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Bartosik M, Moranova L, Izadi N, Strmiskova J, Sebuyoya R, Holcakova J, Hrstka R. Advanced technologies towards improved HPV diagnostics. J Med Virol 2024; 96:e29409. [PMID: 38293790 DOI: 10.1002/jmv.29409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
Persistent infection with high-risk types of human papillomaviruses (HPV) is a major cause of cervical cancer, and an important factor in other malignancies, for example, head and neck cancer. Despite recent progress in screening and vaccination, the incidence and mortality are still relatively high, especially in low-income countries. The mortality and financial burden associated with the treatment could be decreased if a simple, rapid, and inexpensive technology for HPV testing becomes available, targeting individuals for further monitoring with increased risk of developing cancer. Commercial HPV tests available in the market are often relatively expensive, time-consuming, and require sophisticated instrumentation, which limits their more widespread utilization. To address these challenges, novel technologies are being implemented also for HPV diagnostics that include for example, isothermal amplification techniques, lateral flow assays, CRISPR-Cas-based systems, as well as microfluidics, paperfluidics and lab-on-a-chip devices, ideal for point-of-care testing in decentralized settings. In this review, we first evaluate current commercial HPV tests, followed by a description of advanced technologies, explanation of their principles, critical evaluation of their strengths and weaknesses, and suggestions for their possible implementation into medical diagnostics.
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Affiliation(s)
- Martin Bartosik
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ludmila Moranova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Nasim Izadi
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Johana Strmiskova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Ravery Sebuyoya
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Jitka Holcakova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Roman Hrstka
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
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2
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Bober P, Firment P, Sabo J. Diagnostic Test Accuracy of First-Void Urine Human Papillomaviruses for Presence Cervical HPV in Women: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413314. [PMID: 34948919 PMCID: PMC8708158 DOI: 10.3390/ijerph182413314] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 01/07/2023]
Abstract
First-void urine usually contains exfoliated cells of the debris and mucus from the female genital organs and cervix, i.e., high concentration of human papillomavirus deoxyribonucleic acid (HPV DNA). We conducted a meta-analysis of published data and determined an accuracy of HPV detection in first-void urine compared to the women’s cervix. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we carried out a comprehensive literature search. Eligible articles published from 2011 until 2021 were gathered by searching Embase, PubMed and Cochrane Library Central databases. The patient selection, index test, standard test, and patient flow were the factors involved in quality evaluation. A meta-analysis of 15 studies (3412 women) based on 5054 potential records was conducted. Pooled sensitivity for high-risk HPV detection in urine of 78% (70–84%) and specificity of 89% (81–94%) were calculated. Any HPV detection in urine of 87% (74–94%) and 91% (83–96%) were pooled sensitivity and specificity, respectively. HPV 16 and 18 had a pooled sensitivity of 77% (76–77%) and specificity of 98% (98–98%). Meta-analysis indicated variations between the pooled specificities and sensitivities. In meta-regression analysis, a heterogeneity in accuracy by using covariates (bias in patient selection, purpose, sample timing, storage temperature and HPV detection method) were not detected. Our meta-analysis demonstrates the accuracy of detection of HPV in urine for the presence of cervical HPV. Although progress is continuously made in urinary HPV detection, further studies are needed to evaluate and to improve the accuracy of the first-void urine test in order to be comparable with other screening methods.
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Affiliation(s)
- Peter Bober
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P.J. Šafárik in Košice, Trieda SNP 1, 04011 Košice, Slovakia;
- Correspondence:
| | - Peter Firment
- Department of Anaesthesiology and Intensive Medicine, FNsP J. A. Reimana Prešov, Jána Hollého 5898/14, 08181 Prešov, Slovakia;
| | - Ján Sabo
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P.J. Šafárik in Košice, Trieda SNP 1, 04011 Košice, Slovakia;
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Hernández-López R, Hermosillo L, León-Maldonado L, Velázquez-Cruz R, Torres-Ibarra L, Lazcano-Ponce E, Lörincz A, Wheeler CM, Bosch FX, Cuzick J, Rivera-Paredez B, Nedjai B, Salmerón J. Performance of an affordable urine self-sampling method for human papillomavirus detection in Mexican women. PLoS One 2021; 16:e0254946. [PMID: 34288949 PMCID: PMC8294492 DOI: 10.1371/journal.pone.0254946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/06/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Urine self-sampling for human papillomavirus (HPV)-based cervical cancer screening is a non-invasive method that offers several logistical advantages and high acceptability, reducing barriers related to low screening coverage. This study developed and evaluated the performance of a low-cost urine self-sampling method for HPV-testing and explored the acceptability and feasibility of potential implementation of this alternative in routine screening. METHODS A series of sequential laboratory assays examined the impact of several pre-analytical conditions for obtaining DNA from urine and subsequent HPV detection. Initially, we assessed the effect of ethylaminediaminetetraacetic acid (EDTA) as a DNA preservative examining several variables including EDTA concentration, specimen storage temperature, time between urine collection and DNA extraction, and first-morning micturition versus convenience sample collection. We further evaluated the agreement of HPV-testing between urine and clinician-collected cervical samples among 95 women. Finally, we explored the costs of self-sampling supplies as well as the acceptability and feasibility of urine self-sampling among women and healthcare workers. RESULTS Our results revealed higher DNA concentrations were obtained when using a 40mM EDTA solution, storing specimens at 25°C and extracting DNA within 72 hrs. of urine collection, regardless of using first-morning micturition or a convenience sampling. We observed good agreement (Kappa = 0.72) between urine and clinician-collected cervical samples for HPV detection. Furthermore, urine self-sampling was an affordable method (USD 1.10), well accepted among cervical cancer screening users, healthcare workers, and decision-makers. CONCLUSION These results suggest urine self-sampling is feasible and appropriate alternative for HPV-testing in HPV-based screening programs in lower-resource contexts.
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Affiliation(s)
- Rubí Hernández-López
- Oficina de Análisis del Plan de Salud, Subgerencia Técnica del Plan de Salud, Gerencia de Administración del Plan de Salud, Banco de México, Mexico City, Mexico
| | - Luis Hermosillo
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Leith León-Maldonado
- Consejo Nacional de Ciencia y Tecnología-Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Rafael Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Attila Lörincz
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Cosette M. Wheeler
- Department of Pathology and Obstetrics & Gynecology, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, United States of America
| | - F. Xavier Bosch
- Unit of Infections and Cancer—Information and Interventions, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)—IDIBELL, l’Hospitalet de Llobregat, Open University of Catalonia, Barcelona, Spain
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Berenice Rivera-Paredez
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Belinda Nedjai
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Jorge Salmerón
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Torres-Rojas FI, Mendoza-Catalán MA, Alarcón-Romero LDC, Parra-Rojas I, Paredes-Solís S, Leyva-Vázquez MA, Cortes-Arciniega JE, Bracamontes-Benítez CJ, Illades-Aguiar B. HPV molecular detection from urine versus cervical samples: an alternative for HPV screening in indigenous populations. PeerJ 2021; 9:e11564. [PMID: 34178456 PMCID: PMC8214846 DOI: 10.7717/peerj.11564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background Cervical cancer (CC) is the fourth leading cause of death from neoplasms in women and is caused by the human papilloma virus (HPV). Several methods have been developed for the screening of cervical lesions and HPV; however, some socio-cultural factors prevent women from undergoing gynecological inspection, which results in a higher risk of mortality from cervical cancer in certain population groups as indigenous communities. This study aimed to compare the concordance in HPV detection from urine and cervical samples, to propose an alternative to cervical scraping, which is commonly used in the cervical cancer screening. Methodology The DNA from cervical scrapings and urine samples was extracted using the proteinase K method followed by precipitation with alcohol, phenol andchloroform; a modification of the proteinase K method was developed in the management of urine sediment. Viral genotyping was performed using INNOLipa. Results The study population consisted of 108 patients from an indigenous population at southern Mexico, 32 without squamous intraepithelial lesions (NSIL) and 76 with low squamous intraepithelial lesions (LSIL). The majority of NSIL cervical scrapes were negative for HPV (90.63%), whereas more than half of LSIL cases were high-risk HPV positive (51.32%), followed by multiple infection by HR-HPV (17.11%), and multiple infection by LR- and HR-HPV (9.21%). No statistically significant relationship between the cytological diagnosis and the HPV genotypes detected in the urine samples was observed. A concordance of 68.27% for HPV positivity from urine and cervical samples was observed. Similarly, a concordance of 64.52% was observed in the grouping of HPVs by oncogenic risk. HR-HPV was detected in 71% of the urine samples from women with LSIL diagnosis, which suggests that HR-HPV detected in a urine sample could indicate the presence or risk of developing SIL. Conclusion HR-HPV detection in urine samples could be an initial approach for women at risk of developing LSIL and who, for cultural reasons, refuse to undergo a gynecological inspection.
