2021 · International journal of environmental research and public health · open access
Diagnostic Test Accuracy of First-Void Urine Human Papillomaviruses for Presence Cervical HPV in Women: Systematic Review and Meta-Analysis
Bober et al.
The finding, in our words
Pooled sensitivity of 78% and specificity of 89% for high-risk HPV in first-void urine indicate acceptable diagnostic test accuracy for cervical HPV, supporting its use as a non-invasive decentralised screening option.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A time-resolved fluorescence assay detected HPV16-specific IgG in first-void urine with strong correlation to paired serum across four immunoassays in 225 healthy women, supporting first-void urine as a non-invasive alternative to venous blood for HPV antibody monitoring.
First-void urine IgG remained stable for at least 14 days at room temperature when stored with conservation medium. Amicon filtration with Melon Gel purification enriched HPV16-specific IgG that correlated strongly with serum levels, supporting non-invasive disease monitoring and vaccine impact assessment.
First-void urine tested on the GeneXpert platform detected high-risk HPV DNA with 84.8 per cent sensitivity and 92.3 per cent specificity compared with clinician-collected cervical samples, with substantial agreement (kappa 0.77) and high patient acceptability among 100 HIV-positive women in Zambia, suggesting that decentralised urine self-sampling with an EDTA preservative could widen cervical cancer screening coverage where invasive methods deter uptake.
First-void urine HPV antibody concentrations were lower than serum but showed strong positive correlations across four HPV types. The VLP-based multiplex ELISA demonstrated moderate to good agreement with the GST-L1 assay, confirming that self-collected first-void urine offers a viable non-invasive alternative for assessing HPV vaccine responses in decentralised studies, though larger investigations are needed to establish routine feasibility.
This study demonstrates for the first time that HPV vaccine antibodies can be detected in first-void urine from young women, with levels correlating strongly to serum (Spearman r 0.64–0.88). This non-invasive approach could support large-scale epidemiological studies and vaccine monitoring, reducing the need for venous blood draws, though further optimisation and validation is needed.