Xpert® HPV is not a useful screening tool for oral HPV among people living with HIV (PLHIV)

Abstract Background: Rapid diagnostic tests (RPTs) for high-risk HPV genotypes can help triage people living with HIV (PLHIV), who are at greater risk for oral cancers especially in low-and-middle-income-countries (LMICs), that have a high burden of both HIV and oral cancers. We evaluated the utility of Xpert® HPV, a RPT for oral HPV among PLHIV. Methods: We used data from 429 PLHIV receiving care at a tertiary care hospital affiliated antiretroviral therapy center in Pune, India. Oral HPV was evaluated using oral rinse samples. Samples were classified as usable (if they were successfully processed on Xpert® HPV) or not usable (if they were not successfully processed on Xpert® HPV). Factors associated with non-usability were evaluated using logistic regression. We compared the sensitivity and specificity of the Xpert® HPV for oral samples with conventional polymerase chain reaction (PCR). Results: The Xpert® HPV deemed almost a third (29.8%) of the oral samples not usable for oral HPV detection. We were unable to identify factors associated with non-usability. Compared to conventional polymerase chain reaction (PCR), the sensitivity of Xpert® HPV was 6.2% and specificity 100%, for detection of oral HPV. Conclusions: Xpert® HPV cannot be used for the detection of oral HPV among PLHIV presently. More research to optimize Xpert® HPV for oral samples is required.