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Journal of Clinical Microbiology, June 2007, p. 1679-1683, Vol. 45, No. 6
0095-1137/07/$08.00+0     doi:10.1128/JCM.02369-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Agreement between Self- and Clinician-Collected Specimen Results for Detection and Typing of High-Risk Human Papillomavirus in Specimens from Women in Gugulethu, South Africa{triangledown}

Heidi E. Jones,1,2 Bruce R. Allan,3 Janneke H. H. M. van de Wijgert,1,4 Lydia Altini,5 Sylvia M. Taylor,1,2 Alana de Kock,5 Nicol Coetzee,5,6 and Anna-Lise Williamson3,7*

Population Council, One Dag Hammarskjold Plaza, New York, New York 10017,1 Columbia University Medical Center, 622 W. 168th St., PH16-80, New York, New York 10032,2 Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa,3 Academic Medical Center, Center for Poverty-Related Communicable Diseases, University of Amsterdam, Meibergdreef 9 T0-120, 1105 AZ Amsterdam, The Netherlands,4 Infectious Disease Epidemiology Unit, School of Public Health, and Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa,5 Shropshire and Staffordshire Health Protection Unit, Health Protection Agency, Mellor House, Corporation Street, Stafford, Staffordshire ST16 3SR, United Kingdom,6 and National Health Laboratory Service, Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa7

Received 22 November 2006/ Returned for modification 19 February 2007/ Accepted 24 March 2007

We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had high agreement with clinician-obtained brushes when the Roche Reverse Line Blot Assay (RLBA) was used (for swabs, 86% concordance, with a kappa statistic [{kappa}] of 0.71; for tampons, 89% concordance, with {kappa} of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with {kappa} higher for swabs than for tampons (for swabs, 81% concordance, with {kappa} of 0.61; for tampons, 82% concordance, with {kappa} of 0.55). Low-risk HPV types were nearly two times more common in self-collected specimens than in clinician-collected specimens tested by RLBA. All 15 women diagnosed with high-grade lesions by cytology tested positive for high-risk HPV with clinician-collected specimens tested by RLBA and HC2, while 11 out of 15 tested positive with self-collected specimens by HC2 and 5 out of 6 tested positive by RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.

* Corresponding author. Mailing address: Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa. Phone: 021 4066124. Fax: 021 4066681. E-mail: annalise{at}curie.uct.ac.za

{triangledown} Published ahead of print on 4 April 2007.

Journal of Clinical Microbiology, June 2007, p. 1679-1683, Vol. 45, No. 6
0095-1137/07/$08.00+0     doi:10.1128/JCM.02369-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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