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Published on: March 8, 2012
Characterizing the temporal dynamics of human papillomavirus DNA detectability using short-interval sampling
Su-Hsun Liu1, Derek A T Cummings, Jonathan M Zenilman
1Authors' Affiliations: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University; Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine; Institute for Genome Sciences; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland; Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; and Perdana University Graduate School of Medicine, Serdang, Malaysia.
Single human papillomavirus (HPV) DNA tests misclassify many infected women as uninfected. This study quantifies HPV detection variability, highlighting the need for multiple samples to accurately assess infection status.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Human papillomavirus (HPV) DNA detection variability can lead to misclassification of infection status.
- The quantitative impact of this misclassification on prevalence estimates has not been thoroughly evaluated.
Purpose of the Study:
- To quantitatively evaluate the extent of misclassification due to variable HPV DNA detection.
- To assess the impact of single versus multiple sample testing on HPV prevalence estimates.
Main Methods:
- 33 women provided self-collected vaginal swabs twice weekly for 16 weeks (955 total swabs).
- Swabs were tested for 37 HPV types/subtypes.
- Event history analysis determined time to recurrent HPV detection and loss of detection.
Main Results:
- A single baseline HPV DNA test underestimated infection prevalence by a mean of 20.2% (95% CI, 8.9%-29.6%).
- Median times to recurrent detection and loss of detection were 11 and 7 days, respectively.
- Neither sexual activity nor condom use correlated with detection variability.
Conclusions:
- A significant proportion of HPV-infected women may be misclassified as uninfected with single-time DNA testing.
- Short-term fluctuations in detectable HPV DNA necessitate consideration when interpreting infection natural history from infrequent samples.
