Detection of Human Papillomavirus DNA in Patients Referred to a Family Practice Colposcopy Clinic

Abstract

Background: Human papillomavirus (HPV) is strongly implicated in the pathogenesis of cervical neoplasia. The ability of a commercially available kit (Virapap/Viratype) to detect evidence of HPV is compared with cervical cytology, colposcopy, and directed biopsies.

Methods: During a period of 16 months, cervical samples from 241 consecutive new patients referred for a colposcopy examination were obtained for HPV-DNA hybridization typing according to the kit instructions. Samples were sent to a reference laboratory for testing. The results were compared with results of the colposcopy examination, cervical cytology, and directed cervical biopsy samples processed and evaluated by our hospital laboratory.

Results: HPV DNA was detected in 27 of 107 patients who had abnormal colposcopy findings for a sensitivity of 25 ± 7.5 percent at the 90 percent confidence interval. One of 134 patients with normal findings was positive for a specificity of 99 ± 5 percent at the 95 percent confidence interval. Based on a 75 percent probability of HPV in the population, the positive predictive value was 99 percent and the negative predictive value 30 percent.

Conclusions: With the low negative predictive value and sensitivity, HPV-DNA testing by this commercial kit is not an adequate tool for screening HPV in this population.