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IARC 60th Anniversary - 19-21 May 2026

Session : 21/05/26 - Posters

Comparison of high-risk HPV DNA detection using AnyplexTM II HPV28 and XpertTM HPV in nurse-collected cervical samples among women with HIV in Lusaka,

FERNANDEZ VILLALOBOS N. 6, MOONO MUKUPA M. 1, GLASS A. 3, ANDOH J. 6, MADLIWA T. 3, BASU P. 2, MWANAHAMUNTU M. 4, ROHNER E. 6, LOW N. 6, MANASYAN A. 1,5, TAGHAVI K. 6

1 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; 2 Early Detection, Prevention and Infections Branch, IARC/WHO, Lyon, France; 3 Lancet Laboratories, Johannesburg, South Africa; 4 Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia; 5 University of Alabama at Birmingham, Birmingham, United States; 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

Background: Prevalence of cervicovaginal high-risk human papillomavirus (hrHPV) is high among women with HIV (WHIV). There are many hrHPV DNA tests, but genotype-specific comparisons among WHIV are limited. We compared hrHPV detection AnyplexTM II HPV28 and XpertTM HPV among WHIV in Lusaka, Zambia.

Methods: WHIV enrolled in a cervical screening test accuracy study from 05/2019 to 03/2021, were invited for re-screening after 36 months. Trained nurses collected cervical cytology and biopsy samples on all women. Cytology samples were tested for hrHPV using Anyplex and Xpert. Women with paired and valid hrHPV test results were included. We restricted analysis to 14 hrHPV types common to both assays. We calculated hrHPV and genotype-specific prevalence, overall agreement, Cohen’s kappa (κ) with 95% confidence intervals (CIs), and relative sensitivity and specificity for detection of high-grade squamous intraepithelial lesions (HSIL).

Results: Among 237 women seen 05/2022 to 06/2023, hrHPV prevalence was 25% (59/237) using Xpert and 37% (87/237) using Anyplex. Genotype-specific detection was higher with Anyplex than Xpert, including HPV16 (9.3% [n = 22/237]) vs. 5.5% [n = 13/237]). Overall agreement was 84% (κ _= 0.63; 95% CI 0.53-0.73). Genotype-specific agreement ranged from 88% (other hrHPV, κ _= 0.66; 95% CI 0.55-0.77) to 95% (HPV16, κ _= 0.66; 95% CI 0.45-0.84). Relative to Xpert, Anyplex had similar sensitivity (relative sensitivity: 1.06; 95% CI 0.94-1.18) but lower specificity (relative specificity: 0.84; 95% CI 0.78-0.91) for detection of HSIL.

Conclusions: Agreement for hrHPV detection on cervical cytology samples was high among WHIV in Zambia. Anyplex was more sensitive, while Xpert was more specific for detection of HSIL. Genotype-specific agreement was lower and Anyplex detected HPV 16 almost twice as often as Xpert. Lower detection of genotype-specific hrHPV, particularly HPV16, may have downstream consequences, including inappropriate triage or treatment decisions in settings where genotyping guides immediate clinical management.

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Proportion of positive samples for Anyplex and Xpert by hrHPV and subgroup-specific genotypes. Dashed lines represent 95% confidence intervals.