title: Development of a Multiplex PCR Test with Automated Genotyping Targeting E7 for Detection of Six High-Risk Human Papillomaviruses.
abstract: Cervical cancer is caused by high-risk human papillomaviruses (HPV) and viral detection tests aid in the diagnosis of precursor lesions. In the present study, a molecular test for detection of high-risk HPV DNA, called E7-HPV, was standardized and assessed in samples from women with pre-cancerous lesions. The development of the E7-HPV test for detection and genotyping of six high-risk HPV (types 16, 18, 31, 33, 45 and 52), consisted of evaluating primer quality and adjusting the multiplex PCR conditions. Primer design was based on the E7 region of each HPV, and the fluorochrome 6-FAM was added to PCR primers. Viral detection was performed by capillary electrophoresis in automated sequencer in samples obtained from 60 women (55 with ASC-H/HSIL cytology) from August to September 2013. A non-inferiority analysis was conducted with the cobas HPV test as a reference and following international guidelines for the development of new tests. The two tests had a high concordance rate in HPV16 detection (kappa=0.972), with only one discordant case (cervical intraepithelial neoplasia grade 3, negative with cobas and positive for HPV16 by E7-HPV) and complete agreement in HPV18 detection. When comparing detection of all high-risk HPV, three cases were positive with cobas but negative with E7-HPV, and another three cases were negative with cobas but positive with E7-HPV (HPV16, 31 and 52). When we evaluate the cases initially suspected by cytology, the two tests had the same sensitivity in detection CIN2 or worse. In conclusion, the E7-HPV test has satisfactory initial results, and its development can be continued.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
authors.forename: Eliana Ferreira
authors.initials: EF
authors.lastname: Paes
authors.affiliation: Laboratory of Research in AIDS, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: de Assis
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
authors.forename: Cirbia S Campos
authors.initials: CS
authors.lastname: Teixeira
authors.affiliation: Laboratory of Research in AIDS, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
authors.forename: Francisco Hideo
authors.initials: FH
authors.lastname: Aoki
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Teixeira
mesh_terms: D052685:Alphapapillomavirus / Q000235:genetics*; D002584:Cervix Uteri / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques / Q000379:methods; D006801:Humans; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000821:virology*
chemical_list: D004279:DNA, Viral