COMPARATIVE-ANALYSIS OF HUMAN-PAPILLOMAVIRUS DETECTION BY HYBRID CAPTURE ASSAY AND ROUTINE CYTOLOGIC SCREENING TO DETECT HIGH-GRADE CERVICAL LESIONS

A commercial HPV detection test, Hybrid Capture (HC), designed to dete ct 14 HPV types divided into high-risk and low-risk groups, has been e valuated. A total of 1064 scrapes from 1028 unselected women attending routine cytologic screening were tested and results were compared wit h those of classic cytologic screening and cervical biopsies. The reli ability of the test was also evaluated on 38 fresh conization samples. HPV DNA was detected in 108 women (10.5%), including 90 infected by a high-risk HPV (8.8%); 25 high-grade lesions were detected histologica lly, and high-risk HPV was found in 16 of these 25 women (64%), and in 27 (71%) of the 38 conization samples. The overall sensitivity of HC in detecting high-grade SIL on cervical scrapes and conization samples was 71.2%, while its positive predictive value was 17.8%. Classic cyt ologic screening appeared to be the most sensitive method (84%) for de tecting high-grade SIL, with a positive predictive value of 91.3%. The lower sensitivity of HC limits its use for screening high-grade lesio ns on a large scale, even though it may be useful for reducing cytolog ically false-negative results. Moreover, the quantitative approach pro vided by the HC assay for assessment of the viral load cannot clearly distinguish among cases with or without high-grade lesions. (C) 1998 W iley-Liss, Inc.