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J. Clin. Microbiol. doi:10.1128/JCM.02369-06
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Agreement between self- and clinician-collected specimens for diagnosis of high-risk human papillomavirus and typing in women in Gugulethu, South Africa

Population Council/One Dag Hammarskjold Plaza/New York, NY 10017 USA; Columbia University Medical Center/622 W. 168^th St. PH16-80/New York, NY 10032 USA; Institute of Infectious Disease and Molecular Medicine/Faculty of Health Sciences/University of Cape Town/Anzio Road, Observatory 7925/Cape Town, South Africa; Center for Poverty-related Communicable Diseases/University of Amsterdam Academic Medical Center/Pietersbergweg 9/1105 BM Amsterdam, the Netherlands; Infectious Disease Epidemiology Unit, School of Public Health, University of Cape Town, Cape Town, South Africa/Faculty of Health Sciences/University of Cape Town/Anzio Road, Observatory 7925/Cape Town, South Africa; Shropshire and Staffordshire Health Protection Unit/Health Protection Agency/Mellor House/Corporation Street/Stafford, Staffordshire ST16 3SR/United Kingdom

^* To whom correspondence should be addressed. Email: annalise{at}curie.uct.ac.za.

	Abstract

We assessed the agreement for detecting high-risk human papillomavirus (HPV) as well as specific HPV types between self- and clinician-obtained specimens in 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 using the Roche Reverse Line Blot Assay (RLBA) (swab: 86% concordance with kappa () = 0.71; tampon: 89% concordance with = 0 .75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2, with the kappa statistic higher for the swab than tampon (swab: 81% with = 0.61; tampon 82% concordance with =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 on cytology tested positive for high-risk HPV using clinician-collected specimens for RLBA and HC-2, while 11 out of 15 tested positive using self-collected specimens with HC-2, and 5 out of 6 tested positive using RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.

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