title: Concordance of human papillomavirus in the cervix and urine among inner city adolescents.
abstract: OBJECTIVE
  To evaluate concordance for human papillomaviruses (HPVs) between cervix and urine in sexually active adolescents.
  
  
  METHODS
  Cervical swabs and urine were collected from 80 adolescents in Baltimore, MD. Specimens were tested for 34 HPVs by PCR and for cancer-associated HPVs by Hybrid Capture (HC II) Probe B. Cervical vs. urine prevalence was evaluated by logistic regression with general estimating equations. Risk factors for prevalence and viral burden were evaluated by Fisher's exact and Kruskal-Wallis tests, respectively.
  
  
  RESULTS
  HPV prevalence by PCR, for any HPV, was very high in the cervix (90.0%) and somewhat lower in urine (75.0%) (odds ratio, 1.07; 95% confidence interval 1.07 to 1.34). Only one adolescent was HPV-positive in urine alone. Among HPV-PCR positives at either or both sites, concordance was 82% for presence of any HPV and 40% for specific HPV types. Multiple infections were common at both sites. On an average, HC II viral burden (relative light unit ratio) was 9-fold higher in cervix than in urine (median, 47.3 vs. 4.9; P = 0.005) but correlated poorly between the two sites of the same individual (r = 0.14). Compared with normal adolescents, those with squamous intraepithelial lesions had a much higher prevalence of HPV by HC II in cervix (100% vs. 28.6, P<0.0001) as well as in urine (86.7% vs. 35.4%, P = 0.002) and a significantly higher viral burden in the cervix (median, 141.8 vs. 7.3, P = 0.0045) but not in urine (median, 22.7 vs. 4.38; P = 0.13).
  
  
  CONCLUSIONS
  There was a very high prevalence of HPV in cervix and urine of sexually active adolescents. Testing urine for HPV may be useful in epidemiologic investigations and in monitoring of infected women.
authors.affiliation: Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Jacobson
authors.forename: S D
authors.initials: SD
authors.lastname: Womack
authors.forename: L
authors.initials: L
authors.lastname: Peralta
authors.forename: J M
authors.initials: JM
authors.lastname: Zenilman
authors.forename: K
authors.initials: K
authors.lastname: Feroli
authors.forename: J
authors.initials: J
authors.lastname: Maehr
authors.forename: R W
authors.initials: RW
authors.lastname: Daniel
authors.forename: K V
authors.initials: KV
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D002584:Cervix Uteri / Q000821:virology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008396:Maryland / Q000453:epidemiology; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012494:Sampling Studies; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D014505:Urban Population; D014556:Urine / Q000821:virology*; D014626:Vaginal Smears