Human papillomavirus oncogene mRNA testing for the detection of anal dysplasia in HIV-positive men who have sex with men

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• 作者：Steffi Silling^a ; Alexander Kreuter^b ; Martin Hellmich^c ; Jochen Swoboda^d ; Herbert Pfister^a ; Ulrike Wieland^a ; ^{ulrike.wieland@uni-koeln.de}
• 关键词：AC ; anal cancer ; AIN ; anal intraepithelial neoplasia ; ASCUS ; atypical squamous cells of undetermined significance ; CI ; confidence interval ; CIN ; cervical intraepithelial neoplasia ; dl ; detection limit ; HIV ; human immunodeficiency virus ; HIV&#xA0 ; +&#xA0 ; MS
• 刊名：Journal of Clinical Virology
• 出版年：2012
• 期刊代码：150_13866532
• 类别：med
• 出版时间：April, 2012
• 卷：53
• 期：4
• 页码：325-331
• 文件大小：318 K

摘要

ass="h4">Background

Anal human papillomavirus (HPV) infection and anal dysplasia are frequent in HIV-positive men who have sex with men (HIV + MSM), and progression of low-grade (LSIL) to high-grade squamous intraepithelial lesions (HSIL) or anal cancer (AC) occurs faster than in HIV-negative individuals. High-risk (HR)-HPV-E6/E7 oncogene mRNA testing has a higher specificity and a higher positive predictive value (PPV) than HR-HPV-DNA testing for detecting high-grade cervical lesions.

ass="h4">Objective

To evaluate the diagnostic accuracy of the NucliSENS-EasyQ HPV1.1 E6/E7-mRNA-assay for the detection of anal dysplasia in HIV + MSM.

ass="h4">Study design

289 intraanal swabs from HIV + MSM participating in a screening program that included anal cytology, high-resolution anoscopy and histology were analyzed. HR-HPV-DNA detection was performed by PCR and hybridization using a bead-based multiplex genotyping assay. E6/E7-mRNA detection of HR-HPV-types 16, 18, 31, 33 and 45 was performed using the NucliSENS-EasyQ assay.

ass="h4">Results

269 swabs had valid results in both test formats (111 normal, 10 ASCUS, 105 LSIL, 42 HSIL, 1 AC). For the detection of LSIL + (LSIL + HSIL + cancer) sensitivity, specificity, negative predictive value (NPV) and PPV were 80.4%, 26.4%, 52.5%, and 57.2%for HR-HPV-DNA testing, respectively, compared to 75.7%, 57.9%, 66.0%and 68.7%for E6/E7-mRNA testing. The respective values for the detection of HSIL/cancer were 95.3%, 26.1%, 96.7%, 19.7%for HR-HPV-DNA and 95.3%, 46.0%, 98.1%, 25.2%for E6/E7-mRNA detection.

ass="h4">Conclusion

Compared to HR-HPV-DNA detection, E6/E7-mRNA testing has an increased specificity (approximately two-fold), similar sensitivity and higher NPV and PPV for the detection of low- and high-grade anal dysplasia in HIV + MSM.