Human Papillomavirus genotype testing combined with cytology as a ‘test of cure’ post treatment: The importance of a persistent viral infection

Jones, Joanne; Saleem, Azka; Rai, Nima; Shylasree, T. S.; Ashman, Suzanne; Gregory, Kate; Powell, Ned; Tristram, Amanda; Fiander, Alison; Hibbitts, Samantha Jayne

doi:10.1016/j.jcv.2011.06.021

Cited by 35 publications

(53 citation statements)

References 22 publications

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“…These analyses have also confirmed that the absence of HPV is an accurate indicator of a low risk for residual/recurrent disease. The negative predictive value of HPV testing could approach 100%, and women who test HPV negative at 6 to 18 months following treatment can be safely returned to routine screening (202,203,206).…”

Section: Hpv Surveillance Following Colposcopy Treatmentmentioning

confidence: 99%

Human Papillomavirus Laboratory Testing: the Changing Paradigm

2016

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SUMMARYHigh-risk human papillomaviruses (HPVs) cause essentially all cervical cancers, most anal and oropharyngeal cancers, and some vaginal, vulvar, and penile cancers. Improved understanding of the pathogenesis of infection and the availability of newer tests are changing the approach to screening and diagnosis. Molecular tests to detect DNA from the most common high-risk HPVs are FDA approved for use in conjunction with cytology in cervical cancer screening programs. More-specific tests that detect RNA from high-risk HPV types are now also available. The use of molecular tests as the primary screening tests is being adopted in some areas. Genotyping to identify HPV16 and -18 has a recommended role in triaging patients for colposcopy who are high-risk HPV positive but have normal cytology. There are currently no recommended screening methods for anal, vulvar, vaginal, penile, or oropharyngeal HPV infections. HPV testing has limited utility in patients at high risk for anal cancer, but p16 immunohistochemistry is recommended to clarify lesions in tissue biopsy specimens that show moderate dysplasia or precancer mimics. HPV testing is recommended for oropharyngeal squamous cell tumors as a prognostic indicator. Ongoing research will help to improve the content of future guidelines for screening and diagnostic testing.

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Section: Hpv Surveillance Following Colposcopy Treatmentmentioning

confidence: 99%

Human Papillomavirus Laboratory Testing: the Changing Paradigm

2016

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“…The sensitivity of HPV-DNA testing in detecting treatment failure is high, reported in one meta-analysis to reach at least 90% at 6 months after treatment, compared to 65% for conventional cytology, while the specificity of HPV testing ranged from 44% to 95% in the studies analyzed [70]. A British study reported that at 6 months after treatment, combined analysis of cytology and a single high-risk HPV test predicted high grade disease recurrence with a 100% sensitivity, 92% specificity, 100% negative predictive value (NPV), and 20% positive predictive value (PPV) [71]. In the case of persistent HPV infection after treatment, HPV genotyping may allow for the classification of women into risk groups.…”

Section: Application Of Hpv Testing In Screening Treatment and Fmentioning

confidence: 99%

HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

Peralta‐Zaragoza

Deas

Gómez-Cerón

et al. 2013

Obstetrics and Gynecology International

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Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer.

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“…At the 6-month posttreatment examination, HR-HPV testing has a significantly higher sensitivity than cytology, indicated by a relative sensitivity of 1.15 (95% CI 1.06–1.25), without decreasing the specificity (relative specificity 0.95, 0.88–1.02). Combined analysis of cytology and HR-HPV test predicted high-grade disease recurrence with higher sensitivity than the separate individual tests (Figures 3 and 4) [16–22]. …”

Section: Hpv Testing In Followup After Treatmentmentioning

confidence: 99%

The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening

Hoste

Vossaert

Poppe

2013

Obstetrics and Gynecology International

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Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

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Human Papillomavirus genotype testing combined with cytology as a ‘test of cure’ post treatment: The importance of a persistent viral infection

Cited by 35 publications

References 22 publications

Human Papillomavirus Laboratory Testing: the Changing Paradigm

Human Papillomavirus Laboratory Testing: the Changing Paradigm

HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening

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