{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:01:00Z","timestamp":1791381660578,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Cervical cancer screening coverage in low\u2010 and middle\u2010income countries is low, and many screened women are lost to follow\u2010up. Point\u2010of\u2010care testing that allows same\u2010day treatment could reduce the incidence of this cancer, but same\u2010day triage testing is required to prevent overtreatment and minimise loss\u2010to\u2010follow\u2010up before treatment. Built\u2010in extended genotyping with the Xpert\u00ae human papilloma virus (HPV) assay offers point\u2010of\u2010care triage, but treatment thresholds differ. We calculated test performance of the Xpert\u00ae HPV assay for HIV\u2010positive and HIV\u2010negative women. Extended HPV\u2010genotyping was evaluated against histology and missing values were imputed to correct for verification bias. We report test performance at different thresholds, namely Top3 (HPV16, 18, 45), Top8 (HPV16, 18, 45, 31, 33, 35, 52, 58) and Top14 (HPV16, 18, 45, 31, 33, 35, 52, 58, 51, 59, 39, 56, 66, 68) hierarchical viral types. Included were 1063 participants, aged 25\u201365 years, mean age 41.2 years; 42.7% were HIV\u2010positive. HIV\u2010positive women were significantly more likely to test positive on multiple test channels and were more likely to have histology proven disease. Screening only for Top3, sensitivity (CIN3+) was 31.3%\/41.5%, and specificity (CIN2+) 97.0%\/95.6% for HIV\u2010negative\/HIV\u2010positive women respectively. Top8 rendered results of 57.8%\/76.4% and 91.8%\/84.6% respectively, which is acceptable for a triage test. Treatment at the threshold of Top8 types requires less than three referrals among all HIV\u2010groups for one case of histology proven disease. Results confirmed screening for all 14 high\u2010risk HPV types is most sensitive but necessitates triage. Extended genotyping using a threshold of Top8 oncogenic types rendered best balance of sensitivity and specificity and overall test performance for both HIV\u2010groups in a test\u2010and\u2010treat strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>The study was registered as Trial ID NCT02956031 on ClinicalTrials. gov.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmv.70981","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:11:25Z","timestamp":1779455485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extended Genotyping as Triage of HPV Positive Screened Women in Low\u2010and\u2010Middle Income Countries"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1486-7030","authenticated-orcid":false,"given":"Frederick H.","family":"van der Merwe","sequence":"first","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-8408","authenticated-orcid":false,"given":"Greta","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2873-460X","authenticated-orcid":false,"given":"Cathy","family":"Visser","sequence":"additional","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerrit J.","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0526-9215","authenticated-orcid":false,"given":"Karin","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Medical Virology University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7502-2867","authenticated-orcid":false,"given":"Leon C.","family":"Snyman","sequence":"additional","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-5054","authenticated-orcid":false,"given":"Robyn","family":"Adams","sequence":"additional","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6046-1453","authenticated-orcid":false,"given":"Matthys H.","family":"Botha","sequence":"additional","affiliation":[{"name":"Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00241-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-3-11"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.07.019"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo"},{"key":"e_1_2_12_7_1","volume-title":"WHO Guideline for Screening and Treatment of Cervical Pre\u2010cancer Lesions for Cervical Cancer Prevention, Second Edition","author":"World Health Organization","year":"2021"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2024.09.003"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12732"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29250"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29353"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2018.10.009"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-024-00586-3"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-052504"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002325"},{"key":"e_1_2_12_16_1","unstructured":"I. 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