Use of a Hybrid Capture Assay of Self‐Collected Vaginal Swabs in Rural Uganda for Detection of Human Papillomavirus

David Serwadda, Maria J. Wawer, Keerti V. Shah, Nelson K. Sewankambo, Richard Daniel, Chuanjun Li, Attila Lorincz, Mary P. Meehan, Fred Wabwire‐Mangen, Ronald H. Gray
1999 Journal of Infectious Diseases  
A random sample of 960 women aged 15-59 years enrolled in a population-based study in rural Uganda were asked to provide self-collected vaginal swabs for human papillomavirus (HPV) testing by hybrid capture assay. The intensity of HPV infection was assessed by the relative light unit (RLU) ratio in the specimen-to-positive control (PC) ratio. In total, 898 women (93%) provided a swab and 737 provided serum for human immunodeficiency virus type 1 (HIV-1) determination. HPV prevalence was 16.7%
more » ... valence was 16.7% and was highest in younger women. HIV-1 prevalence was 17.8%. HPV prevalence was 44.3% in HIV-positive and 10.2% in HIVnegative women (rate ratio, 5.36; 95% confidence interval, 3.81-7.54). The intensity of HPV infection was significantly greater among HIV-positive than HIV-negative women (54.4 vs. RLU/PC; ); intensity of infection was highest in women aged !30 years. The P = .026 higher prevalence and intensity of HPV infection in HIV-positive women could facilitate HPV transmission in this population. Self-collected vaginal swabs could be used in populationbased screening to identify women at high risk of cervical neoplasia. Cervical cancer is a major public health problem in the developing world, particularly in sub-Saharan Africa [1, 2], in part because of the inadequacy of screening services for detection of preinvasive and early invasive disease [3] . In addition, human immunodeficiency virus (HIV) infection increases the prevalence and persistence of human papillomavirus (HPV) infection, which is associated with an increased incidence of preinvasive and invasive cervical cancer [4, 5] . Thus, the HIV epidemic has added urgency and complexity to the problems of cervical cancer control, particularly in sub-Saharan Africa,
doi:10.1086/315026 pmid:10479163 fatcat:5pjtlxdevfd7zdgerhmrsdfv5y