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Affiliation(s)
- Francisco I Torres-Rojas
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Miguel A Mendoza-Catalán
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Luz Del C Alarcón-Romero
- Laboratorio de Citopatología e Histoquímica. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Isela Parra-Rojas
- Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Marco A Leyva-Vázquez
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Jair E Cortes-Arciniega
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Carlos J Bracamontes-Benítez
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Berenice Illades-Aguiar
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
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HPV Type-Specific Prevalence a Decade after the Implementation of the Vaccination Program: Results from a Pilot Study. Vaccines (Basel) 2021; 9:vaccines9040336. [PMID: 33916132 PMCID: PMC8066234 DOI: 10.3390/vaccines9040336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 12/04/2022] Open
Abstract
Human papillomavirus infection is a cause of the development of invasive cervical cancer. Three types of vaccine are currently available to prevent precancerous/cancerous lesions due to persistent infection, which is supported mainly by 7 different high-risk genotypes. The aim of this pilot study was to acquire preliminary data on type-specific prevalence 10 years after the implementation of the HPV vaccination program in Italy, in order to subsequently plan appropriate observational studies in the Italian population. First-voided urine samples were collected from 393 consenting subjects, both females and males, aged 18–40 years, and HPV DNA was detected by PCR amplification of a 450 bp L1 fragment. All amplified products were genotyped by means of the Restriction Fragment Length Polymorphism (RFLP) method. The female population was divided into three cohorts (“vaccine-eligible”, “pre-screening” and “screening” cohorts) according to the preventive intervention scheduled by age; males were included in the same three cohorts according to their year of birth. The overall prevalence of HPV infection was 19%, being higher in females than in males (22.1% vs. 13.6%, p = 0.03729). In the female population, 10 years after the start of the national immunization program, we observed a reduction in the prevalence of vaccine types and the number of circulating genotypes, especially in the “vaccine-eligible” cohort. The frequency of HPV vaccine types increased with age, particularly in males in the “pre-screening” and “screening” cohorts. Our study highlights the importance of monitoring HPV infection in both genders, to validate the effect of the HPV vaccination program.
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Kuriakose S, Sabeena S, Damodaran B, Ravishankar N, Ramachandran A, Ameen N. Comparison of two self-sampling methods for human papillomavirus (HPV) DNA testing among women with high prevalence rates. J Med Virol 2020; 92:3884-3888. [PMID: 32436997 DOI: 10.1002/jmv.26043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/10/2022]
Abstract
One major advantage of molecular assays for human papillomavirus (HPV) DNA detection is that these assays can be performed on self-collected samples unlike cytology or visual inspection with acetic acid (VIA). This cross-sectional study was carried out between March 2017 and April 2019 to compare the diagnostic performance in self-collected urine and vaginal samples for HPV DNA detection. Viral DNA was extracted from processed samples using a Qiagen viral DNA extraction Kit (QIAamp DNA Mini Kit). To detect four common high-risk HPV types (16, 18, 31, 45), multiplex real-time polymerase chain reaction (PCR) targeting the LCR/E6/E7 region of the HPV genome was performed in ABI 7500 cycler (Applied Biosystems). The negative samples were screened by conventional PCR targeting the L1 capsid region to exclude other HPV types. The overall agreement between the two self-collecting sampling methods was 64.04% with a κ value of 0.29 pointing towards a fair agreement (P < .01). The sensitivity of HPV DNA detection in urine samples was 57.95% (47.52%, 67.72), and specificity was 84.6% (66.47%, 93.85%) when compared with vaginal samples. The study concludes that self-collected vaginal HPV DNA testing is more sensitive than unpreserved-urine samples for HPV DNA detection in a hospital-based setting.
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Affiliation(s)
- Santhosh Kuriakose
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | | | - Binesh Damodaran
- Department of Radiation Oncology, Government Medical College, Kozhikode, Kerala, India
| | - N Ravishankar
- Department of Data Science, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Amrutha Ramachandran
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Nurul Ameen
- Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
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Shin HY, Lee B, Hwang SH, Lee DO, Sung NY, Park JY, Jun JK. Evaluation of satisfaction with three different cervical cancer screening modalities: clinician-collected Pap test vs. HPV test by self-sampling vs. HPV test by urine sampling. J Gynecol Oncol 2020; 30:e76. [PMID: 31328458 PMCID: PMC6658592 DOI: 10.3802/jgo.2019.30.e76] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 02/23/2019] [Accepted: 03/05/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Human papillomavirus testing by self-sampling and urine sampling might be alternatives to Papanicolaou test (Pap test) for cervical cancer screening (CCS), and may increase compliance and adherence thereto. The present study aimed to explore satisfaction and preferences for cervical screening modalities among Korean women. METHODS In total, 732 women aged between 20 and 69 years responded to a questionnaire designed to survey the women's perceived satisfaction for the 3 CCS modalities: clinician-collected Pap test, self-collected vaginal sampling (self-sampling) and urine sampling. RESULTS Overall satisfaction was significantly higher with both the self-sampling and urine sampling than the clinician-collected Pap test (odds ratio [OR]=2.01; 95% confidence interval [CI]=1.48-3.00 and OR=2.47; 95% CI=1.75-3.48, respectively). Psychological distress, including embarrassment, pain, anxiety, discomfort, and stress, with self-sampling and urine sampling were significantly lower than that with the Pap test. 52% of participants reported preferences for self-sampling in the next screening round. CONCLUSIONS Korean women were more likely to report satisfaction with alternative modalities (self-sampling and urine sampling) for CCS in comparison to the Pap test. This suggests that self-collected modalities may help with improving CCS uptake rates by eliminating burden related with the Pap test. However, further studies for test accuracy and cost-effective analysis of the alternative modalities should be conducted in order to apply CCS.
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Affiliation(s)
- Hye Young Shin
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Bomyee Lee
- Department of Medical Education and Medical Humanities, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sang Hyun Hwang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Ock Lee
- Center for Uterine Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Na Young Sung
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Young Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
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Sabeena S, Kuriakose S, Binesh D, Abdulmajeed J, Dsouza G, Ramachandran A, Vijaykumar B, Aswathyraj S, Devadiga S, Ravishankar N, Arunkumar G. The Utility of Urine-Based Sampling for Cervical Cancer Screening in Low-Resource Settings. Asian Pac J Cancer Prev 2019; 20:2409-2413. [PMID: 31450914 PMCID: PMC6852825 DOI: 10.31557/apjcp.2019.20.8.2409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 08/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background: WHO has recommended Visual Inspection with Acetic acid (VIA) or Human Papillomavirus (HPV) DNA testing if feasible, for cervical cancer screening in low income countries. However, the number of women undergoing screening is very low as a result of limited information, inadequate infrastructure and invasive nature of sampling. Methods: A cross sectional study was carried out comparing HPV DNA detection by Polymerase Chain Reaction (PCR) in paired cervical and urine samples procured from histologically confirmed cervical cancer cases. Results: Amongst the samples collected from 114 cervical cancer cases, HPV DNA was tested positive in cervical samples of 89 (78.1%) and urine samples of 55 (48.2%) patients. The agreement between the two sampling methods was 66.7% and the kappa value was 0.35 indicating a fair agreement. The sensitivity of HPV detection using urine samples was 59.6% (95% confidence interval 49.16%-69.15%) and the specificity was 92% (95% confidence interval 75.0%-97.8%). Conclusion: Even though not acceptable as an HPV DNA screening tool due to low sensitivity, the urine sampling method is inexpensive and more socially acceptable for large epidemiological surveys in developing countries to estimate the burden.
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Affiliation(s)
- Sasidharanpillai Sabeena
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Santhosh Kuriakose
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Damodaran Binesh
- Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Jazeel Abdulmajeed
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Giselle Dsouza
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Amrutha Ramachandran
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Bindu Vijaykumar
- Department of Radiation Oncology, Government Medical College, Kozhikode, Kerala, India
| | - Sushama Aswathyraj
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Santhosha Devadiga
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Nagaraja Ravishankar
- Department of Statistics, Prasanna School of Public health, Manipal Academy of Higher Education, Karnatka, India
| | - Govindakarnavar Arunkumar
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
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Sanchez-Garcia EK, Contreras-Paredes A, Martinez-Abundis E, Garcia-Chan D, Lizano M, de la Cruz-Hernandez E. Molecular epidemiology of bacterial vaginosis and its association with genital micro-organisms in asymptomatic women. J Med Microbiol 2019; 68:1373-1382. [PMID: 31329097 DOI: 10.1099/jmm.0.001044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Bacterial vaginosis (BV) is dysbiosis associated with an increased risk of several sexually transmitted infections. It is primarily diagnosed via Gram staining, although molecular analyses have presented higher diagnostic accuracy.Aim. This study aimed to evaluate the molecular epidemiology of BV in asymptomatic women to determine its association with several commensal and pathogenic micro-organisms of the genitalia.Methodology. The prevalence of BV was investigated through semiquantitative assessment of 201 women recruited during their routine gynaecological inspection at an outpatient clinic in Tabasco, Mexico.Results. Women with BV showed an increased prevalence of Chlamydia trachomatis (P=0.021) and Mycoplasma hominis (P=0.001). Of the BV-associated micro-organisms, Gardnerella vaginalis was significantly associated with C. trachomatis (P=0.005) and/or Ureaplasma parvum (P=0.003), whereas Atopobium vaginae and Megasphaera type 1 correlated significantly with Mycoplasma hominis (P=0.001). No significant association was observed between human papillomavirus (HPV) infection and BV, although there was increased prevalence of HPV59, HPV73, HPV52 and HPV58 in women displaying cervical cytological abnormalities.Conclusion. Identification of BV-associated micro-organisms via molecular analysis may help to distinguish recurrent cases from new infections and identify micro-organisms potentially associated with pharmacological resistance.
