Characterizing the temporal dynamics of human papillomavirus DNA detectability using short-interval sampling.
Characterizing the temporal dynamics of human papillomavirus DNA detectability using short-interval sampling.
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DOI：
10.1158/1055-9965.epi-13-0666
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Brotman RM
中科院分区：
文献类型：
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作者：
Liu SH;Cummings DA;Zenilman JM;Gravitt PE;Brotman RM
人类乳头瘤病毒(HPV)DNA的可变检测可能导致对感染状态的错误分类，但错误分类的程度尚未得到定量评估。在2005-2007年间，33名年龄在22-53岁的妇女在连续16周内每周收集两次阴道拭子。在收集的955个拭子中，每一个都进行了37种HPV类型/亚型的测试。假设一名妇女的潜在感染状况在短期研究期间没有改变，计算了从单次拭子与多次拭子获得的患病率估计的偏差。使用事件历史分析方法，分别确定至少一种HPV类型的复发收益和丢失时间。高危和高危HPV的基线患病率分别为60.6%和24.2%。16周期间，高危和高危HPV累计患病率分别为84.8%和60.6%。总体而言，有319起检测事件和313起检测丢失事件。重复检测和丢失检测的中位时间分别为11天和7天。无论是阴道性行为，还是在随访期间使用避孕套，都与反复检测到病毒或丢失病毒检测没有关系。假设16周的累积流行率反映了感染的真实流行率，基线的任何HPV流行率比估计的感染状态低24.2%，自举平均值为20.2%(95%可信区间[CI]：8.9%，29.6%)。这些发现表明，在使用一次性DNA测量时，相当大比例的HPV感染妇女被错误地归类为未感染。在使用长时间收集的单个样本解释感染的自然历史时，需要考虑可检测到的HPV DNA的短期变异。
Variable detection of human papillomavirus (HPV) DNA can result in misclassification of infection status, but the extent of misclassification has not been quantitatively evaluated. In 2005–2007, 33 women aged 22–53 self-collected vaginal swabs twice per week for 16 consecutive weeks. Each of the 955 swabs collected was tested for 37 HPV types/subtypes. Assuming that a woman’s underlying infection status did not change over the short study period, biases in prevalence estimates obtained from single versus multiple swabs were calculated. Using event history analysis methods, time to recurrent gain and loss of at least one HPV type was determined, separately. Baseline any- and high risk-HPV prevalence was 60.6% and 24.2%, respectively. Cumulative any- and high risk-HPV prevalence over the 16-week period was 84.8% and 60.6%, separately. Overall, there were 319 events of detection and 313 events of loss of detection. Median times to a recurrent detection and loss of detection was 11 and 7 days, respectively. Neither vaginal sex nor condom use during follow-up was associated with recurrent viral detection or loss of detection. Assuming the cumulative 16-week prevalence reflects the true prevalence of infection, the baseline any-HPV prevalence under-estimated infection status by 24.2%, with a bootstrapped mean of 20.2% (95% confidence interval [CI]: 8.9%, 29.6%). These findings suggest that a substantial proportion of HPV-infected women are misclassified as being un-infected when using a single-time DNA measurement. Short-term variation in detectable HPV DNA needs to be considered while interpreting the natural history of infections using single samples collected at long intervals.