Assessment of Accuracy and Reliability: Validation trial for a Fluorescent Probe-Based Real-Time PCR Assay Kit in Detecting Human Papillomavirus Nucleic Acid
Authors: Barbra Mutamba , Alice Nyamwiza , Kassa Dawit , Rulisa Stephen 
Published: November 2024

Background

Human Papillomavirus (HPV) infection is a potential risk for cervical cancer, the latter is the fourth leading cause of cancer related death worldwide. Effective testing procedures are particularly important in its prevention and management. More accurate HPV tests replace traditional cytology-based screening, and they are in line with national and international guidelines that recommend primary HPV testing due to its better efficacy. The purpose of the study was to confirm that these Gynius HPV detection kits were equal in efficiency compared with Roche Cobas® HPV assay-based testing, which could better facilitate earlier detection and stratification by risk level for cervical lesions.

Methods

The prospective parallel control study recruited 1000 women from the district hospitals of Kibagabaga and Muhima in Rwanda. Participants were tested for HPV DNA tests using both Roche and Gynius kits and then the samples were sent to Rwanda National Reference Laboratory. We analyzed the concordance of two Gynius variants (liquid and lyophilized ) and Roche across for several different HPV subtypes, such as 16, 18 or other high risk types (31,33,35,39,45,51,52,56,58,59,66,68,73,53,82 &26). Statistics like sensitivity, specificity, predictive values and consistency (Kappa) were calculated to compare the concordance of assays.

Results

We found that the Gynius HPV solution is exceptionally easy to implement in laboratory settings within low- and middle-income countries (LMICs). It offers effective sampling control through color detection, making it highly suitable for self-sampling procedures. Additionally, the Gynius HPV solution includes an automated extraction system that completes full plate extraction in under 20 minutes.

The Gynius solution is compatible with various qPCR systems, eliminating the need for costly qPCR machine repurchases. Using lyophilized reagents, which can be stored and transported at room temperature, it bypasses the need for a cold chain and refrigeration.

The Gynius solution also has a high sample processing capacity. For instance, using the BioRad CFX96, it can produce up to 1,200 results per day per machine; with the BioRad CFX384, it can generate up to 4,000 results per day—making it ideal for large-scale screening.

In a comparison of 987 samples, high-risk HPV detection rates were consistent across all three tests: Roche (20%), Gynius liquid (23%), and Gynius lyophilized (21%). Concordance analysis showed high agreement rates, with both Gynius kits achieving over 80% compatibility with Roche for detecting HPV 16, 18, and other virus subtypes.

Conclusion

This study provides compelling evidence for the efficacy of the Gynius HPV kits (both lyophilized and liquid formulations), which demonstrated high concordance rates with established assays for detecting high-risk HPV genotypes, particularly HPV 16 and 18. Engineered specifically for low- and middle-income countries (LMICs), the Gynius HPV kits integrate innovative sampling and detection technologies optimized for resource-limited settings, facilitating seamless implementation. These findings indicate that Gynius HPV kits present a viable and scalable solution for cervical cancer screening programs, with the potential to significantly enhance early detection capabilities and broaden preventive care accessibility.