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Affiliation(s)
| | - Adriana Contreras-Paredes
- Unidad de Investigación Biomédica en Cancer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Eduardo Martinez-Abundis
- Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Magisterial, Mexico
| | - Dominga Garcia-Chan
- Unidad de Atencion Primaria de la Salud, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, 86205 Jalpa de Méndez, Mexico
| | - Marcela Lizano
- Unidad de Investigación Biomédica en Cancer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Erick de la Cruz-Hernandez
- Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Magisterial, Mexico
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Lopez-Arias M, Vazquez-Jimenez S, Martinez-Abundis E, Gomez-Crisostomo NP, Chavez-Blanco A, Contreras-Paredes A, De la Cruz-Hernandez E. Genital association of human papillomavirus with Mycoplasma and Ureaplasma spp. in Mexican women with precancerous lesions. Int J STD AIDS 2019; 30:969-977. [PMID: 31284837 DOI: 10.1177/0956462419855508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The genital colonization of certain Mycoplasma and Ureaplasma spp. has been associated with an increased the risk of acquisition and persistence of human papillomavirus. However, its association with high-risk human papillomavirus genotypes is not entirely clear, and the prevalence of such coinfections in cervical precancerous lesions has been poorly explored. Therefore, the aim of this study was to investigate the association of high-risk human papillomavirus with Mycoplasma and Ureaplasma spp. in 258 women recruited during their routine gynecological inspection at an outpatient clinic in Tabasco, Mexico. Among the Mycoplasma and Ureaplasma spp. evaluated in the present study, the highest peak of prevalence was attributed to Ureaplasma parvum (32.9%), followed by Mycoplasma hominis (14%), Ureaplasma urealyticum (6.6%), and Mycoplasma genitalium (0.8%). The overall prevalence rates of papillomavirus DNA and high-risk human papillomavirus were 25.6% and 17.1%, respectively. The overall association showed that M. hominis and U. urealyticum correlated significantly with high-risk human papillomavirus infection. According to the cytological results, the distribution of coinfection with high-risk human papillomavirus and U. urealyticum did not show significant differences with respect to severity of cervical lesions. Conversely, the association of high-risk human papillomavirus with M. hominis was more frequent in women with high-grade squamous intraepithelial lesions ( P = 0.037).
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Affiliation(s)
- Maria Lopez-Arias
- 1 Laboratory of Research in Metabolic and Infectious Diseases, Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Tabasco, Mexico
| | - Silvia Vazquez-Jimenez
- 1 Laboratory of Research in Metabolic and Infectious Diseases, Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Tabasco, Mexico
| | - Eduardo Martinez-Abundis
- 1 Laboratory of Research in Metabolic and Infectious Diseases, Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Tabasco, Mexico
| | - Nancy P Gomez-Crisostomo
- 1 Laboratory of Research in Metabolic and Infectious Diseases, Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Tabasco, Mexico
| | - Alma Chavez-Blanco
- 2 Laboratory of Epigenetics, Division of Basic Research, National Cancer Institute of Mexico, Mexico City, Mexico
| | - Adriana Contreras-Paredes
- 3 Laboratory of Epidemiology and Molecular Biology of Oncogenic Virus Division of Basic Research, National Cancer Institute of Mexico, Mexico City, Mexico
| | - Erick De la Cruz-Hernandez
- 1 Laboratory of Research in Metabolic and Infectious Diseases, Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Tabasco, Mexico
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11
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Snoek BC, Splunter APV, Bleeker MCG, Ruiten MCV, Heideman DAM, Rurup WF, Verlaat W, Schotman H, Gent MV, Trommel NEV, Steenbergen RDM. Cervical cancer detection by DNA methylation analysis in urine. Sci Rep 2019; 9:3088. [PMID: 30816167 PMCID: PMC6395822 DOI: 10.1038/s41598-019-39275-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/11/2019] [Indexed: 12/20/2022] Open
Abstract
Urine samples provide a potential alternative to physician-taken or self-collected cervical samples for cervical screening. Screening by primary hrHPV testing requires additional risk assessment (so-called triage) of hrHPV-positive women. Molecular markers, such as DNA methylation, have proven most valuable for triage when applied to cervical specimens. This study was set out to compare hrHPV and DNA methylation results in paired urine and cervical scrapes, and to evaluate the feasibility of DNA methylation analysis in urine to detect cervical cancer. Urine samples (n = 41; native and sediment) and paired cervical scrapes (n = 38) from cervical cancer patients, and urine from 44 female controls, were tested for hrHPV and 6 methylation markers. Results on native urine and sediment were highly comparable. A strong agreement was found between hrHPV testing on urine and scrapes (kappa = 0.79). Also, methylation levels in urine were moderately to strongly correlated to those detected in scrapes (r = 0.508-0.717). All markers were significantly increased in urine from cervical cancer patients compared to controls and showed a good discriminatory power for cervical cancer (AUC = 0.744-0.887). Our results show a good agreement of urine-based molecular analysis with reference cervical samples, and suggest that urine-based DNA methylation testing may provide a promising strategy for cervical cancer detection.
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Affiliation(s)
- Barbara C Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Annina P van Splunter
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Maaike C G Bleeker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Maartje C van Ruiten
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Daniëlle A M Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - W Frederik Rurup
- BIOS Lab on a Chip group, MESA+ and MIRA institutes, University of Twente, Enschede, Netherlands
| | - Wina Verlaat
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Hans Schotman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Chemistry, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Mignon van Gent
- Department of Gynecologic Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Nienke E van Trommel
- Department of Gynecologic Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Renske D M Steenbergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands.
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12
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León-Ordóñez K, Abad-Sojos S. Prevention of cervical cancer development through early detection of HPV using novelty molecular applications. BIONATURA 2019. [DOI: 10.21931/rb/cs/2019.02.01.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Human Papillomavirus (HPV) is the predominant cause of cervical cancer worldwide. The infections with HPVs 16 and 18 have a high oncogenic risk for cancer development. Besides, the genes E6 and E7 encode viral oncoproteins associated with infection. New molecular techniques for HPV detection, show important advantages such as high sensitivity, recognition capacity, reliability, among others. These techniques allow the standardization of new protocols associated with the detection in a variety of substances and samples. The stretch relationship between the virus and the disease open a new field to study early detection of the HPV infection. Additionally, less concentration of the sample is needed. Considering the significance of the detection, the present paper explains five novelty molecular applications for the prevention cervical cancer and early detection of HPV such as RNA in situ Hybridization for the detection of HPV E6/E7, genosensors, electrochemical DNA biosensor, PCR-based urine assay and a semen assay for detection of HPV. All the methods related to DNA samples could be used for both genders, there are more acceptable and easy to collect.
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13
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Detection and Phylogenetic Analysis of Human Papilloma Virus in Urine from a Sample of Iraqi Women with Vaginal Discharge. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.4.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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14
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Orlando G, Frati ER, Fasolo MM, Bianchi S, Matteelli A, Mazza F, Rizzardini G, Amendola A, Tanzi E. Incident genital HPV infections and potential impact of HPV vaccines in adult women living with HIV/AIDS. Hum Vaccin Immunother 2018; 15:1904-1910. [PMID: 30261149 PMCID: PMC6746504 DOI: 10.1080/21645515.2018.1528834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This study aims to describe and characterize incident HR-HPV infections and associated diseases in HIV-infected women. 805 HIV-infected women enrolled in the VALHIDATE Study were screened and followed-up for HPV by co-testing. Social, behavioral and health data were collected. HPV-DNA positive samples were typed using a commercial kit or RFLP analysis. Conventional Pap-smears were evaluated using the 2001 Bethesda System. The participants with abnormal cytological results were referred for colposcopy. 565 HIV-infected women (median age: 43 years) were analysed, 40.9% had >5 lifetime sexual partners, 77.2% contracted HIV through sexual intercourse, 93% were receiving antiretroviral treatment and 77.3% had undetectable HIV-RNA. The women underwent 1254 follow-ups (median follow-up: 33 months) for 1430.6 PersonYear-Follow-Up. 37.4% of baseline HPV-negative women acquired incident HPV-infections, 69.6% of which were HR-HPVs. HPV-53 was the most common HPV type detected (9.3%). 18.2% of women showed incident or progressive cytological abnormalities (7.8% ASC-US, 9.7% LSIL and 0.6% HSIL) and colposcopy revealed CIN2 (N = 2), CIN1 (N = 2) and VIN3 (N = 1). The preventable fraction of incident infections was 11.3%, 16.7%, and 35.2% for the 2v-4v-9v-HPV vaccines respectively (χ2 p < 0.0001). The overall burden of incident lesions attributable to the vaccine types were 9.1% for 2v-, 14.5% for 4v- and 30.9% for 9v-vaccine. High HPV incidence rates and high percentages of multiple HR-HPV infections were observed in a cohort of HIV-infected women receiving effective antiretroviral treatment. Primary prevention strategies based on the new 9v-HPV vaccine may help to prevent incident infections and disease progression in this cohort of women.
