Cited by 22Cervical Cancer and HPV ResearchReproductive tract infections researchClinical Laboratory Practices and Quality Control

Comparison between the Roche Cobas 4800 Human Papillomavirus (HPV), Abbott RealTime High-Risk HPV, Seegene Anyplex II HPV28, and Novel Seegene Allplex HPV28 Assays for High-Risk HPV Detection and Genotyping in Mocked Self-Samples

Open access
Bell, Margo, Verberckmoes, Bo, Devolder, Janne, Vermandere, Heleen, Degomme, Olivier, Guimarães, Yasmin Medeiros, Godoy, Luani Rezende, Ambrosino, Elena +2 more·2023·Microbiology Spectrum

Abstract

This study proves that the novel Allplex HPV28 assay has a good diagnostic performance in comparison with the well-known, validated, and frequently used Roche Cobas 4800, Abbott RealTime, and Anyplex II HPV28 assays. According to our experience, the novel Allplex HPV28 assay had a user-friendly and automated workflow with short hands-on time, had an open platform which facilitates the use of add-on assays, and provided quick and easy-to-interpret results.

AI snapshot

Written from the paper’s full text.

TL;DR

In 114 mocked self-samples, the novel Seegene Allplex HPV28 assay showed high concordance with Roche Cobas 4800, Abbott RealTime HR HPV, and Seegene Anyplex II HPV28 for hrHPV detection and genotyping. Overall agreement was 85.9% under Abbott’s manufacturer cutoff and 91.2% under an adapted 32.00–36.00 cutoff.

Key findings

  • All four HPV assays agreed in 85.9% (98/114) of samples using the Abbott RealTime manufacturer’s Cq cutoff for positivity (<32.00), and in 91.2% (104/114) using an adapted Cq range (32.00–36.00).
  • Pairwise overall agreement ranged from 85.9% to 100.0% (κ = 0.42–1.00) with manufacturer guidelines and from 92.9% to 100.0% (κ = 0.60–1.00) with the adapted range. The lowest agreement was Roche Cobas vs Abbott RealTime (85.9%, κ = 0.42; adapted 92.9%, κ = 0.60), and the highest was Anyplex II HPV28 vs Allplex HPV28 (100%, κ = 1.00).
  • HPV positivity rates were 92.9% (106/114) for Roche Cobas, 78.9% (90/114) for Abbott RealTime, 88.6% (101/114) for Anyplex II HPV28, and 88.6% (101/114) for Allplex HPV28. Coinfections were detected in 4.7% to 6.9% of samples, with Anyplex II HPV28 detecting the highest number (6.9%).
  • Cq values of positive test results were strongly positively correlated across assays: r = 0.71, 0.73, and 0.78, all with P < 0.0001.

Methods

  • Cross-sectional study within the ELEVATE project; 114 participants with cervical cytology data were selected from Belgium (24), Brazil (29), Ecuador (41), and Portugal (20). Two mocked self-samples per participant were collected by gynecologists using Viba-Brush devices, rinsed in Hologic ThinPrep medium except in Ecuador, where Roche Cell Collection medium was used, and analyzed with Roche Cobas 4800, Abbott RealTime HR HPV, Anyplex II HPV28, and Allplex HPV28 qPCR assays.
  • Concordance was assessed by positive, negative, and overall percent agreement with Cohen’s kappa. Abbott RealTime results were analyzed using the manufacturer’s Cq cutoff (<32.00) and an adapted Cq range (32.00–36.00) for not-detected-but-amplified samples. Pearson correlation coefficients were calculated for Cq values, with negative samples assigned an arbitrary Cq of 45.0.

Limitations

  • Stated by the authors: no reference standard assay was available for mocked self-samples; results refer to agreement in the presence of hrHPV genotypes in general rather than specific genotypes, and discrepancies within specific genotypes could still occur (e.g., Table S1 for Anyplex and Allplex). The authors also state that Ecuador samples used Roche Cell Collection medium instead of Hologic ThinPrep, acknowledged as a possible performance-bias limitation.
  • Evident from the text: the samples were “mocked self-samples” collected by gynecologists rather than true self-collected specimens, and the study included only 114 selected samples balanced by location and cytology, which may limit generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1128/spectrum.00081-23

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

6 of 9 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Findingcitation

    Comparable to earlier research, HPV DNA positivity rates increased with higher cervical cytology grades for all included HPV assays.

