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. 2014 May;60(1):44-9.
doi: 10.1016/j.jcv.2014.02.002. Epub 2014 Feb 14.

Individual detection of 14 high risk human papilloma virus genotypes by the PapType test for the prediction of high grade cervical lesions

Jack Cuzick  1 , Linda Ho  2 , George Terry  2 , Michelle Kleeman  2 , Michael Giddings  2 , Janet Austin  2 , Louise Cadman  2 , Lesley Ashdown-Barr  2 , Maria J Costa  2 , Anne Szarewski  2
Affiliations

Individual detection of 14 high risk human papilloma virus genotypes by the PapType test for the prediction of high grade cervical lesions

Jack Cuzick et al. J Clin Virol. 2014 May.

Abstract

Background: HR HPV genotypes when assayed collectively, achieve high sensitivity but low specificity for the prediction of CIN2+. Knowledge of the specific genotypes in an infection may facilitate the use of HR HPV detection in routine clinical practice.

Objectives: To compare the rate of HR HPV detection and the accuracy of CIN2+ prediction between PapType test (Genera Biosystems) and other commercially available HR HPV assays, and to examine the value of full HPV genotyping.

Study design: PreservCyt samples from 1099 women referred for abnormal cervical cytology were used. CIN2+ was chosen as the primary end-point but CIN3+ was also evaluated. A hierarchy of HR HPV genotypes was created using PPV and this was used to create 3 groups of genotypes with potentially different management.

Results: The PapType assay has a specificity of 22.4% and a sensitivity of 94.6% for CIN2+ prediction. Classification into Groups A (HPV33 and HPV16, very highly predictive), B (HPV31, 18, 52, 35, 58, 51 highly predictive) and C (HPV68, 45, 39, 66, 56, 59, intermediate predictive) could double the specificity (44.5%) but only slightly reduce the sensitivity for CIN2+ (91.5%) and CIN3+ (94.0%).

Conclusions: The PapType assay is a simple, reproducible and effective test for HR HPV detection and genotyping. HPV 33 was found to have a very high PPV and should therefore be managed as for HPV16.

Keywords: CIN; Cervix; Genotypes; High risk HPV; Positive predictive value.

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Figures

Fig. 1
Fig. 1
Detection of CIN2+ by different HR HPV assays. Sensitivity and specificity are indicated with 95%CIs. APTIMA (Hologic/Gen-Probe), BD Viper LT (Becton Dickinson), CINtecp16 (Roche mtm), Cobas (Roche), HC2 (Qiagen), PapType (Genera), PreTectHPV-Proofer (Norchip), RealTime (Abbott).
Fig. 2
Fig. 2
ROC curve of cumulative sensitivity and specificity for CIN2+ (•—•) or CIN3+ (ο - - ο) when genotypes are ordered according to positive predictive value in women not already deemed positive by prior genotypes.
Fig. 3
Fig. 3
Odds ratio for CIN2+ for multiple versus single type infection. For all individual genotypes except HPV16, the multiple infections considered are those which do not include HPV16. There were no CIN2+ lesions with single HPV59 infection.
See this image and copyright information in PMC

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