Detection of human papillomavirus DNA in patients referred to a family practice colposcopy clinic.
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.
Holman
J R
JR
Puget Sound Family Medicine Residency, Naval Hospital, Bremerton, Wash 98312, USA.
D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D003127:Colposcopy; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000235:genetics*; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D010348:Patient Care Team; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D011237:Predictive Value of Tests; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears
D015344:DNA Probes, HPV; D004279:DNA, Viral