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Affiliation(s)
- Giovanna Orlando
- a Infectious Diseases Outpatient Unit, Centro Diagnostico Italiano (CDI) , Milan , Italy
| | - Elena R Frati
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Michela M Fasolo
- c STD Unit, Infectious Diseases 1st, L Sacco University Hospital , Milan , Italy
| | - Silvia Bianchi
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Alberto Matteelli
- d Department of Infectious and Tropical Diseases, University of Brescia , Brescia , Italy
| | - Francesca Mazza
- e U.O. Laboratorio Analisi, ASST Santi Paolo e Carlo , Milan , Italy
| | | | - Antonella Amendola
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Elisabetta Tanzi
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
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15
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ORLANDO G, BIANCHI S, FASOLO M, MAZZA F, FRATI E, RIZZARDINI G, MATTEELLI A, ZANCHETTA N, AMENDOLA A, TANZI E. Cervical Human Papillomavirus genotypes in HIV-infected women: a cross-sectional analysis of the VALHIDATE study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2017; 58:E259-E265. [PMID: 29707656 PMCID: PMC5912788 DOI: 10.15167/2421-4248/jpmh2017.58.4.804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/19/2017] [Indexed: 11/24/2022]
Abstract
Introduction Primary-prevention by prophylactic vaccination against HPV-related cancers and HPV-based screening programs are based on HPV-type distribution in immunocompetent individuals. HIV-infected women are at high risk of invasive HPV-disease sustained by a broader range of HPV-types and have higher multi-type infection rates than immunocompetent hosts. Methods This is a cross-sectional analysis of High Risk HPV (HR HPV) type distribution in 805 HIV+ women (HIW) compared with a control group of 1402 immunocompetent HIV- women (SPW) enrolled in the VALHIDATE study in order to define HPV type-specific distribution according to cytology. Results HIW had a 3.8, 3.6, and 2.7 times higher risk of atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL) than SPW respectively. HPV-DNA prevalence was 28.4% in HIW and 11.81% in SPW (p<0.0001). The prevalence of infection increased from normal cytology to HSIL both in HIW (from 21.45% to 90.91%) and SPW (from 9.54% to 75%). The OR for women with normal cytology of having a positive HPV-DNA test result of was 2.6 times higher in HIW than in SPW. The cumulative prevalence of HPV-16/18 in HSIL is much lower in HIW (36.4±28.4) than SPW (62.5±33.5). Conclusions A higher prevalence of infection and broader HPV type distribution were observed in HIV+ women compared to the general population. More than 60% of HSIL lesions of HIW patients are caused by single or multi-type infections from non-HPV16/18 HPVs. The potential 9v-HPV vaccine coverage could be even higher than that expected for the general population given the wide panel of HPV-types observed in the HSIL of HIV+ women.
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Affiliation(s)
- G. ORLANDO
- Infectious Diseases Outpatient Unit, Centro Diagnostico Italiano, Milan, Italy
| | - S. BIANCHI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - M.M. FASOLO
- STD Unit, Infectious Diseases 1, L Sacco University Hospital, Milan, Italy
| | - F. MAZZA
- U.O. Laboratorio Analisi - ASST Santi Paolo e CarloMilano
| | - E.R. FRATI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - G. RIZZARDINI
- Infectious Diseases 1, L Sacco University Hospital, Milan, Italy
| | | | - N. ZANCHETTA
- Clinical Microbiology, Virology and Bioemergency, L. Sacco Teaching Hospital, Milan, Italy
| | - A. AMENDOLA
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - E. TANZI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- * Correspondence: Elisabetta Tanzi, Department of Biomedical Sciences for Health, University of Milan, Italy - Tel. +39 02 50315139 - E-mail:
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16
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Frati ER, Fasoli E, Martinelli M, Colzani D, Bianchi S, Carnelli L, Amendola A, Olivani P, Tanzi E. Sexually Transmitted Infections: A Novel Screening Strategy for Improving Women's Health in Vulnerable Populations. Int J Mol Sci 2017. [PMID: 28632191 PMCID: PMC5486132 DOI: 10.3390/ijms18061311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65) were enrolled at the NAGA Centre (2012–2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis (Ct), Trichomonas vaginalis (Tv), Neisseria gonorrhoeae (Ng)-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required.
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Affiliation(s)
- Elena R Frati
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Ester Fasoli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Marianna Martinelli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
| | - Luciana Carnelli
- Lega Italiana per la Lotta contro i Tumori (LILT), Section of Milan, Viale Molise 5, 20137 Milan, Italy.
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- Coordinated Research Center "EpiSoMI", University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- CIRI-IV, Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16100 Genoa, Italy.
| | - Pierfranco Olivani
- NAGA Centre, Associazione Volontaria di Assistenza Socio-Sanitaria e per i Diritti di Cittadini Stranieri, Rom e Sinti, Via L. L. Zamenhof 7/A, 20136 Milan, Italy.
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- Coordinated Research Center "EpiSoMI", University of Milan, Via C. Pascal 36, 20133 Milan, Italy.
- CIRI-IV, Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16100 Genoa, Italy.
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17
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Detection of genital chlamydial and gonococcal infection using urine samples: A community-based study from India. J Infect Public Health 2017; 11:75-79. [PMID: 28506737 DOI: 10.1016/j.jiph.2017.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 04/02/2017] [Accepted: 04/28/2017] [Indexed: 11/21/2022] Open
Abstract
Sexually transmitted infections (STI) have a major impact on the reproductive health of women. Among the different etiological agents of STIs, Chlamydia trachomatis and Neisseria gonorrhoeae are the main bacterial pathogens that cause sexually transmitted infections in women. The aim of the study was to estimate the prevalence of genital chlamydial and gonococcal infection among women in the age group of 18-65 years from a community-based setting. A community-based cross-sectional study was performed using the archived urine samples (n=811) of women in the age group of 18-65 years for C. trachomatis and N. gonorrhoeae using a multiplex conventional Polymerase Chain Reaction (PCR). Out of 811 samples tested in the present study, 2 (0.24%) were tested positive for C. trachomatis and none were positive for N. gonorrhoeae. The study demonstrates the very low prevalence of C. trachomatis and N. gonorrhoeae infection in a rural community. For large population-based screening, urine samples were observed to be more socially acceptable and cost-effective.
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18
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Sabeena S, Bhat P, Kamath V, Mathew M, Aswathyraj S, Devadiga S, Prabhu S, Hindol M, Chameetachal A, Krishnan A, Arunkumar G. Detection of Genital HPV Infection Using Urine Samples: a Population Based Study in India. Asian Pac J Cancer Prev 2017; 17:1083-8. [PMID: 27039728 DOI: 10.7314/apjcp.2016.17.3.1083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the second commonest cancer among Indian women and its association with human papilloma virus (HPV) is well established. This preventable cancer accounts for the maximum number of cancer related deaths among rural Indian women. Unlike in developed countries there are no organized cervical cancer screening programmes in India due to lack of resources and manpower. OBJECTIVE To detect genital HPV infection using urine samples among asymptomatic rural women in the age group of 18-65 years. MATERIALS AND METHODS The study area chosen was Perdoor village in Udupi Taluk, Karnataka State and all the women in the age group of 18-65 years formed the study cohort. A cross sectional study was conducted by house visits and 1,305 women were enrolled in the study. After taking written informed consent a data sheet was filled and early stream random urine samples were collected, transported to a laboratory at 4OC and aliquoted. Samples were tested using nested HPV PCR with PGMY09/11 and GP5+/6+ primers. Positive cases were genotyped by sequence analysis. RESULTS Study participants included 1,134 sexually active and 171 unmarried women with a mean age at marriage of 22.1 (SD=3.9) years. Study area showed high female literacy rate of 86.6%. Five urine samples tested positive for HPV DNA (0.4%). CONCLUSIONS We found very low genital HPV infection rate among women from monogamous community. This is the first major population based study carried out among asymptomatic rural women to detect genital HPV infectio from Karnataka using urine samples.
