Comparative performance of three HPV DNA detection assays for cervical cancer screening in Algeria

Nabila Masdoua, Lamia Boublenza, Ilyes Zatla, Lamia Lablack, Nabila Sadouki, Michel Segondy

Abstract

Persistent infection with high-risk human papillomavirus (HR-HPV) is the principal etiological driver of cervical cancer, making accurate HPV detection central to contemporary screening strategies. This study compared three molecular assays—INNO-LiPA HPV Genotyping Extra, Cobas 4800 HPV, and Amplicor HPV—using overlapping cervical-sample subsets from Algerian women at increased risk of cervical disease. Among the 94 specimens tested by both INNO-LiPA and Cobas, HR-HPV was detected in 54.3% and 29.8%, respectively; INNO-LiPA also identified HPV16 and HPV18 more frequently. In the 18-specimen subset tested by all three assays, HR-HPV positivity was 27.8% with INNO-LiPA, 33.3% with Cobas, and 50.0% with Amplicor. Pairwise agreement ranged from weak to substantial (κ=0.116–0.667), and discordance was significantly associated with multiple HPV infections (OR=5.88, 95% CI 1.29–26.85; p=0.012). HR-HPV positivity was more frequent in specimens with abnormal cytology, with the strongest association observed for INNO-LiPA (OR=4.9, 95% CI 1.5–15.9; p=0.005). Using the study-defined composite reference classification, INNO-LiPA showed higher sensitivity (93%) but lower specificity (62%) than Cobas (71% and 88%, respectively). These findings demonstrate substantial assay-dependent variation in HR-HPV detection and highlight the value of detailed genotyping for epidemiological investigation, while supporting the use of clinically validated HR-HPV assays for screening applications.

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References

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