Diagnosis of human papillomavirus infection by dry vaginal swabs in military women

Objective: Human papillomavirus (HPV) assays are likely to be used with inc reasing frequency in clinical management of women with abnormal Papanicolao u smears and in cervical cancer screening. Our objective was to simplify th e method of collection of female genital tract specimens. The utility of va ginal dry swabs for HPV diagnosis was evaluated. Methods: Specimens for cytology and for HPV identification were collected b y a clinician from 189 female soldiers. attending a military clinic. Three methods of specimen collection for HPV identification were compared: a vagi nal dry swab (v-DRY), and vaginal and cervical swabs placed into specimen t ransport medium (v-STM and c-STM). Swabs were shipped to a STD laboratory f or processing. Specific HPV types were identified by a consensus primer bas ed PCR based method. Results from 165 women were evaluable. Results: HPV prevalence by the three methods was similar and ranged from 44 .8% to 50.9%. 53 (32.1%) women were HPV positive and 60 (36.4%) women were HPV negative by all three collection methods. With respect to the risk cate gories of specific HPV types, there was greater agreement between the resul ts from the two vaginal (v-DRY and v-STM) samples (kappa values of 0.69-0.8 1) than between the cervical (c-STM) and either of the vaginal samples (kap pa values of 0.37-0.55). The HPV yield from c-STM was somewhat greater than that from the vaginal specimens but the correlation between cytological ab normalities and HPV was high for all three methods. Conclusion. A dry vaginal swab may be an acceptable method of specimen coll ection for HPV diagnosis.