Objectives. To evaluate concordance for human papillomaviruses (HPVs) betwe
en cervix and urine in sexually active adolescents.
Methods. Cervical swabs and urine were collected from 80 adolescents in Bal
timore, MD. Specimens were tested for 34 HPVs by PCR and for cancer-associa
ted HPVs by Hybrid Capture (HC II) Probe B. Cervical vs. urine prevalence w
as evaluated by logistic regression with general estimating equations. Risk
factors for prevalence and viral burden were evaluated by Fisher's exact a
nd Kruskal-Wallis tests, respectively.
Results. HPV prevalence by PCR, for any HPV, was very high in the cervix (9
0.0%) 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 alon
e. 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 we
re 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 indivi
dual (r = 0.14). Compared with normal adolescents, those with squamous intr
aepithelial 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).
Conclusion. There was a very high prevalence of HPV in cervix and urine of
sexually active adolescents. Testing urine for HPV may be useful in epidemi
ologic investigations and in monitoring of infected women.