    “Comparable to earlier research (14), the positivity rates of HPV DNA increased with higher cervical cytology grades for all included HPV assays.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Park Y, Lee E, Choi J, Jeong S, Kim HS. 2012. Comparison of the Abbott realtime high-risk human papillomavirus (HPV), Roche Cobas HPV, and Hybrid Capture 2 assays to direct sequencing and genotyping of HPV DNA. J Clin Microbiol 50: 2359– 2365. doi: 10.1128/JCM.00337-12. 22518863 PMC3405569 source
  • Findingown data

    No cervical cytology category other than cancer had a 100% HPV positivity rate for all HPV assays.

    “While all assays were able to detect HPV DNA in 100% of the cancer cytology samples, no other cervical cytology category had a 100% positivity rate for all HPV assays.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The NDBA phenomenon for the Abbott RealTime assay occurred frequently within the study's sample selection.

    “the not detected but amplified (NDBA) phenomenon for the Abbott RealTime assay, i.e., the event in which the assay reports samples to be negative despite showing an amplification curve with a Cq value higher than the manufacturer’s positivity cutoff (32.00), as described by earlier research of Kim and colleagues (21), also occurred frequently within our sample selection.”
    Quote in the paperSubstantial claim
  • Findingown data

    Of the 11 samples that initially showed discrepancies for the Abbott RealTime assay, 7 (63.6%) could be explained by a similar phenomenon with Cq value ≥32.00.

    “Of the 11 samples that initially showed discrepancies for the Abbott RealTime assay, 7 (63.6%) could be explained by a similar phenomenon as the one explained above (Cq value, ≥32.00).”
    Quote in the paperSubstantial claim
  • Findingown data

    For ASC-H cervical cytology, Abbott RealTime, Anyplex, and Allplex HPV28 assays showed reduced positivity rates compared with LSIL cytology.

    “For the ASC-H cervical cytology, however, the Abbott RealTime, Anyplex, and Allplex HPV28 assays demonstrated deviating results, indicating reduced positivity rates compared with LSIL cytology.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 5
  • May combine two claims. 8
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Roche Cobas 4800 assay is known for having relatively high sensitivity compared with other HPV assays.

    “as shown by multiple previous studies, the Roche Cobas 4800 assay is known for having a relatively high sensitivity compared with other HPV assays (12, 13, 17).”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [12] Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on Self-Sampling and HPV Testing. 2018. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ 363: k4823. doi: 10.1136/bmj.k4823. 30518635 PMC6278587 source

      The Results (Accuracy of hrHPV assay; page unavailable) report high pooled sensitivity for PCR-based HPV assays and lower sensitivity for signal-amplification assays on self samples. The paper does not give a Cobas 4800-specific sensitivity estimate or establish that Cobas is more sensitive than other HPV assays; Cobas 4800 appears in a reference title. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
    • cites [13] Cuzick J, Cadman L, Mesher D, Austin J, Ashdown-Barr L, Ho L, Terry G, Liddle S, Wright C, Lyons D, Szarewski A. 2013. Comparing the performance of six human papillomavirus tests in a screening population. Br J Cancer 108: 908– 913. doi: 10.1038/bjc.2013.22. 23370211 PMC3590662 source
    • cites [17] Ouh YT, Park JJ, Kang M, Kim M, Song JY, Shin SJ, Shim SH, Yoo HJ, Lee M, Lee SJ, Shin W, Chong GO, Choi MC, Choi CH, Min KJ. 2022. Comparative performance of various human papillomavirus assays available in Korea for detecting cervical intraepithelial neoplasia. J Obstet Gynaecol Res 48: 207– 214. doi: 10.1111/jog.15078. 34713538 source
  • Classified as probably not a substantial claim.