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Cómbita AL, Gheit T, González P, Puerto D, Murillo RH, Montoya L, Vorsters A, Van Keer S, Van Damme P, Tommasino M, Hernández-Suárez G, Sánchez L, Herrero R, Wiesner C. Comparison between Urine and Cervical Samples for HPV DNA Detection and Typing in Young Women in Colombia. Cancer Prev Res (Phila) 2016; 9:766-71. [PMID: 27417431 DOI: 10.1158/1940-6207.capr-16-0038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/24/2016] [Indexed: 11/16/2022]
Abstract
Urine sampling for HPV DNA detection has been proposed as an effective method for monitoring the impact of HPV vaccination programs; however, conflicting results have been reported. The goal of this study was to evaluate the performance of optimized urine HPV DNA testing in women aged 19 to 25 years. Optimization process included the use of first void urine, immediate mixing of urine with DNA preservative, and the concentration of all HPV DNA, including cell-free DNA fragments. Urine and cervical samples were collected from 535 young women attending cervical screening at health centers from two Colombian cities. HPV DNA detection and genotyping was performed using an HPV type-specific multiplex genotyping assay, which combines multiplex polymerase chain reaction with bead-based Luminex technology. Concordance between HPV DNA detection in urine and cervical samples was determined using kappa statistics and McNemar tests. The accuracy of HPV DNA testing in urine samples was evaluated measuring sensitivity and specificity using as reference the results obtained from cervical samples. Statistical analysis was performed using STATA11.2 software. The findings revealed an overall HPV prevalence of 60.00% in cervical samples and 64.72% in urine samples, HPV-16 being the most frequent HPV type detected in both specimens. Moreover, our results indicate that detection of HPV DNA in first void urine provides similar results to those obtained with cervical samples and can be used to monitor HPV vaccination trials and programs as evidenced by the substantial concordance found for the detection of the four vaccine types. Cancer Prev Res; 9(9); 766-71. ©2016 AACR.
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Affiliation(s)
- Alba Lucía Cómbita
- Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología (INC), Bogotá, Colombia. Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Paula González
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Devi Puerto
- Grupo de Investigación en Salud Pública y Vigilancia Epidemiológica, Instituto Nacional de Cancerología (INC), Bogotá, Colombia
| | - Raúl Hernando Murillo
- Grupo de Investigación en Salud Pública y Vigilancia Epidemiológica, Instituto Nacional de Cancerología (INC), Bogotá, Colombia. Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Luisa Montoya
- Unidad de Análisis, Subdirección de Investigaciones, Instituto Nacional de Cancerología (INC), Bogotá, Colombia
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium
| | - Severien Van Keer
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Gustavo Hernández-Suárez
- Grupo de Investigación en Salud Pública y Vigilancia Epidemiológica, Instituto Nacional de Cancerología (INC), Bogotá, Colombia
| | - Laura Sánchez
- Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología (INC), Bogotá, Colombia
| | - Rolando Herrero
- Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Carolina Wiesner
- Grupo de Investigación en Salud Pública y Vigilancia Epidemiológica, Instituto Nacional de Cancerología (INC), Bogotá, Colombia
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20
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MARTINELLI M, MAZZA F, FRATI ER, FASOLO MM, COLZANI D, BIANCHI S, FASOLI E, AMENDOLA A, ORLANDO G, TANZI E. HPV genotypes detected in the oropharyngeal mucosa of HIV-infected men who have sex with men in Northern Italy. Epidemiol Infect 2016; 144:2641-7. [PMID: 27267944 PMCID: PMC9150477 DOI: 10.1017/s0950268816001163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/01/2016] [Accepted: 05/18/2016] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to investigate the epidemiological profile of HPV oropharyngeal infections in HIV-infected men who have sex with men. A total of 135 subjects were enrolled at the L. Sacco University Hospital (Milan, Italy) to evaluate their HPV oropharyngeal infection status at baseline and at a follow-up visit at least 12 months later. HPV DNA was detected from oropharyngeal swabs using an in-house nested PCR that amplifies a segment of the L1 gene. The PCR products were then sequenced and genotyped. A greater percentage of high-risk genotypes was identified compared to low-risk genotypes (13·7% vs. 6·9%, P < 0·05), and two uncommon alpha-HPV genotypes were detected, i.e. HPV-102 and HPV-114. HPV infection prevalence was 24·4% and the cumulative incidence was 24·1%. During the follow-up period, one case of HPV infection (HPV-33) persisted, while the overall rate of infection clearance was 58·3%. HPV oropharyngeal infection was widespread in the cohort examined, and most of the infections were transient and cleared within 12 months. These results may help to clarify the role of HPV in the oropharynx and may also improve our understanding of the need to implement preventive strategies in at-risk populations.
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Affiliation(s)
- M. MARTINELLI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - F. MAZZA
- STD Unit, Infectious Diseases I, Department of Infectious Diseases, L Sacco University Hospital, Milan, Italy
| | - E. R. FRATI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - M. M. FASOLO
- STD Unit, Infectious Diseases I, Department of Infectious Diseases, L Sacco University Hospital, Milan, Italy
| | - D. COLZANI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - S. BIANCHI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - E. FASOLI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - A. AMENDOLA
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - G. ORLANDO
- STD Unit, Infectious Diseases I, Department of Infectious Diseases, L Sacco University Hospital, Milan, Italy
| | - E. TANZI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Molden T, Feiring B, Ambur OH, Christiansen IK, Hansen M, Laake I, Meisal R, Myrvang E, Jonassen CM, Trogstad L. Human papillomavirus prevalence and type distribution in urine samples from Norwegian women aged 17 and 21 years: A nationwide cross-sectional study of three non-vaccinated birth cohorts. PAPILLOMAVIRUS RESEARCH 2016; 2:153-158. [PMID: 29074174 PMCID: PMC5886875 DOI: 10.1016/j.pvr.2016.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 05/06/2016] [Accepted: 05/07/2016] [Indexed: 11/25/2022]
Abstract
Background The aim of the current study was to assess the HPV prevalence in unscreened and unvaccinated young women living in Norway, to provide important baseline data for early estimation of the impact of the HPV vaccination program. Methods A total of 13,129 self-sampled urine samples from two complete birth-cohorts of 17-year old women born in 1994 and 1996 and one third of a birth-cohort of 21-year old women born in 1990, were analysed for the presence of 37 HPV types using PCR and a DNA hybridization technique. Results In the two birth cohorts of 17-year old women, HPV was detected in 19.9% (95% CI 18.8–20.9) and 15.4% (95% CI 14.5–16.3), respectively. High-risk HPV types were detected in 11.2% (95% CI 10.3–12.0) and 7.6% (95% CI 6.9–8.2), respectively, while vaccine types were detected in 7.4% (95% CI 6.7–8.1) and 6.0% (95% CI 5.4–6.6), respectively. Among the 21-year old women HPV was detected in 45.4% (95% CI 42.9–47.8), whereas high-risk types were detected in 29.8% (95% CI 27.5–32.0). Vaccine types (HPV 6, 11, 16, 18) were detected in 16.2% (95% CI 14.4–18.1). Conclusion This large population based study confirms that HPV testing in urine samples is easy and highly feasible for epidemiological studies and vaccine surveillance in young women. HPV was very common and a broad spectrum of HPV types was identified. Differences in HPV prevalence was seen both between age groups and between the two birth cohorts of 17-year old women. Self-sampled urine proved suitable for large scale HPV testing. HPV 16 and 18 was very common among young girls. A wide variety of HPV types circulates in the population. HPV was detected in nearly half of the 21-year old women. HPV was detected in 15–20% of the 17-year old women.
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Affiliation(s)
- Tor Molden
- Norwegian Institute of Public Health, PO Box, 4404 Nydalen, 0403 Oslo, Norway.
| | - Berit Feiring
- Norwegian Institute of Public Health, PO Box, 4404 Nydalen, 0403 Oslo, Norway.
| | - Ole Herman Ambur
- Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway.
| | | | - Mona Hansen
- Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway.
| | - Ida Laake
- Norwegian Institute of Public Health, PO Box, 4404 Nydalen, 0403 Oslo, Norway.
| | - Roger Meisal
- Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway.
| | - Ellen Myrvang
- Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway.
| | - Christine Monceyron Jonassen
- Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway; Østfold Hospital Trust, PO Box 300, 1714 Grålum, Norway.
| | - Lill Trogstad
- Norwegian Institute of Public Health, PO Box, 4404 Nydalen, 0403 Oslo, Norway.
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Natural history of human papillomavirus infection in non-vaccinated young males: low clearance probability in high-risk genotypes. Eur J Clin Microbiol Infect Dis 2016; 35:463-9. [PMID: 26753992 DOI: 10.1007/s10096-015-2562-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
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23
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HPV Testing from Dried Urine Spots as a Tool for Cervical Cancer Screening in Low-Income Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:283036. [PMID: 26180790 PMCID: PMC4477205 DOI: 10.1155/2015/283036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/24/2014] [Indexed: 01/04/2023]
Abstract
Nowadays, several screening strategies are available to prevent cervical cancer, but inadequate resources, sociocultural barriers, and sampling issues impede their success in low-income countries. To overcome these issues, this study aimed to evaluate the performance of human papillomavirus (HPV) testing from dried urine spots (DUS). Eighty-eight urine samples (including 56 HPV DNA positive specimens) were spotted on filter paper, dried, and stored in paper-bags. HPV DNA was detected from the DUS after 1 week and 4 weeks of storage using a polymerase chain reaction (PCR) assay. The sensitivity, specificity, and concordance of the DUS-based HPV test were evaluated by comparing the results with those of HPV testing on fresh urine samples as the gold standard. The sensitivity of the test was 98.21% (95% CI: 90.56–99.68) for DUS stored for 1 week and 96.42% (95% CI: 87.88–99.01) for DUS stored for 4 weeks. The specificity was 100% (95% CI: 89.28–100) at both time points. The concordance between DUS and fresh urine HPV testing was “almost perfect” using the κ statistic. These preliminary data suggest that a DUS-based assay could bypass sociocultural barriers and sampling issues and therefore could be a suitable, effective tool for epidemiological surveillance and screening programs, especially in low-income countries.
