A comparison of human papillomavirus genotype-specific DNA and E6/E7 mRNA detection to identify anal precancer among HIV-infected men who have sex with men
A partir d'échantillons tissulaires prélevés sur 363 hommes infectés par le virus de l'immunodéficience humaine et ayant des relations homosexuelles, cette étude compare la sensibilité et la spécificité de deux tests de détection de lésions anales précancéreuses : l'un reposant sur la recherche de l'ARN messager E6/E7 de 5 types de papillomavirus humain (HPV16, 18, 31, 33, et 45) et l'autre sur la recherche de l'ADN de 13 types de HPV
Background: Human papillomavirus (HPV) RNA detection is reportedly more specific for the detection of anogenital precancer than HPV DNA but it is unknown whether this is due to detection of RNA or due to HPV genotype restriction. Materials and Methods: 363 human immunodeficiency virus (HIV)-positive men who have sex with men had two anal cytology samples taken and were evaluated using high-resolution anoscopy and biopsies of visible lesions. Anal specimens were tested for E6/E7 RNA for 5 carcinogenic HPV genotypes (HPV16, 18, 31, 33, and 45) and tested for the DNA of 13 carcinogenic HPV genotypes. Results: DNA testing was more likely to be positive than RNA testing (53% vs. 48%, p = 0.02) for the same 5 HPV genotypes in aggregate. When restricted to 5 HPV genotypes targeted by the RNA test, the sensitivity to detect anal precancer was the same for DNA and RNA (81%) while RNA was more specific than DNA (65% vs. 58%, p = 0.007). By comparison, DNA detection of all 13 carcinogenic HPV genotypes was more sensitive (96% vs. 81%, p = 0.001) but much less specific (65% vs. 33%, p < 0.001) compared to RNA detection of the 5 HPV genotypes. Conclusions: After controlling for HPV genotypes, RNA was only slightly more specific than DNA detection for anal precancer Impact:DNA or RNA testing for a subset of the most carcinogenic HPV genotypes may be useful for distinguishing between those HPV-positive men at higher and lower risk of anal precancer and cancer.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2012