    Interpretationown data

    The study supports the conclusion that manufacturer's Cq cutoffs for positivity in HPV assays should always be handled with caution, especially when performing research within different age categories, socioeconomic settings, or types of (self-)sampling.

    “our study supports the assumption of other previous studies which concluded that the, often for specific circumstances validated and optimized, manufacturer’s Cq cutoffs for positivity in HPV assays should always be handled with caution, especially when performing research within different age categories (23), socioeconomic”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites [23] Kang LN, Jeronimo J, Qiao YL, Zhao FH, Chen W, Valdez M, Zhang X, Bansil P, Paul P, Bai P, Peck R, Li J, Chen F, Stoler MH, Castle PE. 2014. Optimal positive cutoff points for careHPV testing of clinician- and self-collected specimens in primary cervical cancer screening: an analysis from rural China. J Clin Microbiol 52: 1954– 1961. doi: 10.1128/JCM.03432-13. 24671789 PMC4042749 source

      The Discussion says the manufacturer-set careHPV threshold warrants consideration and recommends different cutoffs for clinician- and self-collected specimens. It also says the study could not adequately assess age-specific cutoffs. The paper uses relative light units/cutoff ratios, not Cq cutoffs, and does not establish that manufacturer cutoffs for HPV assays should always be treated cautiously across socioeconomic settings. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [24] Kuhn L, Saidu R, Boa R, Tergas A, Moodley J, Persing D, Campbell S, Tsai WY, Wright TC, Denny L. 2020. Clinical evaluation of modifications to a human papillomavirus assay to optimise its utility for cervical cancer screening in low-resource settings: a diagnostic accuracy study. Lancet Glob Health 8: e296– e304. doi: 10.1016/S2214-109X(19)30527-3. 31981559 PMC8720235 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [25] Sargent A, Fletcher S, Bray K, Kitchener HC, Crosbie EJ. 2019. Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. BMJ Open 9: e025388. doi: 10.1136/bmjopen-2018-025388. PMC6502061 31036707 source

      The Discussion (page unavailable) says more work is needed to define clinically useful viral-load thresholds for urine testing, which supports some caution when applying assay thresholds to a different sample type. But it also says the manufacturer’s cut-offs appeared appropriate for the urine samples studied. The paper does not assess whether cut-offs require particular caution across age categories or socioeconomic settings, so it does not support the claim’s broader conclusion. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • May combine two claims.

    Findingown data

    Among samples positive with all HPV assays using the manufacturer's cutoff, 12 were positive for HPV16, 7 for HPV18, and 71 for other hrHPV genotypes.

    “Among the samples found positive with all HPV assays, 12 samples were positive for HPV16, 7 samples were positive for HPV18, and 71 samples tested positive for other hrHPV genotypes.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    For all assays, Cq values of positive test results were strongly positively correlated (r = 0.71, 0.73, 0.78) and statistically significant (P < 0.0001).

    “For all assays, highly significant, strongly positive Pearson correlations were shown between the Cq values of positive test results.”
    • Also stated in: § Pearson correlation between Cq values of the HPV assays. · boosted
      “All Cq values of the different HPV assays were demonstrated to be strongly and positively correlated (r values of 0.71, 0.73, and 0.78) and statistically significant (all P values are <0.0001).”
    • Also stated in: § Pearson correlation between Cq values of the HPV assays. · hedged
      “Graphs visualize a significant Pearson’s correlation between the Cq values of all qPCR HPV assays (r = 0.71, P < 0.001; r = 0.78, P < 0.001; 0.73, P < 0.001), indicating a strongly positive relationship.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The Roche Cobas assay showed the highest overall HPV positivity rate, with 100% positivity for all cytology categories apart from normal and ASC-US cytology.

    “The Roche Cobas assay overall showed the highest positivity rate, with 100% HPV positivity for all cytology categories, apart from normal and ASC-US cytology.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Overall HPV DNA positivity rates in the study ranged between 78.9% and 92.9% (mean 87.3%), with the highest positivity rate for Roche Cobas.

    “Overall, HPV DNA positivity rates within our study ranged between 78.9% and 92.9% (mean positivity rate of 87.3%), with the highest positivity rate detected for the Roche Cobas HPV assay.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Roche Cobas detected all positive ASC-H cases (n=17), while Anyplex and Allplex each missed one case and Abbott RealTime missed three.