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Magaña-Contreras M, Contreras-Paredes A, Chavez-Blanco A, Lizano M, De la Cruz-Hernandez Y, De la Cruz-Hernandez E. Prevalence of sexually transmitted pathogens associated with HPV infection in cervical samples in a Mexican population. J Med Virol 2015; 87:2098-105. [PMID: 26010580 DOI: 10.1002/jmv.24278] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2015] [Indexed: 01/11/2023]
Abstract
Cervical cancer development has been mainly associated with persistent human papillomavirus (HPV) infections. However, HPV infection is unlikely to be sufficient to cause cervical cancer, and the contribution of other sexually transmitted infections (STIs) could be the determining factor for cervical lesion-progression. The aim of this study was to estimate the prevalence of STIs associated with HPV-positivity in 201 cervical samples from patients who underwent annual routine gynecological exams. The overall prevalence of STIs was 57.7%, and the most frequent infection was Ureaplasma spp (UP) (39.8%), followed by Gardnerella vaginalis (GV) (25.9%), α-HPV (18.4%), Chlamydia trachomatis (CT) (1.5%), and Mycoplasma genitalium (MG) (0.5%). The highest prevalence rate of multiple non-HPV infections was observed for the age-range 31-40; for papillomavirus infection, the age-range was 21-30. In normal cervical samples, HPV16 was the most prevalent genotype (24.3%), followed by genotypes 58 (13.5%) and 52 (10.8%). Intriguingly, HPV18 was not detected in the study population, and genotypes 52 and 58 were found exclusively in samples with abnormal cytology. Papillomavirus infection with oncogenic types was significantly associated with GV (P = 0.025) and strongly associated with multiple non-HPV pathogens (P = 0.002). The following variables correlated significantly with cytological diagnosis of low-grade squamous intraepithelial lesion (LSIL): GV (P = 0.028), multiple non-HPV infections (P = 0.001), and high-risk HPV positivity (P = 0.001). Epidemiological data from this study will contribute to the molecular detection of sexually transmitted pathogens from screening programs to identify those women who are at risk for developing cervical lesions.
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Affiliation(s)
- Mariana Magaña-Contreras
- Multidisciplinary Academic Division of Comalcalco, Laboratory of Molecular Biology, Juarez Autonomous University of Tabasco, Rancheria sur cuarta seccion, Comalcalco, Tabasco, Mexico
| | | | | | - Marcela Lizano
- Division of Basic Research, National Cancer Institute of Mexico, Mexico
| | | | - Erick De la Cruz-Hernandez
- Multidisciplinary Academic Division of Comalcalco, Laboratory of Molecular Biology, Juarez Autonomous University of Tabasco, Rancheria sur cuarta seccion, Comalcalco, Tabasco, Mexico
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Abstract
Cervical cancer is a treatable and preventable cancer that remains a concern for women worldwide. Efforts to reduce rates of cervical cancer focus on the promotion of human papillomavirus (HPV) vaccination and the promotion of routine recommended cervical cancer screening, primarily done by cervical cytology and cervical HPV testing. Recently researchers have begun to examine urine-based HPV testing as a future potential alternative to the current cervical screening methodology. This column takes a second look at two recent U.S.-based studies in which researchers evaluated urine-based HPV testing as a simple and noninvasive approach to screen for cervical cancer.
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A population-based study of the prevalence of HPV in three districts of Tamil Nadu, India. Int J Gynaecol Obstet 2014; 129:58-61. [PMID: 25556078 DOI: 10.1016/j.ijgo.2014.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/18/2014] [Accepted: 12/10/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the prevalence of HPV infection among women from three districts of Tamil Nadu (Erode, Salem, and Namakkal). METHODS Between January 27, 2007, and December 15, 2009, 1800 women aged 20-70years who had normal cervical cytology were enrolled into a cross-sectional study. Participants completed interviews and provided first void urine samples for assessment of HPV infection. RESULTS Among 1699 eligible samples, 179 (10.5%) were HPV positive. HPV16 was the most common type (affecting 68 [4.0%] women), followed by HPV6 (58 [3.4%]). Among the 179 HPV-positive women, 71 (39.7%) were aged 36-45years. An annual income of less than 25 000 INR was significantly associated with HPV infection in all three districts (P<0.05). Regular intercourse was also associated with HPV in Erode and Salem (P<0.05). CONCLUSION Screening and prophylactic vaccines containing HPV16 and HPV6 should be promoted in western Tamil Nadu.
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Panatto D, Amicizia D, Bianchi S, Frati ER, Zotti CM, Lai PL, Domnich A, Colzani D, Gasparini R, Tanzi E. Chlamydia trachomatis prevalence and chlamydial/HPV co-infection among HPV-unvaccinated young Italian females with normal cytology. Hum Vaccin Immunother 2014; 11:270-6. [PMID: 25483545 DOI: 10.4161/hv.36163] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infections caused by Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the two main sexually transmitted infections; however, epidemiological data on Ct prevalence and Ct/HPV co-infection in Italy are scant. This study aimed at estimating the prevalence of Ct infection and Ct/HPV co-infection in young HPV-unvaccinated females with normal cytology, and placed particular attention on the possible association between Ct-DNA positivity and different HPV infecting genotypes. Five hundred 66 healthy females aged 16-26 years without cervical lesions, previously assessed for HPV infection (HPV-DNA prevalence: 18.2%), were tested for Ct-DNA. The overall prevalence of Ct was 5.8% (95% CI: 4.2-8.1), while Ct/HPV co-infection was recorded in 2.7% (95% CI: 1.6-4.3) of subjects. Compared with HPV-DNA-negative females, HPV-DNA positive subjects had significantly (P < 0.001) higher odds of being infected with Ct (odds ratio of 4.20, 95% CI: 2.01-8.71). Both Ct and Ct/HPV infections were much more prevalent in under 18-year-olds than in older women. Subjects positive for single high-risk HPV genotypes and various multiple HPV infections had higher odds of being Ct-DNA positive. Our findings confirm that HPV and Ct infections are very common among asymptomatic young Italian females. This underlines the urgent need for nationwide Ct screening programs and reinforcement of sexual health education, which would be the most important public health strategies, since no Ct vaccines are currently available.
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Comparison of urine and cervical samples for detecting human papillomavirus (HPV) with the Cobas 4800 HPV test. J Clin Virol 2014; 61:548-52. [PMID: 25453566 DOI: 10.1016/j.jcv.2014.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the main cause of cervical cancer. The development of non-invasive self-sample collection methods would have the potential advantage of increasing the acceptance of the screening procedures. OBJECTIVES To compare human papillomavirus (HPV) DNA detection and genotyping with the Cobas 4800 HPV test (Roche Diagnostic, Spain) on paired cervical and first voided urine. STUDY DESIGN Paired urine and cervical samples were collected from 125 women referred for evaluation of abnormal Pap smear results. RESULTS The overall percent agreement between HPV detection in urine and cervical samples was 88%. A substantial concordance rate of HPV DNA detection in both samples was observed (κ=0.76; 95% IC: 64-87). In this high prevalence population the sensitivity, specificity, NPV and PPV for detection of HPV DNA from urine versus cervical samples were 90.5% (95% IC: 80-95%), 85%, (95% IC: 74-92%), 89.8% (95% IC: 79.5-95.3) and 86.4% (95% IC: 76.1-92.7) respectively. Compared to histologically confirmed CIN 2/3 disease, the clinical sensitivity and specificity for the detection of high-risk HPV in urine samples were 95% (95% IC: 76-97%) and 52.4% (95% IC: 40-64%) respectively. CONCLUSIONS These results suggest that urine samples processed with Cobas 4800 HPV test may be useful for clinical management of HPV infection.
