Conflicts of interest: none to declare.
High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping†
Article first published online: 23 OCT 2012
Copyright © 2012 Wiley Periodicals, Inc.
Journal of Medical Virology
Volume 85, Issue 1, pages 91–98, January 2013
How to Cite
Tanzi, E., Bianchi, S., Fasolo, M. M., Frati, E. R., Mazza, F., Martinelli, M., Colzani, D., Beretta, R., Zappa, A. and Orlando, G. (2013), High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping. J. Med. Virol., 85: 91–98. doi: 10.1002/jmv.23434
- Issue published online: 13 NOV 2012
- Article first published online: 23 OCT 2012
- Manuscript Accepted: 3 SEP 2012
- Italian Ministry of University and Research, MIUR, PRIN-2007. Grant Number: 20074B5ZBC_002
- Regione Lombardia, Dote Ricerca. Grant Number: FSE 2007-2013
- PCR-based assay;
- HPV DNA;
- HPV genotyping;
- urine testing;
- molecular screening
Human papillomavirus (HPV) testing has been proposed as a means of replacing or supporting conventional cervical screening (Pap test). However, both methods require the collection of cervical samples. Urine sample is easier and more acceptable to collect and could be helpful in facilitating cervical cancer screening. The aim of this study was to evaluate the sensitivity and specificity of urine testing compared to conventional cervical smear testing using a PCR-based method with a new, designed specifically primer set. Paired cervical and first voided urine samples collected from 107 women infected with HIV were subjected to HPV-DNA detection and genotyping using a PCR-based assay and a restriction fragment length polymorphism method. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated using the McNemar's test for differences. Concordance between tests was assessed using the Cohen's unweighted Kappa (k). HPV DNA was detected in 64.5% (95% CI: 55.1–73.1%) of both cytobrush and urine samples. High concordance rates of HPV-DNA detection (k = 0.96; 95% CI: 0.90–1.0) and of high risk-clade and low-risk genotyping in paired samples (k = 0.80; 95% CI: 0.67–0.92 and k = 0.74; 95% CI: 0.60–0.88, respectively) were observed. HPV-DNA detection in urine versus cervix testing revealed a sensitivity of 98.6% (95% CI: 93.1–99.9%) and a specificity of 97.4% (95% CI: 87.7–99.9%), with a very high NPV (97.4%; 95% CI: 87.7–99.9%). The PCR-based assay utilized in this study proved highly sensitive and specific for HPV-DNA detection and genotyping in urine samples. These data suggest that a urine-based assay would be a suitable and effective tool for epidemiological surveillance and, most of all, screening programs. J. Med. Virol. 85:91–98, 2012. © 2012 Wiley Periodicals, Inc.