Could APTIMA mRNA Assay Contribute to Predicting Cervical Bacterial Sexually Transmitted Co-Infections? A Colposcopy...

Area of Science:

• Gynecologic Oncology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Chronic high-risk human papillomavirus (hrHPV) infection and persistent cervical inflammation contribute to precancerous cervical lesions.
• While some inflammatory changes in younger women resolve spontaneously, persistent precancer or bacterial co-infections may necessitate managing inflammation.
• Controlling inflammation may shorten the HPV cycle and potentially avoid cervical surgery.

Purpose of the Study:

• To investigate the impact of molecularly detected bacterial sexually transmitted infections (STIs) on HPV DNA and APTIMA positivity rates.
• To compare the performance of HPV DNA assays versus APTIMA assays in predicting STI positivity and negativity in a colposcopy population.

Main Methods:

• A study involving 336 predominantly young, asymptomatic individuals undergoing colposcopy.
• Molecular detection of bacterial STIs using validated assays.
• Comparison of HPV DNA testing and APTIMA testing performance metrics (sensitivity, specificity, PPV, NPV, accuracy).

Main Results:

• HPV DNA testing demonstrated higher sensitivity (52.94%) in predicting STI positivity compared to APTIMA (33.82%).
• APTIMA testing showed higher specificity (77%) in predicting bacterial STI negativity compared to HPV DNA testing (60%).
• No significant differences were observed between the two assays regarding positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.

Conclusions:

• In this cohort, HPV DNA testing performed better than APTIMA for predicting concurrent bacterial STIs.
• APTIMA assay did not superiorly predict bacterial STIs compared to HPV DNA assay, despite high Ureaplasma urealyticum prevalence.
• Further research is needed to understand the interplay between HPV biomarkers and bacterial STIs in cervical health.