    “While the Roche Cobas assay detected all positive cases (n = 17) of ASC-H cervical cytology, the Anyplex and Allplex HPV28 assays both missed one case and the Abbott RealTime missed three.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Discordances between Anyplex II HPV28 and Allplex HPV28 were present for hrHPV genotypes 51, 52, and 59, with Anyplex detecting 9, 13, and 10 samples and Allplex detecting 10, 14, and 12 samples, respectively.

    “Discordances were present for hrHPV genotypes 51, 52, and 59, with the Anyplex II HPV28 assay detecting 9, 13, and 10 samples, respectively, and the Allplex HPV28 assay detecting 10, 14, and 12 samples, respectively (see Table S1 in the supplemental material).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Anyplex and Allplex HPV28 assays demonstrated perfect agreement for the "other" hrHPV genotypes, but discrepancies within these genotypes were observed.

    “Although the Anyplex and Allplex HPV28 assays demonstrate a perfect agreement in the examination of the results for the “other” hrHPV genotypes, discrepancies within these other hrHPV genotypes could be observed.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Using the manufacturer's cutoff, 5 (4.4%) samples tested positive by Roche Cobas but negative with the other HPV assays, and 11 (9.7%) samples were positive by all HPV assays except Abbott RealTime.

    “Moreover, 5 (4.4%) samples tested positive by the Roche Cobas HPV assay but negative with the other HPV assays and 11 (9.7%) samples were positive by all HPV assays, except for the Abbott RealTime HR HPV assay.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Kim and colleagues suggested that NDBA samples should be regarded as equivocal, not negative, because they could indicate low-copy hrHPV.

    “Kim and colleagues (21) suggested that samples NDBA should be regarded as equivocal, not negative, considering that they could be a sign of a low-copy presence of hrHPV.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kim and colleagues (21)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Results found within the study refer to agreement in the presence of hrHPV genotypes in general (HPV16, HPV18, and other hrHPVs), rather than to specific genotypes.

    “results found within our study refer to the agreement in the presence of hrHPV genotypes in general (HPV16, HPV18, and other hrHPVs), rather than of specific genotypes.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The origin-specific use of preservation medium (Roche Cell Collection medium in Ecuador instead of Hologic ThinPrep medium) results in a minimal chance of performance bias because of potential increased or decreased compatibility with a specific HPV assay.

    “As this origin-specific use of preservation medium results in a minimal chance of performance bias because of potential increased or decreased compatibility with a specific HPV assay, we acknowledge this as a limitation of our study.”
    Quote in the paperNot a substantial claim
13 of 13
  • The paper relies on this without support.

    No published studies have compared the Allplex HPV28 assay with commercially available HPV assays.

    “Interestingly, considering the novelty of the Allplex 28 HPV assay, no published studies have compared this assay with commercially available HPV assays.”
  • The paper relies on this without support.

    This is the first study to compare the performances of these HPV assays with that of the novel Allplex HPV28 assay.

    “However, to the best of our knowledge, this is the first study to compare the performances of these HPV assays with that of the novel Allplex HPV28 assay.”
  • The paper relies on this without support.

    Mocked self-samples (semicervical samples collected by gynecologists using the Viba-Brush) are representative of actual self-samples for HPV assay comparison.

    “A total of 114 mocked self-samples, i.e., semicervical samples collected by gynecologists using the Viba-Brush, were analyzed with all four HPV assays.”
  • The paper relies on this without support.

    Agreement with the comparator HPV assays indicates good diagnostic performance.

    “This study proves that the novel Allplex HPV28 assay has a good diagnostic performance in comparison with the well-known, validated, and frequently used Roche Cobas 4800, Abbott RealTime, and Anyplex II HPV28 assays.”
  • The paper relies on this without support.

    No reference standard assay for the use of mocked self-samples was available.