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Tanzi E, Bianchi S, Frati ER, Amicizia D, Martinelli M, Bragazzi NL, Brisigotti MP, Colzani D, Fasoli E, Zehender G, Panatto D, Gasparini R. Human papillomavirus detection in paraffin-embedded colorectal cancer tissues. J Gen Virol 2014; 96:206-209. [PMID: 25296558 DOI: 10.1099/vir.0.070672-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Human papillomavirus (HPV) has a well-recognized aetiological role in the development of cervical cancer and other anogenital tumours. Recently, an association between colorectal cancer and HPV infection has been suggested, although this is still controversial. This study aimed at detecting and characterizing HPV infection in 57 paired biopsies from colorectal cancers and adjacent intact tissues using a degenerate PCR approach. All amplified fragments were genotyped by means of sequencing. Overall, HPV prevalence was 12.3 %. In particular, 15.8 % of tumour tissues and 8.8 % of non-cancerous tissue samples were HPV DNA-positive. Of these samples, 85.7 % were genotyped successfully, with 41.7 % of sequences identifying four genotypes of the HR (high oncogenic risk) clade Group 1; the remaining 58.3 % of HPV-genotyped specimens had an unclassified β-HPV. Examining additional cases and analysing whole genomes will help to outline the significance of these findings.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena R Frati
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Marianna Martinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Maria Pia Brisigotti
- Pathological Anatomy and Histology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ester Fasoli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
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Pathak N, Dodds J, Zamora J, Khan K. Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis. BMJ 2014; 349:g5264. [PMID: 25232064 PMCID: PMC4166201 DOI: 10.1136/bmj.g5264] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine the accuracy of testing for human papillomavirus (HPV) DNA in urine in detecting cervical HPV in sexually active women. DESIGN Systematic review and meta-analysis. DATA SOURCES Searches of electronic databases from inception until December 2013, checks of reference lists, manual searches of recent issues of relevant journals, and contact with experts. ELIGIBILITY CRITERIA Test accuracy studies in sexually active women that compared detection of urine HPV DNA with detection of cervical HPV DNA. DATA EXTRACTION AND SYNTHESIS Data relating to patient characteristics, study context, risk of bias, and test accuracy. 2 × 2 tables were constructed and synthesised by bivariate mixed effects meta-analysis. RESULTS 16 articles reporting on 14 studies (1443 women) were eligible for meta-analysis. Most used commercial polymerase chain reaction methods on first void urine samples. Urine detection of any HPV had a pooled sensitivity of 87% (95% confidence interval 78% to 92%) and specificity of 94% (95% confidence interval 82% to 98%). Urine detection of high risk HPV had a pooled sensitivity of 77% (68% to 84%) and specificity of 88% (58% to 97%). Urine detection of HPV 16 and 18 had a pooled sensitivity of 73% (56% to 86%) and specificity of 98% (91% to 100%). Metaregression revealed an increase in sensitivity when urine samples were collected as first void compared with random or midstream (P=0.004). LIMITATIONS The major limitations of this review are the lack of a strictly uniform method for the detection of HPV in urine and the variation in accuracy between individual studies. CONCLUSIONS Testing urine for HPV seems to have good accuracy for the detection of cervical HPV, and testing first void urine samples is more accurate than random or midstream sampling. When cervical HPV detection is considered difficult in particular subgroups, urine testing should be regarded as an acceptable alternative.
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Affiliation(s)
- Neha Pathak
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and dentistry, London E1 2AB, UK
| | - Julie Dodds
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and dentistry, London E1 2AB, UK
| | - Javier Zamora
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and dentistry, London E1 2AB, UK Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS) and CIBER Epidemiologia y Salud Publica, Madrid, Spain
| | - Khalid Khan
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and dentistry, London E1 2AB, UK
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Mantzana P, Pournaras S, Skentou C, Deligeoroglou E, Katsioulis A, Antonakopoulos G, Hadjichristodoulou C, Tsakris A, Messinis IE, Daponte A. Applicability of self-obtained urine and vaginal samples for HPV-16, -18, -31 and -45 cervical cancer screening in pregnancy: a pilot cross-sectional study. Future Virol 2014. [DOI: 10.2217/fvl.14.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
ABSTRACT: Aim: To conduct a pilot cross-sectional study to evaluate the rates of detection of four common high-risk HPV (hr-HPV) types using first-void urine paired with vaginal self-obtained samples in a nonvaccinated population of pregnant women. We also aimed to compare these results with a matched nonpregnant group in order to test the applicability of self-sampled hr-HPV cervical cancer screening during antenatal visits. Materials & methods: Samples from 550 pregnant women were subjected to hr-HPV-16, -18, -31 and -45 type detection by inhouse PCR and compared with 250 paired urine, vaginal and cervical samples from an age-matched cohort of nonpregnant women. Results: Comparing overall hr-HPV prevalence in urine and vaginal samples between pregnant (15 out of 550; 2.7%) and nonpregnant women (eight out of 250; 3.2%) for each HPV type revealed no significant differences. All paired urine/vaginal samples were both positive for the same type of hr-HPV and there was no positive urine sample with the other samples being negative. Conclusion: hr-HPV detection in pregnant women using self-obtained urine and vaginal samples seems to be a feasible cervical cancer screening method.
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Affiliation(s)
- Paraskevi Mantzana
- Department of Microbiology, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Spyros Pournaras
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Chara Skentou
- Department of Obstetrics & Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Efthimios Deligeoroglou
- Division of Pediatric–Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, Medical School, University of Athens, Athens, Greece
| | - Antonios Katsioulis
- Department of Hygiene & Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - George Antonakopoulos
- Department of Histology & Embryology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene & Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Ioannis E Messinis
- Department of Obstetrics & Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Alexandros Daponte
- Department of Obstetrics & Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Ducancelle A, Legrand MC, Pivert A, Veillon P, Le Guillou-Guillemette H, De Brux MA, Beby-Defaux A, Agius G, Hantz S, Alain S, Catala L, Descamps P, Postec E, Caly H, Charles-Pétillon F, Labrousse F, Lunel F, Payan C. Interest of human papillomavirus DNA quantification and genotyping in paired cervical and urine samples to detect cervical lesions. Arch Gynecol Obstet 2014; 290:299-308. [PMID: 24622934 DOI: 10.1007/s00404-014-3191-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. PURPOSE To compare HPV viral loads and genotypes in paired cervical and urine samples, and to assess correlation between virological and cytological results in women seeking gynecological consultation. METHODS Paired urine and cervical specimens were collected and analyzed from 230 of 245 women participating in the previously described prospective PapU study. HPV DNA detection and quantification were performed using a real-time PCR method with short fragment PCR primers. Genotyping was carried out using the INNO-LiPA HPV genotyping assay. RESULTS The prevalence of HPV in the 230 paired urine and cervical smear samples was 42 and 49 %, respectively. Overall agreement for HPV positivity and negativity between the paired samples was 90 % (κ = 0.80). High HPV viral load in both cervical and urine samples was associated with cytological abnormalities. HPV-positive women were mostly infected with HR-HPV types. The agreement between high- and low-risk HPV (LR-HPV) detection in both samples was 97 % (κ = 0.95 for HR-HPV and κ = 0.97 for LR-HPV). CONCLUSIONS High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.
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Affiliation(s)
- A Ducancelle
- Laboratoire de Virologie, UPRES EA 3859, Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49000, Angers, France,
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Brestovac B, Wong ME, Costantino PS, Groth D. A rapid DNA extraction method suitable for human papillomavirus detection. J Med Virol 2014; 86:653-7. [PMID: 24443320 DOI: 10.1002/jmv.23882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/12/2022]
Abstract
Infection with oncogenic human papillomavirus (HPV) genotypes is necessary for the development of cervical cancer. Testing for HPV DNA from liquid based cervical samples can be used as an adjunct to traditional cytological screening. In addition there are ongoing viral load, genotyping, and prevalence studies. Therefore, a sensitive DNA extraction method is needed to maximize the efficiency of HPV DNA detection. The XytXtract Tissue kit is a DNA extraction kit that is rapid and so could be useful for HPV testing, particularly in screening protocols. This study was undertaken to determine the suitability of this method for HPV detection. DNA extraction from HeLa and Caski cell lines containing HPV 18 and 16 respectively together with DNA from five liquid based cervical samples were used in a HPV PCR assay. DNA was also extracted using the QIAamp DNA mini kit (Qiagen, Hilden, Germany) as a comparison. DNA extracts were serially diluted and assayed. HPV DNA was successfully detected in cell lines and cervical samples using the XytXtract Tissue kit. In addition, the XytXtract method was found to be more sensitive than the QIAmp method as determined by a dilution series of the extracted DNA. While the XytXtract method is a closed, the QIAamp method uses a spin column with possible loss of DNA through DNA binding competition of the matrix, which could impact on the final extraction efficiency. The XytXtract is a cheap, rapid and efficient method for extracting HPV DNA from both cell lines and liquid based cervical samples.
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Affiliation(s)
- Brian Brestovac
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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34
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Orlando G, Fasolo M, Mazza F, Ricci E, Esposito S, Frati E, Zuccotti GV, Cetin I, Gramegna M, Rizzardini G, Tanzi E. Risk of cervical HPV infection and prevalence of vaccine-type and other high-risk HPV types among sexually active teens and young women (13-26 years) enrolled in the VALHIDATE study. Hum Vaccin Immunother 2014; 10:986-94. [PMID: 24423757 PMCID: PMC4896517 DOI: 10.4161/hv.27682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
HPV vaccination is expected to reduce the incidence of cervical cancer. The greatest and the earliest health gains will be ensured by high vaccine coverage among all susceptible people. The high costs and the risk of a reduced cost/effectiveness ratio in sexually active girls still represent the main obstacles for a more widespread use of HPV vaccination in many countries. Data on the rate, risk factors, and HPV types in sexually active women could provide information for the evaluation of vaccination policies extended to broader age cohorts. Sexually active women aged 13–26 years enrolled in an Italian cohort study were screened for cervical HPV infections; HPV-DNA positive samples were genotyped by InnoLipa HPV Genotyping Extra or by RFLP genotype analysis. Among the 796 women meeting the inclusion criteria, 10.80% (95% CI 8.65–12.96) were HPV-DNA infected. Age >18 years, lifetime sexual partners >1, and history of STIs were associated to higher risk of HPV infection in the multivariable models adjusted for age, lifetime sexual partners, and time of sexual exposure. The global prevalence of the four HPV vaccine-types was 3.02% (95% CI 1.83–4.20) and the cumulative probability of infection from at least one vaccine-type was 12.82% in 26-years-old women and 0.78% in 18-years-old women. Our data confirm most of the previously reported findings on the risk factors for HPV infections. The low prevalence of the HPV vaccine-types found may be useful for the evaluation of the cost/efficacy and the cost/effectiveness of broader immunization programs beyond the 12-years-old cohort.
