The following is a summary of “Performance of Human Papillomavirus Attribution Algorithms to Predict Causative Genotypes in Anal High-Grade Lesions,” published in the June 2023 issue of Infectious Diseases by Phillips, et al.

For a study, researchers sought to compare different algorithms used to predict the fractions of anal high-grade squamous intraepithelial lesions (HSILs) attributed to human papillomavirus (HPV) genotypes in gay and bisexual men (GBM).

Data for the study were obtained from the Study of the Prevention of Anal Cancer Study. Anal swab samples from 160 participants were analyzed for baseline HPV genotypes, and anal HSILs (222 lesions) were determined through laser capture microdissection (LCM). The study included samples from GBM participants with available HPV genotype data and anal HSILs determined by LCM. Five algorithms (proportional, hierarchical, maximum, minimum, and maximum likelihood estimation) were compared. The HPV genotypes detected in the anal swab samples were compared to the HPV genotypes identified in the anal HSILs using LCM. The five algorithms were evaluated based on their ability to predict the fractions of HSILs attributed to specific HPV genotypes. Correlation analyses assessed the agreement between the algorithms and the LCM results.

All algorithms consistently identified HPV-16 as the most common genotype attributed to HSILs. However, the predicted proportions differed from each algorithm’s LCM detection rate (37.8%) (with differences of -6.1%, +20.9%, -20.4%, +2.9%, and +2.2%, respectively). The proportional algorithm showed a strong positive correlation with the LCM results, both overall (R = 0.73, P = .002) and when stratified by human immunodeficiency virus (HIV) status (HIV-positive: R = 0.74, P = .001; HIV-negative: R = 0.68, P = .005).

The algorithms tested in the study provided varying accuracy in predicting the fractions of HSILs attributed to specific HPV genotypes in GBM. Among the algorithms, the proportional method performed the best. However, due to the high prevalence of multiple HPV infections in GBM, these algorithms may have limited utility in accurately attributing HSILs to specific genotypes.

Source: academic.oup.com/jid/article-abstract/227/12/1407/6966960?redirectedFrom=fulltext