    “As no reference standard assay for the use of mocked self-samples was available, concordance in terms of detecting and genotyping (HPV16, HPV18, and other hrHPV) HPV among the four different HPV assays was assessed by the positive percent agreement, the negative percent agreement, and the overall percent agreement with Cohen’s kappa score calculation.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A previous study by Bell M. et al. demonstrated a high concordance between the Allplex HPV28 and Anyplex II HPV28 assays in mocked self-samples (100% concordance, K = 1.00, analysis performed on the 14 HPV types included in set A).

    “Our results are in line with a previous study conducted by Bell M. et al., demonstrating a high concordance between the AllplexTM HPV28 and AnyplexTM II HPV28 assays in mocked self-samples (100% concordance, K = 1.00, analysis performed on the 14 HPV types included in set A) [19].”

    From Comparative evaluation of Allplex HPV28 and Anyplex II HPV28 assays for high-risk HPV genotyping in cervical samples (2025) · cites this paper as [19]

    The Results section, ‘Concordance for detecting any hrHPV genotype’ (page unavailable), reports 100% agreement and κ = 1.00 between Anyplex and Allplex in mocked self-samples. However, the Methods section, ‘Data analysis’ (page unavailable), says the comparison grouped high-risk genotypes other than HPV16 and HPV18; the paper does not identify this as a ‘set A’ analysis of 14 individual types. The Results also note discrepancies for individual genotypes 51, 52, and 59. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Recent data report a slightly higher detection rate of multiple HPV infections using the Anyplex II HPV28 assay compared with the Allplex HPV28 assay.

    “This observation aligns with recent data reporting a slightly higher detection rate of multiple HPV infections using the AnyplexTM II HPV28 assay compared with the AllplexTM HPV28 assay [19].”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Adapted-cutoff Roche-Abbott agreement conflicts with Table 5

    Major

    In Table 5, Roche and Abbott agree for the 8 jointly negative samples, the 96 samples positive by all assays, and the 1 sample positive by Roche and Abbott only: 105 of 114, or 92.1%. Table 7 instead reports 92.9%.

  • Adapted-cutoff Abbott-Seegene agreement conflicts with Table 5

    Major

    Table 5 gives 96 jointly positive and 13 jointly negative Abbott-Seegene results, for 109 agreements among 114 samples (95.6%). Table 7 reports 96.5% for Abbott against either Seegene assay.

  • Text understates the remaining Abbott-negative discrepancies

    Minor

    The text describes five samples that remained Abbott-negative while positive by another assay. Table 5 lists nine such samples: five positive by Roche alone and four positive by Roche and both Seegene assays.

  • Table 5 loses a Seegene-positive sample

    Minor

    Table 5 has 96 samples positive by all assays and 4 positive by both Seegene assays but negative by Abbott, giving 100 Seegene-positive samples. Table 3 reports 101 for each Seegene assay, although the adapted cutoff changes only Abbott results.

4 of 4

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Authors
Bell, M., Verberckmoes, B., Devolder, J., Vermandere, H., Degomme, O., Guimarães, Y. M., Godoy, L. R., Ambrosino, E., Cools, P., & Padalko, E.
Affiliations
  • Ghent University (BE)
  • Ghent University Hospital (BE)
  • Hospital de Câncer de Barretos (BR)
  • Maastricht University (NL)
Corresponding author
Vermandere, Heleen
Venue
Microbiology Spectrum
Published
2023-08-17
Volume
11
Issue
4
Pages
e0008123-e0008123
ISSN
2165-0497 (ISSN-L)
OpenAlex
W4379598348
Cited by
22
References
24
Citations by year
2026: 6 · 2025: 10 · 2024: 5 · 2023: 1
FWCI
3.67
Type
journal article
Language
en
Open access
Locations
  • Microbiology Spectrum (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
  • PubMed Central (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
EC | Horizon 2020 Framework Programme (825747)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Keywords
human papillomavirus, high-risk HPV detection, HPV genotyping, self-collected samples, assay comparison, diagnostic performance
MeSH terms
Human Papillomavirus Viruses, Female, Genotype, Humans, Sensitivity and Specificity, Molecular Diagnostic Techniques, Papillomaviridae, Papillomavirus Infections, Alphapapillomavirus

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