Menstrual Blood as a Diagnostic Specimen for Human Papillomavirus Genotyping and Genital Tract Infection Using Next-Generation Sequencing as a Novel Diagnostic Tool

BACKGROUND

Menstrual blood (MB) is a convenient specimen type that can be self-collected easily and non-invasively by women. This study assessed the potential application of MB as a diagnostic specimen to detect genital tract infections (GTIs) and human papillomavirus (HPV) infections in women.

METHOD

Genomic DNA was extracted from MB samples. Pacific Bioscience (Pacbio) 16S ribosomal DNA (rDNA) high-fidelity (HiFi) long-read sequencing and HPV PCR were performed.

RESULTS

MB samples were collected from women with a pathological diagnosis of CIN1, CIN2, CIN3 or HPV infection. The sensitivity and positive predictive value (PPV) of high-risk HPV detection using MB were found to be 66.7%. A shift in vaginal flora and a significant depletion in Lactobacillus spp. in the vaginal microbiota communities were observed in the MB samples using 16S rDNA sequencing.

CONCLUSIONS

In this study, we demonstrated that MB is a proper diagnostic specimen of consideration for non-invasive detection of HPV DNA and genotyping using PCR and the diagnosis of GTIs using metagenomic next-generation sequencing (mNGS). MB testing is suitable for all women who menstruate and this study has opened up the possibility of the use of MB as a diagnostic specimen to maintain women's health.

Implementation and new insights in molecular diagnostics for HIV infection

INTRODUCTION

Acquired immunodeficiency syndrome (AIDS) is a kind of acquired disease that breaks down the immune system. Human immunodeficiency virus (HIV) is the causative agent of AIDS. By the end of 2016, there were 36.7 million people living with HIV worldwide. Early diagnosis can alert infected individuals to risk behaviors in order to control HIV transmission. Infected individuals are also benefited from proper treatment and management upon early diagnosis. Thanks to the public awareness of the disease, the annual increase of new HIV infections has been slowly declining over the past decades. The advent of molecular diagnostics has allowed early detection and better management of HIV infected patients. Areas covered: In this review, the authors summarized and discussed the current and future technologies in molecular diagnosis as well as the biomarkers developed for HIV infection. Expert Commentary: A simple and rapid detection of viral load is important for patients and doctors to monitor HIV progression and antiretroviral treatment efficiency. In the near future, it is expected that new technologies such as digital PCR and CRISPR-based technology will play more important role in HIV detection and patient management.

Large-scale mercury exposure due to a cream cosmetic: community-wide case series

OBJECTIVE

To describe demographic characteristics, patterns of use, reported symptoms, and laboratory results associated with mercury exposure among people who used a beauty cream containing mercury. DESIGN. Descriptive study of a case series.

SETTING

The Hong Kong community.

PARTICIPANTS

Users of a cream cosmetic who contacted the Department of Health following a public announcement.

MAIN OUTCOME MEASURES

Urine and blood mercury concentrations, cream mercury content, self-reported symptoms, duration of cream use, and duration since last cream use.

RESULTS

We interviewed 314 cream users, 99% of whom were women. The mean urine and blood mercury concentrations of 286 users, who submitted a urine or blood sample, were 45.2 microg/L (reference level, <20 microg/L) and 17.1 microg/L (reference level, <10 microg/L), respectively; 65% of these participants had elevated mercury concentrations. The mercury content of the cream cosmetic ranged from 660 to 57 000 ppm. Seventy-eight percent of all cream users reported no symptoms, but absence of symptoms was not predictive of low urine and blood mercury concentrations. Urine mercury concentrations were significantly higher among people who last used the cream within 45 days. Blood mercury concentrations were elevated following cream use for as short as 2 days.

CONCLUSIONS

The majority of cream users had increased urine or blood mercury concentrations but remained asymptomatic, implying that the incidence of overt symptomatic mercury poisoning resulting from dermal application of creams with mercury content lower than 57 000 ppm is low. Doctors should take a history of the use of cosmetics if patients have clinical or laboratory evidence of mercury exposure; such cases should be reported to public health authorities.