Comparison of HPV DNA Detection in Self-Collected Urine and Vaginal Samples

To compare the prevalence and detection of human papilloma virus (HPV) DNA from urine and self-collected vaginal samples of women with cervical neoplasia.

In this cross-sectional study, approved by the institutional review board, 40 women attending the Gynaecologic Oncology clinic with an abnormal Pap smear or cervical biopsy were recruited for the study after obtaining informed consent. Women were asked to self-collect urine and vaginal samples. If positive for HPV DNA, genotyping was done either by CHUV assay or the linear array. The acceptability of the two self-collected methods was assessed by a questionnaire.

HPV DNA was detected in 24 (60%) of the urine samples and in 33 (83%) of the vaginal samples. Excepting one vaginal sample where low risk type was only detected, all other vaginal samples and all positive urine samples had high-risk HPV. HPV 16 was the most common genotype isolated from urine and vaginal samples. Self-collection of vaginal samples was acceptable to most and, 60% preferred it over physician collection. Most (65%) women preferred collecting urine over vaginal self-sampling, the agreement between urine and vaginal samples was fair (PABAK = 0.350, p = 0.062). For type specific HPV, there was moderate agreement for HPV 16 (PABAK = 0.650, p = 0.355) and moderate agreement (PABAK = 0.450, p = 0.007) for HPV 16/18/both.

The agreement between urine HPV and vaginal HPV for HPV 16 and 18 genotypes was moderate. Detection of high-risk HPV in urine is a promising alternative to detection from self-collected vaginal samples.