Performance of HPV DNAdetection using HC2, LA and anal cytology for identification of HGAIN lesions results among HIV-infected men who have sex with men
| Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | PLR (95% CI) | NLR (95% CI) | Area under ROC curve (95% CI) | Youden’s index | |
| HPV DNA detection | ||||||||
| HC2 | 90.0% (68.3 to 98.8) | 58.4% (50.2 to 66.3) | 22.0% (13.6 to 32.5) | 97.8% (92.4 to 99.7) | 2.2 (1.7 to 2.7) | 0.2 (0.5 to 0.6) | 0.74 (0.66 to 0.82) | 0.484 |
| LA (oncogenic HPV genotypes) | 95.0% (75.1 to 99.9) | 27.3% (20.4 to 35.0) | 14.5% (9.0 to 21.7) | 97.7% (87.7 to 99.9) | 1.3 (1.1 to 1.5) | 0.2 (0.0 to 1.3) | 0.61 (0.55 to 0.67) | 0.223 |
| LA HPV16 | 70.0% (45.7 to 88.1) | 76.6% (69.1 to 83.1) | 28.0% (16.2 to 42.5) | 95.2% (89.8 to 98.2) | 3.0 (2.0 to 4.5) | 0.4 (0.2 to 0.8) | 0.73 (0.63 to 0.84) | 0.466 |
| LA HPV18 | 25.0% (8.7 to 49.1) | 91.6% (86.0 to 95.4) | 27.8% (9.7 to 53.5) | 90.4% (84.6 to 94.5) | 3.0 (1.2 to 7.4) | 0.8 (0.6 to 1.1) | 0.58 (0.48 to 0.68) | 0.166 |
| LA HPV16/18* | 90.0% (68.3 to 98.8) | 72.7% (65.0 to 79.6) | 30.0% (18.8 to 43.2) | 98.2% (93.8 to 99.8) | 3.3 (2.4 to 4.4) | 0.1 (0.0 to 0.5) | 0.81 (0.74 to 0.89) | 0.627 |
| LA HPV6 and/or 16 and/or 18 | 95.0% (75.1 to 99.9) | 61.0% (52.9 to 68.8) | 24.1% (15.1 to 35.0) | 98.9% (94.3 to 100) | 2.4 (1.9 to 3.0) | 0.1 (0.0 to 0.6) | 0.78 (0.72 to 0.84) | 0.560 |
| LA HPV genotypes frequently identified in anal cancer (HPV16, 18, 33, 35, 58) | 90.0% (68.3 to 98.8) | 59.1% (50.9 to 66.9) | 22.2% (13.7 to 32.8) | 97.8% (92.4 to 99.7) | 2.2 (1.7 to 2.8) | 0.2 (0.5 to 0.6) | 0.745 (0.67 to 0.82) | 0.491 |
| Anal cytology | ||||||||
| Abnormal | 95.0% (75.1 to 99.9) | 56.4% (48.0 to 64.5) | 22.6% (14.2 to 33.0) | 98.8% (93.6 to 100.0) | 2.2 (1.8 to 2.7) | 0.1 (0.0 to 0.6) | 0.76 (0.69 to 0.82) | 0.514 |
| HSIL | 45.0% (23.1 to 68.5) | 96.0% (91.4 to 98.5) | 60.0% (32.3 to 83.7) | 92.9% (87.6 to 96.4) | 11.2 (4.4 to 28.1) | 0.6 (0.4 to 0.9) | 0.70 (0.59 to 0.82) | 0.410 |
| HPV DNA detection and anal cytology | ||||||||
| HC2 and abnormal | 85.0% (62.1 to 96.8) | 72.5% (64.6 to 79.5) | 29.3% (18.1 to 42.7) | 97.3% (92.3 to 99.4) | 3.1 (2.3 to 4.3) | 0.2 (0.1 to 0.6) | 0.79 (0.70 to 0.88) | 0.575 |
| HPV16/18 and abnormal | 85.0% (62.1 to 96.8) | 81.9% (74.7 to 87.7) | 38.6% (24.4 to 54.5) | 97.6% (93.1 to 99.5) | 4.7 (3.2 to 6.9) | 0.2 (0.1 to 0.5) | 0.83 (0.75 to 0.92) | 0.669 |
| HC2 and HSIL | 45.0% (23.1 to 68.5) | 96.0% (91.4 to 98.5) | 60.0% (32.3 to 83.7) | 92.9% (87.6 to 96.4) | 11.2 (4.5 to 28.1) | 0.6 (0.4 to 0.9) | 0.71 (0.59 to 0.82) | 0.410 |
| HPV16/18 and HSIL | 45.0% (23.1 to 68.5) | 97.3% (93.3 to 99.3) | 69.2% (38.6 to 90.9) | 92.9% (87.7 to 96.4) | 16.8 (5.7 to 49.4) | 0.6 (0.4 to 0.8) | 0.71 (0.60 to 0.82) | 0.423 |
Abnormal: ASC-US or ASC-H or LSIL.
Table created by the authors.
*Presence of HPV16, HPV18 or both HPV genotypes.
ASC-H, atypical squamous cells cannot exclude HSIL; ASC-US, atypical squamous cells of undetermined significance; HC2, Hybrid Capture 2 HPV DNA test; HGAIN, high-grade anal intraepithelial neoplasia; HPV, human papillomavirus; HSIL, high-grade squamous intraepithelial lesion; LA, Linear Array Genotyping Test; LSIL, low-grade squamous intraepithelial lesion; NLR, negative likelihood ratio; NPV, negative predictive value; PLR, positive likelihood ratio; PPV, positive predictive value; ROC, receiver operating characteristic.