Application of Cobas 6800 HPV testing and qPCR utilizing three genomically-optimized primer sets for detecting HPV DNA in the blood of HPV Positive dysplasia and cancer patients

Use of quantitative polymerase chain reaction (qPCR) to measure viral DNA in plasma has promise for the detection and/or monitoring of high-risk human papillomavirus (hrHPV)-associated cancers. We examined Roche's cobas 6800 HPV test for detection of hrHPV in plasma or peripheral blood mononuclear cells (PBMC) of patients with HPV-associated dysplasia or cancer. In our pilot study, this assay detected hrHPV DNA in 1 mL pre-treatment plasma of patients with advanced (stage II-IV) cervical cancer, but not stage I or dysplasia cases, or in PBMC. Plasma of oropharyngeal cancer patients also tested positive in most cases. Seeking to enhance sensitivity, we re-tested these pilot samples with qPCR employing three published primer sets (E7, BR E1-5, HR E5L2-4) selected for improved detection of HPV16 in cancer. This triplex assay detected quantifiable levels of HPV16 in pre-treatment plasma of advanced (stage II-IV) cervical cancer cases, and lower levels in some stage I and dysplasia cases. In serial sampling of HPV16 + cervical cancer patients post-treatment with no evidence of disease over ~2 years, no reproducible signal was detected by cobas HPV testing, whereas the triplex qPCR sporadically detected HPV DNA in plasma and PBMC samples of a subset of these patients.