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Affiliation(s)
- Giovanna Orlando
- STD Unit; Infectious Diseases I; L Sacco University Hospital; Milan, Italy
| | - Michela Fasolo
- STD Unit; Infectious Diseases I; L Sacco University Hospital; Milan, Italy
| | - Francesca Mazza
- STD Unit; Infectious Diseases I; L Sacco University Hospital; Milan, Italy
| | - Elena Ricci
- Infectious Diseases I; L Sacco University Hospital; Milan, Italy
| | - Susanna Esposito
- Pediatric Clinic I; Department of Pathophysiology and Transplantation; University of Milan; Milan, Italy
| | - Elena Frati
- Department of Biomedical Sciences for Health; University of Milan; Milan, Italy
| | | | - Irene Cetin
- Gynaecology Unit; L Sacco University Hospital; Milan, Italy
| | - Maria Gramegna
- Unità Organizzativa Governo della Prevenzione e Tutela Sanitaria; Direzione Generale Sanità; Regione Lombardia; Milan, Italy
| | | | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health; University of Milan; Milan, Italy
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Franciscatto LG, Silva CM, Barcellos RB, Angeli S, Silva MS, Almeida SE, Rossetti ML. Comparison of urine and self-collected vaginal samples for detecting human papillomavirus DNA in pregnant women. Int J Gynaecol Obstet 2014; 125:69-72. [DOI: 10.1016/j.ijgo.2013.09.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 09/19/2013] [Accepted: 12/23/2013] [Indexed: 11/29/2022]
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Prevalence of human papillomavirus in young Italian women with normal cytology: how should we adapt the national vaccination policy? BMC Infect Dis 2013; 13:575. [PMID: 24313984 PMCID: PMC4029487 DOI: 10.1186/1471-2334-13-575] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 12/02/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) is the most common sexually transmitted infection. In Italy, HPV vaccination is now offered free of charge to 12-year-old females. However, some regional health authorities have extended free vaccination to other age-groups, especially to girls under 18 years of age. We conducted a multicentre epidemiological study to ascertain the prevalence of different genotypes of HPV in young Italian women with normal cytology, with the aim of evaluating the possibility of extending vaccination to older females. METHODS The study was performed in 2010. Women aged 16-26 years with normal cytology were studied. Cervical samples were analyzed to identify the presence of HPV by PCR amplification of a segment of ORF L1 (450 bp). All positive HPV-DNA samples underwent viral genotype analysis by means of a restriction fragment length polymorphism assay. RESULTS Positivity for at least one HPV genotype was found in 18.2% of the 566 women recruited: 48.1% in the 16-17 age-class, 15.4 in the 18-20 age-class, 21.9% in the 21-23 age-class, and 15.5% in the 24-26 age-class; 10.1% of women were infected by at least one high-risk HPV genotype. HPV-16 was the most prevalent genotype. Only 4 (0.7%), 4 (0.7%) and 3 (0.5%) women were infected by HPV-18, HPV-6 and HPV-11, respectively. Of the HPV-DNA-positive women, 64.1% presented only one viral genotype, while 24.3% had multiple infections. The HPV genotypes most often involved in multiple infections were high-risk. A high prevalence was noted in the first years of sexual activity (48.1% of HPV-DNA-positive women aged 16-17 years); HPV prevalence subsequently declined and stabilized.The estimate of cumulative proportions of young women free from any HPV infection at each age was evaluated; 93.3% and 97.1% of 26 year-old women proved free from HPV-16 and/or HPV-18 and from HPV-6 and/or HPV-11, respectively. CONCLUSIONS Our findings confirm the crucial importance of conducting studies on women without cytological damage, in order to optimise and up-date preventive interventions against HPV infection, and suggest that vaccinating 26-year-old females at the time of their first pap-test is to be recommend, though this issue should be further explored.
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Bianchi S, Frati ER, Panatto D, Martinelli M, Amicizia D, Zotti CM, Martinese M, Bonanni P, Boccalini S, Coppola RC, Masia G, Meloni A, Castiglia P, Piana A, Gasparini R, Tanzi E. Detection and genotyping of human papillomavirus in urine samples from unvaccinated male and female adolescents in Italy. PLoS One 2013; 8:e79719. [PMID: 24255711 PMCID: PMC3821858 DOI: 10.1371/journal.pone.0079719] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022] Open
Abstract
The introduction of vaccination against Human Papillomavirus (HPV) in adolescent girls in 2006 has focused virological surveillance on this age group. As few studies have evaluated HPV infections in young populations, further data are needed in order to improve and extend prophylactic policy and to monitor epidemiological changes. The present study aimed at evaluating overall and type-specific HPV prevalence in both female and male adolescents in Italy. HPV DNA detection and genotyping was performed on urine samples collected from 870 unvaccinated adolescents (369 females, 501 males, 11-18 years of age) in five cities in Italy. Following DNA extraction by means of a commercial kit (NucliSENS(®)-miniMAG(®), bioMérieux), the L1 gene fragment was PCR amplified and genotyped by restriction fragment length polymorphism analysis. HPV DNA was detected in 1.5% of all samples, and in 3% and 0.4% of samples from females and males, respectively. In approximately 70% of HPV DNA positive adolescents, the infection was due to a single genotype, with 88.9% of genotypes belonging to the HR-clade. The only two HPV-positive boys (14 and 18 years old) had HPV-70 genotype. Only one of the 11 HPV-infected girls was in the 11-14 age-group. HPV prevalence was 4.2% in girls aged 15-18 years and 60% of infections were due to vaccine types HPV-16 or HPV-6/-11. This is one of the few studies, the first conducted in Italy, on HPV infection in adolescents. Urine testing is the easier way of detecting HPV infection in younger populations. Our data revealed a very low HPV prevalence, and no infections were observed in the 12-year-old vaccine target population. The majority of infections were seen in females aged 15-18 years. Overall, more than 50% and 30% of the potentially persistent HPV infections detected in this group could have been prevented by the quadrivalent and the bivalent vaccines, respectively.
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Affiliation(s)
- Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Rosanna Frati
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Marianna Martinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Carla Maria Zotti
- Department of Public Health and Paediatrics Sciences, University of Turin, Turin, Italy
| | - Morena Martinese
- Department of Public Health and Paediatrics Sciences, University of Turin, Turin, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Rosa Cristina Coppola
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Giuseppina Masia
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Angelo Meloni
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Paolo Castiglia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Piana
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Roberto Gasparini
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Department of Health Sciences, University of Genoa, Genoa, Italy
- * E-mail:
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Mendez K, Romaguera J, Ortiz AP, López M, Steinau M, Unger ER. Urine-based human papillomavirus DNA testing as a screening tool for cervical cancer in high-risk women. Int J Gynaecol Obstet 2013; 124:151-5. [PMID: 24296266 DOI: 10.1016/j.ijgo.2013.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/26/2013] [Accepted: 10/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To test the hypothesis that self-collected urine could be used to detect high-risk human papillomavirus (HPV) DNA with sensitivity and specificity comparable to those of standard cervical testing. METHODS Women attending a gynecology clinic for evaluation of abnormal cytology were recruited. Fifty-two participants (21-60years of age) collected urine samples, and clinicians collected cervical brush samples. When appropriate, cervical biopsies were obtained during colposcopy. HPV detection and typing were performed on DNA extracts from each sample, using commercial reagents for L1 consensus polymerase chain reaction (PCR) and type-specific hybridization. HPV 16 viral load was determined by quantitative PCR in HPV 16-positive samples. A diagnostic test analysis was conducted for urine samples. RESULTS Fifty paired samples were analyzed, with 76% agreement between samples. The 12 discrepant pairs were all urine negative/cervix positive. The most common HPV types detected were 16, 51, 53, and 62. The urine test correctly identified 100% of the uninfected and 65% of the infected patients. CONCLUSION The results indicate that HPV DNA detection using urine is less sensitive than cervical sampling in a population with abnormal cytology. Further exploration is warranted to determine clinical utility when other options are unavailable.
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Affiliation(s)
- Keimari Mendez
- Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico, San Juan, USA.
| | - Josefina Romaguera
- Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico, San Juan, USA
| | - Ana P Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Cancer Control and Population Sciences Program at Comprehensive Cancer Center, University of Puerto Rico, San Juan, USA
| | - Mariel López
- Puerto Rico Clinical and Translational Research Consortium, University of Puerto Rico, San Juan, USA
| | - Martin Steinau
- Centers for Disease Control and Prevention, Atlanta, USA
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