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1.
J Clin Virol ; 74: 26-31, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26655264

ABSTRACT

BACKGROUND: Urine testing for high-risk human papillomavirus (HR-HPV) detection could provide a non-invasive, simple method for cervical cancer screening. OBJECTIVES: We examined whether HR-HPV detection is affected by urine collection time, portion of urine stream, or urine fraction tested, and assessed the performance of HR-HPV testing in urine for detection of cervical intraepithelial neoplasia grade II or worse (CIN2+). STUDY DESIGN: A total of 37 female colposcopy clinic attendees, ≥ 30 years, provided three urine samples: "first void" urine collected at home, and "initial stream" and "mid-stream" urine samples collected at the clinic later in the day. Self- and physician-collected brush specimens were obtained at the same clinic visit. Colposcopy was performed and directed biopsies obtained if clinically indicated. For each urine sample, HR-HPV DNA testing was conducted for unfractionated, pellet, and supernatant fractions using the Trovagene test. HR-HPV mRNA testing was performed on brush specimens using the Aptima HPV assay. RESULTS: HR-HPV prevalence was similar in unfractionated and pellet fractions of all urine samples. For supernatant urine fractions, HR-HPV prevalence appeared lower in mid-stream urine (56.8%[40.8-72.7%]) than in initial stream urine (75.7%[61.9-89.5%]). Sensitivity of CIN2+ detection was identical for initial stream urine and physician-collected cervical specimen (89.9%[95%CI=62.7-99.6%]), and similar to self-collected vaginal specimen (79.1%[48.1-96.6%]). CONCLUSION: This is among the first studies to compare methodologies for collection and processing of urine for HR-HPV detection. HR-HPV prevalence was similar in first void and initial stream urine, and was highly sensitive for CIN2+ detection. Additional research in a larger and general screening population is needed.


Subject(s)
Early Detection of Cancer/methods , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Precancerous Conditions/diagnosis , Urine Specimen Collection/methods , Urine/virology , Uterine Cervical Dysplasia/diagnosis , Adult , DNA, Viral/isolation & purification , Female , Humans , Middle Aged , Papillomavirus Infections/complications , Pilot Projects , Precancerous Conditions/virology , RNA, Messenger/isolation & purification , RNA, Viral/isolation & purification , Sensitivity and Specificity , Uterine Cervical Dysplasia/virology
3.
Epidemiol Infect ; 143(2): 225-41, 2015 Jan.
Article in English | MEDLINE | ID: mdl-24877975

ABSTRACT

We conducted a systematic review summarizing data on incidence of high- and low-grade lesions in women with normal baseline cervical cytology, stratified by age (<30 and ⩾30 years), and baseline human papillomavirus (HPV) infection. Incidence of high- and low-grade lesions in women aged ⩾30 years with a baseline HPV infection increased over follow-up time (5-127 months), although incidence generally remained <10%. Without baseline HPV infection, incidence of high-grade lesions remained low over follow-up time (<5% over 5-122 months). Incidence of high-grade lesions in women aged ⩾30 years with baseline HPV infection appeared similar to that in women aged <30 years. In some women aged <30 years, high-grade lesions can develop relatively shortly after initial HPV infection. We observed an increase in low-grade lesions over time in women aged ⩾30 years with baseline HPV infection, potentially indicative of an HPV infection that is potentially progressing to higher grade lesions.


Subject(s)
Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Dysplasia/virology , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Papillomaviridae , Young Adult
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