HPV Infection Identified In Self-Collected Vaginal Swabs

High risk, potentially cancer causing human papillomavirus infections (HPV) are common among women in the developing world, but self-sampling with vaginal swabs may provide materials that screen as accurately as the more labor-intensive approach using cervical samples obtained by clinicians.

Evaluating self-collected samples was a critical milestone as it would enable same-day screening and treatment. Same-day treatment is needed in high-burden; low-income countries such as Papua New Guinea because when patients leave the clinic, it often becomes impossible to find them again, should their results show that they need treatment.

Scientists at The Kirby Institute (Sydney, Australia) conducted the first evaluation of self-collected vaginal specimens compared with clinician-collected cervical specimens for the detection of high-risk human papillomavirus (hrHPV) infection. Women aged 30 to 54 years attending two well woman clinics in Papua New Guinea were invited to participate and provided self-collected vaginal and clinician-collected cervical cytobrush specimens.

Both specimens were tested at point-of-care using the Xpert HPV test (Cepheid, Sunnyvale, CA, USA). Women were given their cervical test result the same day. Those with a positive hrHPV test and a positive examination on visual inspection of the cervix with acetic acid were offered same-day cervical cryotherapy. A total of 1,005 women were enrolled with 124 (12.3%) positive for any hrHPV infection. There was 99.4% overall percentage agreement (OPA) between vaginal and cervical tests for HPV-16, 98.5% OPA for HPV-18/45; 94.4% OPA for other hrHPV infections, and 93.4% OPA for all hrHPV types.

The authors concluded that self-collected vaginal specimens had excellent agreement with clinician-collected cervical specimens for the detection of hrHPV infection using the Xpert HPV test. This approach provides for the first time an opportunity to incorporate point-of-care hrHPV testing into clinical cervical screening algorithms in high-burden, low-income settings.

Andrew Vallely, PhD, an Associate Professor and corresponding author of the study said, “This is the first time there's been a direct comparison between self-collected vaginal swabs and clinician-collected cervical specimens using a screening device that can provide same day results.” The study was published online on April 13, 2016, in the Journal of Clinical Microbiology.

Related Links:
The Kirby Institute
Cepheid