{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:08:13Z","timestamp":1779368893070,"version":"3.53.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cervical cancer is the fourth most common cancer among women worldwide, with higher prevalence in low\u2010resource countries due to limited access to screening and HPV vaccination. Nucleic acid amplification tests (NAATs) such as Xpert HPV (Cepheid), enable rapid detection of high\u2010risk HPV (HR\u2010HPV) genotypes. However, the clinical significance of weak and late amplification signals (cycle threshold \u2265\u200938), interpreted as negative, remains unclear. In this study, a comparison with cytological results aimed to assess their significance. Out of 6846 cervical samples analyzed at Brest University Hospital (Jan. 2022\u2013June 2024), 45 showed late amplification and were reported negative by Xpert. These samples were retested using an in\u2010house HPV pangenotypic PCR followed by genotyping (LiPA) and were assessed by cytology. Of the 44 available cytology results, 65.9% were normal, 15.9% showed low\u2010grade squamous intraepithelial lesions (LSIL), and 18.2% were atypical squamous cells of undetermined significance (ASC\u2010US). No high\u2010grade squamous intraepithelial lesions (HSIL) were found at initial cytology. Among the 42 samples available for in\u2010house PCR, 59.5% tested positive for HPV, and 11.9% were confirmed as HR\u2010HPV genotypes (types 52, 56, 35). Additionally, among patients with available HPV history, 73.3% had a previous positive test. In 91% of these cases, the genotype suspected during the late amplification was concordant with the previous infection. During the 1\u2010year follow\u2010up, one patient initially classified as LSIL developed a histologically confirmed HSIL (CIN2) and needed treatment by conization, whereas 3 others were found to have low\u2010grade CIN1 cell lesions. Overall, for 15 out of 45 patients with weak HPV PCR signal and abnormal cytology (33.3%), clinicians chose to recommend a closer 1\u2010year follow\u2010up and not at 5 years as recommended for HPV negative patients. In conclusion, cytological triage and a review of patient history remain crucial to avoid missing at\u2010risk patients, especially in settings where HPV\u2010negative women are re\u2010screened only 5 years later. A multicenter study using Xpert HPV and other automated platforms is recommended to strengthen these findings and further explore potential correlations between viral load and clinical severity.<\/jats:p>","DOI":"10.1002\/jmv.70915","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T07:18:07Z","timestamp":1776237487000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Negative Xpert HPV Test (Cepheid) With Late Amplification Signals: Is There a Clinical Significance? (the PaPCR Study)"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4087-3075","authenticated-orcid":false,"given":"Valentin","family":"Lemoine","sequence":"first","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"},{"name":"Present address: Laboratory of Bacteriology and Hospital Hygiene University Hospital of Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3599-2475","authenticated-orcid":false,"given":"Romain","family":"Legros","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"},{"name":"G\u00e9n\u00e9tique, G\u00e9nomique fonctionnelle et Biotechnologies (UMR 1078), Inserm Universit\u00e9 de Bretagne Occidentale Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Rosec","sequence":"additional","affiliation":[{"name":"Clinical Investigation Center (CIC 1412) Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Salaun","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adissa","family":"Tran\u2010Minoui","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8154-6579","authenticated-orcid":false,"given":"L\u00e9a","family":"Pilorg\u00e9","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-4247","authenticated-orcid":false,"given":"Sophie","family":"Vallet","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"},{"name":"G\u00e9n\u00e9tique, G\u00e9nomique fonctionnelle et Biotechnologies (UMR 1078), Inserm Universit\u00e9 de Bretagne Occidentale Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Le Gourrierec","sequence":"additional","affiliation":[{"name":"Gynecology unit Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Alemany","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology and Cytology Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Marcorelles","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology and Cytology Brest University Hospital Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7321-4593","authenticated-orcid":false,"given":"Christopher","family":"Payan","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Laboratory of Virology Brest University Hospital Brest Bretagne France"},{"name":"G\u00e9n\u00e9tique, G\u00e9nomique fonctionnelle et Biotechnologies (UMR 1078), Inserm Universit\u00e9 de Bretagne Occidentale Brest Bretagne France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"WHO. Cervical cancer accessed August 9 2024 https:\/\/www.who.int\/fr\/news-room\/fact-sheets\/detail\/cervical-cancer."},{"key":"e_1_2_14_3_1","unstructured":"NIH. Cervical Cancer Causes Risk Factors and Prevention accessed September 14 2025 https:\/\/www.cancer.gov\/types\/cervical\/causes-risk-prevention."},{"key":"e_1_2_14_4_1","unstructured":"IARC. Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. World Health Organization International Agency for Research on Cancer; 2007."},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70230-8"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-024-02083-w"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24010"},{"key":"e_1_2_14_8_1","unstructured":"HAS. Evaluation of Human Papillomavirus (HPV) Tests for Primary Screening of Precancerous and Cancerous Lesions of the Cervix and the Role of P16\/Ki67 Dual Immunostaining. 2019:4 accessed August 12 2025 https:\/\/www.has-sante.fr\/upload\/docs\/application\/pdf\/2019-09\/synthese_anglais_hpv.pdf."},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/509622"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.21955"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2024.105657"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.606335"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.70482"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29465"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1099\/jgv.0.001374"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12081855"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02022-06"},{"key":"e_1_2_14_18_1","unstructured":"Cepheid. 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