Clinical performance of RNA and DNA based HPV testing in a colposcopy setting: Influence of assay target, cut off and age

Kate Cuschieri, Heather Cubie, Catriona Graham, Jennifer Rowan, Alison Hardie, Andrew Horne, Camille Busby Earle, Andrew Bailey, Emma J Crosbie, Henry Kitchener

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: As HPV testing is used increasingly for cervical disease management, there is a demand to optimise the performance of HPV tests, particularly with respect to specificity.

OBJECTIVES: To compare the clinical performance of an HPV DNA and a RNA based test in women with cytological abnormalities. The influence of age and assay cut off on test performance was also assessed.

STUDY DESIGN: A prospective comparison of the Hybrid Capture 2 test (HC2) and the Aptima HPV assay (AHPV) was performed within a colposcopy setting. Clinical sensitivity and specificity were determined for the detection of cervical intraepithelial neoplasia (CIN) grade 2 or worse.

RESULTS: Both assays were >90% sensitive for the detection of CIN2+. AHPV was slightly more specific than HC2 [49.9% (46.8-53.1) vs 45.9% (42.8, 49.1), p<0.0001]. Raising HC2 cut off to 2 RLU did not improve specificity. A cut-off of 10 RLU increased specificity by approximately 10% - although this led to a reduction in sensitivity of 6.3% which equated to 24 missed cases of CIN2+. Both assays were more specific in women over 30 years of age, compared to women under 30 (p<0.001).

CONCLUSION: Although AHPV was more specific than HC2 in the total cohort (p<0.001), we found this difference to be smaller than other studies. This could be attributed to different indications for colposcopic referral across different settings. This study also confirms the relatively poor specificity of commercial HPV assays in women under 30.

Original languageEnglish
Pages (from-to)104-108
Number of pages5
JournalJournal of Clinical Virology
Issue number2
Early online date12 Dec 2013
Publication statusPublished - Feb 2014

Keywords / Materials (for Non-textual outputs)

  • Adult
  • Colposcopy
  • DNA, Viral
  • Early Detection of Cancer
  • Female
  • Humans
  • Middle Aged
  • Molecular Diagnostic Techniques
  • Papillomaviridae
  • Papillomavirus Infections
  • RNA, Viral
  • Sensitivity and Specificity
  • Young Adult


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