During the last decade, growing efforts have focused on human papillomavirus (HPV) detection using liquid hybridization, conventional PCR, and real-time PCR-based methods to increase the overall proportion of patients participating in cervical cancer screening procedures. We proposed a new general HPV DNA real-time PCR on the Mx4000 (Stratagene) and LightCycler (Roche Diagnostics) systems usable for both cervical scrape specimens and urine samples. A linear range was obtained from 5 DNA copies to 8 log 10 DNA copies/ml, and intra-and interassay variations were between 1.8 and 4%. Cervical carcinoma and HPV DNA screening was performed in 333 individual women referred for gynecological examination at the university hospitals of Angers and Brest and enrolled in the PapU study. Among cervical specimens (n ‫؍‬ 333), 45% were positive for HPV DNA, with a mean viral load at 5.00 log/ml (؎ 1.73). Among urine samples (n ‫؍‬ 177), 37% were positive with a significant 50-fold-lower mean viral load (3.77 ؎ 1.32 log/ml; P < 0.0001). Kappa agreement for HPV DNA between cervical and urine specimens was excellent (93%). Thus, we developed a highly sensitive and quantitative general HPV DNA real-time PCR method that allows mass screening of patients with HPV infection. The ongoing longitudinal and prospective multicenter PapU study should give us the opportunity to validate this method adapted to HPV DNA screening in urine samples in a larger population.Human papillomaviruses (HPVs) are epitheliotropic viruses associated with benign and malignant lesions of cutaneous and mucosal epithelia. More than 100 different types of HPV have been identified to date, of which 40 have been reported in anogenital infections. In a recent multicenter analysis involving 1,918 women in 11 case-control studies (14), 15 HPV genotypes (HPV types 16,18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) were classified as high risk (HR-HPV) and associated with precancerous lesions of the cervix, 3 were classified as probable HR-HPV (types 26, 53, and 66), and 12 were classified as low risk (LR), i.e., not associated with the development of cervical carcinoma (types 6,11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108). Because of the strong association between HPV infection and cervical cancer, detection of HPV DNA in cervical samples may be an option for identifying women at risk of developing cancer (13). However, cervical sampling is uncomfortable, time-consuming, and requires a degree of skill. Self-collected cervical sampling was not found to be as efficient as sampling done by a physician (19). Therefore, about 40% of the women in France presenting a cervical carcinoma have never been screened. Moreover, it would be easier to use urine specimens as is done with molecular detection of Chlamydia trachomatis (7,21). This would simplify mass screening and survey of HR-HPV female carriers.Efficient HPV culturing remains elusive, and the clinical performance of serological assays is still poor. Thus, diagnosis of HPV infection is based almost...

High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.

International audienceVulvodynia has been defined by the International Society for the Study of Vulvovaginal Diseases (ISSVD) as vulvar discomfort, which is most often described as a burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable, neurological disorder (1). Much remains to be understood regarding the patho genesis, natural history, and management of this distressing condition. As postulated for many chronic pain syndromes, the involvement of both peripheral and central sensitization mechanisms in the pathogenesis of vulvodynia has been suggested (2, 3). The characteristics of the pain experienced by patients with vulvodynia suggests the involvement of a neuropathic component in vulvodynia; this includes: hyperalgesia, paraesthesia, dysesthesia and allodynia. In addition, the ineffectiveness of common pain-killers, the effectiveness of certain anticonvulsants (4), anti-depressants and transcutaneous electrical nerve stimulation (TENS) (5) are occasionally reported in association with vulvodynia. The primary objective of the present study was to generate further evidence in support of the existence of a neuropathic component underlying the pathogenesis of vulvodynia. An additional aim was to determine the presence of anxiety, depression and other chronic pain conditions in patients with vulvodynia

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