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Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers

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Abstract

Cervical cancer is the second most common malignant neoplasm in women worldwide representing approximately 10% of all types of cancers. Triage of women through cervical cytology has been an important strategy for the surveillance and control of new cases of cervical cancer. However, in many regions around the world cervical cytology has a low coverage compared to developed countries. The molecular detection of HPV is the most effective method to increase the screening sensitivity of women at risk of developing cervical cancer. There are very few studies about the efficacy of urine testing for detection of HPV in women followed up in primary health care centers. Consequently, the efficacy of using urine HPV screening in these populations has not been addressed yet. Here, we compared the detection of HPV in simultaneous urine and cervical samples of women followed up in primary health care centers. Urine and cervical samples were analyzed in 543 women attending at primary health care centers. HPV was detected by real time PCR, and HPV typing performed by PCR–RLB. A general HPV concordance of 86.2% (κ = 0.72) was determined between urine and cervical samples. The concordance for HPV-16 and 18 was almost perfect (κ = 0.82) and strong (κ = 0.77), respectively. The sensitivity and specificity for all HPV genotypes in urine using cervical samples as reference were 82.1 and 93.7%, respectively. The results showed that urine is a good alternative as clinical sample for HPV screening in women attending primary health care centers. Therefore, urine should be used as an alternative sample for increasing triage coverage either in refractory women participating in Pap surveillance programs or when cervical samples are not available.

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Authors and Affiliations

  1. Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile

    Nicolás Vergara, Monserrat Balanda, Héctor San Martín, Francisco Roldán, Tania Villalón, Melissa Hott & Eugenio Ramírez

  2. Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile

    Nicolás Vergara, Gloria Espinoza & Andrea Quiero

  3. Dirección de Salud, Municipalidad de Huechuraba, Santiago, Chile

    Wilma Hidalgo & Francisco Roldán

  4. Sección Biofarmacia, Agencia Nacional de Medicamentos, Instituto de Salud Pública de Chile, Santiago, Chile

    Alexis Aceituno

  5. Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile

    Alexis Aceituno

  6. Vicedecanato Investigación y Postgrado, Facultad de Medicina, Universidad de los Andes, Santiago, Chile

    María T. Valenzuela

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  1. Nicolás Vergara
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  12. Eugenio Ramírez
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Vergara, N., Balanda, M., Hidalgo, W. et al. Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers. Med Microbiol Immunol 207, 95–103 (2018). https://doi.org/10.1007/s00430-017-0530-1

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