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High-Risk Human Papillomavirus Messenger RNA Testing in Wet- and Dry- Self-Collected Specimens for High-Grade Cervical Lesion Detection in Mombasa, Kenya

Citation

Islam, Jessica Yasmine; Mutua, Michael M.; Kabare, Emmanuel; Manguro, Griffins; Hudgens, Michael G.; Poole, Charles L.; Olshan, Andrew F.; Wheeler, Stephanie B.; McClelland, R. Scott; & Smith, Jennifer S. (2020). High-Risk Human Papillomavirus Messenger RNA Testing in Wet- and Dry- Self-Collected Specimens for High-Grade Cervical Lesion Detection in Mombasa, Kenya. Sexually Transmitted Diseases, 47(7), 464-472.

Abstract

BACKGROUND: Self-collection for high-risk HPV (hr-HPV) mRNA testing may improve cervical cancer screening. Hr-HPV mRNA with self-collected specimens stored dry could enhance feasibility and acceptance of specimen collection and storage; however, its performance is unknown. We compared the performance of hr-HPV mRNA testing with dry- as compared to wet-stored self-collected specimens for detecting ≥HSIL.
METHODS: A total of 400 female sex workers in Kenya participated (2013-2018), of which 50% were HIV-positive based on enrollment procedures. Participants provided two self-collected specimens: one stored dry (sc-DRY) using a Viba brush (Rovers), and one stored wet (sc-WET) with Aptima media (Hologic) using an Evalyn brush (Rovers). Physician-collected specimens were collected for HPV mRNA testing (Aptima) and conventional cytology. We estimated test characteristics for each hr-HPV screening method using conventional cytology as the reference standard (≥HSIL detection). We also examined participant preference for sc-DRY and sc-WET collection.
RESULTS: HR-HPV mRNA positivity was higher in sc-WET (36.8%) than sc-DRY samples (31.8%). Prevalence of ≥HSIL was 6.9% (10.3% HIV-positive; 4.0% HIV-negative). Sensitivity of hr-HPV mRNA for detecting ≥HSIL was similar in sc-WET (85%, 95% CI: 66-96), sc-DRY specimens (78%, 95% CI: 58-91), and physician-collected specimens (93%, 95% CI: 76-99).Overall, the specificity of hr-HPV mRNA for ≥HSIL detection was similar when comparing sc-WET to physician-collection. However, specificity was lower for sc-WET [66% (61-71)] than sc-DRY [71% (66-76)]. Women preferred sc-DRY specimen collection (46.1%) compared to sc-WET (31.1%). However, more women preferred physician-collection (63.9%) compared to self-collection (36.1%).
CONCLUSIONS: Sc-DRY specimens appeared to perform similarly to sc-WET for the detection of ≥HSIL.

URL

http://dx.doi.org/10.1097/olq.0000000000001167

Reference Type

Journal Article

Article Type

Regular

Year Published

2020

Journal Title

Sexually Transmitted Diseases

Author(s)

Islam, Jessica Yasmine
Mutua, Michael M.
Kabare, Emmanuel
Manguro, Griffins
Hudgens, Michael G.
Poole, Charles L.
Olshan, Andrew F.
Wheeler, Stephanie B.
McClelland, R. Scott
Smith, Jennifer S.

Continent/Country

Kenya