Browsing by Author "Glass, Allison"

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    Genotype-specific agreement and accuracy of human papillomavirus DNA detection using AnyplexTM II HPV28 and XpertTM HPV among women with HIV in Lusaka, Zambia: a diagnostic accuracy analysis
    (2026) Nathalie, Villalobos V. F; Moono, Misinzo; Andoh, John; Glass, Allison; Basu, Partha; Madliwa, Thamsanga; Mwanahamuntu, Mulindi; Rohner, Eliane; Low, Nicola; Manasyan, Albert; Taghavi, Katayoun
    Abstract Objectives: The prevalence of cervicovaginal high-risk human papillomavirus (hrHPV) is high among women with human immunodeficiency virus (WHIV). Many hrHPV tests exist, but genotype-specific comparisons among WHIV are limited. We compared hrHPV detection and diagnostic accuracy using AnyplexTM II HPV 28 and XpertTM HPV among WHIV in Lusaka, Zambia. Methods: WHIV enrolled in a cervical screening test accuracy study (05/2019-03/2021) were invited for rescreening after 36 months. Trained nurses collected the cervical cytology and biopsy samples. Cytology samples were tested using Anyplex and Xpert. Women with paired and valid hrHPV results were included. We compared hrHPV and genotype-specific prevalence, overall agreement, Cohen kappa (κ), and relative sensitivity and specificity for the detection of high-grade squamous intraepithelial lesions (HSIL). Results: Among 230 women seen between 05/2022 and 06/2023, hrHPV prevalence was 24% (55/230) using Xpert and 36% (82/230) using Anyplex. Detection of HPV16 was higher with Anyplex (9%, 20/230) than with Xpert (6%, 13/230). Overall agreement was 85% (κ = 0.64; 95% confidence interval [CI] = 0.53-0.74). Genotype-specific agreement ranged from 88% (other hrHPV, κ = 0.66) to 96% (HPV16, κ = 0.70). For the detection of HSIL, the relative sensitivity of Anyplex compared with Xpert was 1.07 (95% CI = 0.94-1.21), and the relative specificity was 0.85 (95% CI = 0.79-0.91). Conclusion: Agreement between Anyplex and Xpert for hrHPV detection was high, but genotype-specific detection differed, with Anyplex detecting HPV16 more frequently than Xpert. While both assays had similar sensitivity, Xpert was more specific for HSIL. The choice of assay should balance the goals of maximizing HSIL detection with minimizing overtreatment.
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    Human papillomavirus detection in liquid-based cytology and cervical histology samples among women living with human immunodeficiency virus in Zambia
    (2026-08-11) Taghavi, Katayoun; Moono, Misinzo; Villalobos, Nathalie V. F.; Andoh, John; Glass, Allison; Basu, Partha; Madliwa, Thamsanqa; Mwanahamuntu, Mulindi H.; Manasyan, Albert; Rohner, Eliane
    Abstract Objectives: Cervicovaginal human papillomavirus (HPV) prevalence is high among women living with human immunodeficiency virus (WLHIV), but not all HPV genotypes detected in liquid-based cytology (LBC) may be present in cervical tissue. We explored HPV genotype concordance in paired LBC and histology samples among WLHIV in Zambia. Methods: WLHIV aged 18-65 years who were enrolled in a cervical screening test accuracy study were invited for follow-up after 30-36 months. LBC samples and two or more cervical biopsies were collected and tested for 28 HPV genotypes (Anyplex II/Allplex HPV28, Seegene, South Korea). HPV prevalence and genotype-specific agreement were assessed using Cohen's kappa. Results: From April 2022 to May 2023, 242 WLHIV (22 with high-grade squamous intraepithelial lesions) had valid paired HPV results. The prevalence of any HPV was similar on LBC (39%) and histology (34%). Multiple-type infections were more common on LBC (18%) than on histology (10%). HPV 16 was the most frequent genotype: 9% (n = 22) on LBC, and 15% (n = 36) on histology. Agreement for any high-risk HPV genotype was 66.1% (kappa = 0.27). Conclusions: Among Zambian WLHIV with mostly low-grade cervical lesions, LBC showed more multiple-type HPV infections and limited agreement with histology samples, possibly reflecting transient infections detected by LBC. The frequent detection of HPV 16 in histology samples but not in LBC warrants further investigation.