A direct comparison of four high-risk human papillomavirus tests versus the cobas test: Detecting CIN2+ in low-resource settings

J Med Virol. 2019 Jul;91(7):1342-1350. doi: 10.1002/jmv.25451. Epub 2019 Mar 21.

Abstract

Low-cost, accurate high-risk human papillomavirus (HR-HPV) tests are needed for cervical cancer screening in limited-resource settings. More than 200 cervical cytological specimens from hospital patients were collected and analyzed for a real-world study. We evaluated the analytical and clinical performance of four widely used HR-HPV test (Tellgen, Hybribio, Liferiver, and Sansure) based on real-time polymerase chain reaction technology platforms, compared with the cobas test. Cervical intraepithelial neoplasia grade 2 or worse lesions (CIN2+) were set as the disease endpoint, and all the five HPV tests were performed with equal sensitivity (McNemar's test; P = 0.971) and specificity (McNemar's test; P = 0.953). All genotyping using the INNO-LiPA HPV test showed that HPV-16, -52, and -54 were the most common types among CIN2+ cases. Overall, the four HR-HPV tests analyzed appear to be as effective as the cobas HPV test in both agreement and clinical performance. Therefore, each of these low-cost HPV test kits could be implemented in limited-resource settings to accelerate the control of cervical cancer. However, we suggest that there is a need to further standardize and optimize testing around clinical sensitivity and specificity.

Keywords: INNO-LiPA; cervical screening; cobas HPV test (cobas); human papillomavirus (HPV); real-time polymerase chain reaction (PCR).

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Cervix Uteri / pathology
  • Cervix Uteri / virology
  • Clinical Laboratory Techniques / economics
  • Clinical Laboratory Techniques / methods
  • Clinical Laboratory Techniques / standards*
  • Early Detection of Cancer / instrumentation
  • Early Detection of Cancer / methods*
  • Female
  • Health Resources*
  • Humans
  • Middle Aged
  • Papillomaviridae / genetics
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / virology
  • Reagent Kits, Diagnostic / economics
  • Reagent Kits, Diagnostic / standards
  • Sensitivity and Specificity
  • Uterine Cervical Dysplasia / diagnosis*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / virology
  • Young Adult

Substances

  • Reagent Kits, Diagnostic