-3279 ◽  
Author(s):  
K. Cuschieri ◽  
D. T. Geraets ◽  
C. Moore ◽  
W. Quint ◽  
E. Duvall ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Confidence Interval ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Relative Sensitivity ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Screening Population ◽  
Relative Specificity ◽  
Hpv Types

As the demand for human papillomavirus (HPV)-related cervical screening increases, emerging HPV tests must be evaluated robustly using well-annotated samples, such as those generated in the Validation of HPV Genotyping Tests (VALGENT) framework. Through VALGENT, we assessed the performance of the BD Onclarity HPV assay, which detects 14 high-risk (HR) types and resolves six individual types and three groups of types. Consecutive samples from a screening population (n= 1,000), enriched with cytologically abnormal samples (n= 300), that had been tested previously with the GP5+/6+ PCR enzyme immunoassay (EIA) and the GP5+/6+ PCR LMNX assay (Diassay) were tested with the Onclarity assay. Type-specific HPV prevalences were analyzed according to age and cytological result. The accuracy of the Onclarity assay for the detection of cervical intraepithelial neoplasia grade 2+ (CIN2+) and CIN3+ was assessed relative to the GP5+/6+ EIA results by using noninferiority criteria. Overall agreement and type-specific agreement between the Onclarity assay and the GP5+/6+ LMNX assay were assessed. The prevalence of HPV types 16, 18, 31, and 45 increased with the severity of cytological results (Pfor trend, <0.05). For the detection of CIN2+, the Onclarity assay had a relative sensitivity of 1.02 (95% confidence interval [CI], 0.99 to 1.05;P< 0.001 for noninferiority) and a relative specificity of 0.99 (95% CI, 0.97 to 1.00;P= 0.186 for noninferiority). The kappa for agreement between the Onclarity assay and the GP5+/6+ LMNX assay for HR-HPV was 0.92 (95% CI, 0.89 to 0.94), and values for the six individual types ranged from 0.78 (95% CI, 0.68 to 0.87) for HPV-52 to 0.96 (95% CI, 0.93 to 0.99) for HPV-16. These data suggest that the Onclarity assay offers applications for clinical workstreams while providing genotyping information that may be useful for risk stratification beyond types 16 and 18.

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