南非感染艾滋病毒女性的肛门人乳头瘤病毒（HPV）患病率及赛沛Xpert和杂交捕获2（hc2）HPV检测方法的性能
Prevalence of Anal Human Papillomavirus (HPV) and Performance of Cepheid Xpert and Hybrid Capture 2 (hc2) HPV Assays in South African HIV-Infected Women.
作者信息
Mbulawa Zizipho Z A, Wilkin Timothy, Goeieman Bridgette J, Jong Eefje, Michelow Pamela, Swarts Avril, Smith Jennifer S, Kegorilwe Patricia, Firnhaber Cynthia S, Williamson Anna-Lise
机构信息
Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Center for HIV and STIs, National Institute for Communicable Disease, National Health Laboratory Service, Cape Town, South Africa.
出版信息
Am J Clin Pathol. 2017 Aug 1;148(2):148-153. doi: 10.1093/ajcp/aqx050.
OBJECTIVES
This study investigated anal high-risk HPV (HR-HPV) prevalence in HIV-infected women using the Cepheid Xpert HPV assay and compares its performance with that of Hybrid Capture-2 (hc2).
METHODS
A total of 199 HIV-infected women were recruited from Helen Joseph Hospital, Johannesburg. Stored ThinPrep anal swabs that had previously been tested using hc2 were tested for HPV using Xpert.
RESULTS
The HR-HPV prevalence by Xpert was 40.8% and similar to hc2 (41.8%) with overall agreement of 86.7%; Cohen's kappa 0.73 (95% CI 0.63-0.82). High grade squamous intraepithelial lesions (HSIL) was associated with increasing number of multiple HPV infection (P < .001). Xpert and hc2 were similarly sensitive (77.4% and 77.4%, respectively) and specific (66.1% and 64.8% respectively) for HSIL detection. HPV16 (OR: 14.0, 95% CI: 3.9-48.0, P < .0001), HPV39/68/56/66 (OR: 4.1, 95% CI: 1.4-12, P = .01) and HPV51/59 (OR: 2.8, 95% CI: 1.1-7.6, P = .04) were independently associated with anal HSIL.
CONCLUSIONS
Xpert HPV typing is a promising anal screening test in HIV-infected women that performs similarly to hc2.
目的
本研究使用赛沛Xpert HPV检测法调查了HIV感染女性的肛门高危型人乳头瘤病毒（HR-HPV）感染率，并将其检测性能与杂交捕获-2（hc2）检测法进行比较。
方法
从约翰内斯堡的海伦·约瑟夫医院招募了199名HIV感染女性。使用赛沛Xpert检测法对之前已用hc2检测过的保存的液基薄层制片肛门拭子进行HPV检测。
结果
赛沛Xpert检测法的HR-HPV感染率为40.8%，与hc2检测法（41.8%）相似，总体一致性为86.7%；科恩kappa系数为0.73（95%可信区间0.63 - 0.82）。高级别鳞状上皮内病变（HSIL）与多种HPV感染数量增加相关（P < 0.001）。赛沛Xpert检测法和hc2检测法在检测HSIL方面的敏感性（分别为77.4%和77.4%）和特异性（分别为66.1%和64.8%）相似。HPV16（比值比：14.0，95%可信区间：3.9 - 48.0，P < 0.0001）、HPV39/68/56/66（比值比：4.1，95%可信区间：1.4 - 12，P = 0.01）和HPV51/59（比值比：2.8，95%可信区间：1.1 - 7.6，P = 0.04）与肛门HSIL独立相关。
结论
赛沛Xpert HPV分型检测法在HIV感染女性中是一种很有前景的肛门筛查检测方法，其性能与hc2检测法相似。
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