Biomedical subjects
P Gravitt
Publications and source records attributed to P Gravitt.
A direct comparison of methods proposed for use in widespread screening of human papillomavirus infections.
We obtained cervical swabs from 397 women participating in a human papillomavirus (HPV) prevalence study. Samples were assayed for HPV infection using ViraPap expanded cocktail (detecting HPV types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52 and 56), ViraType and PCR amplifications. Consensus primers from the L1 region were used with generic and type-specific oligonucleotide probes. Additionally, the generic amplifications were analysed with a novel restriction digest scheme. Samples positive by these methods were confirmed by PCR amplification using primers from the E5 region specific for HPV types 6, 16 and 18. The presence of human DNA in the samples was verified with amplification of the human KM-19 haplotyping primers. Our results confirm that the PCR reporter oligomer hybridization method is more sensitive than ViraPap/ViraType, but encompasses a narrower range of HPV types. This is particularly true of the higher number types in the expanded cocktail. The narrow range seems to occur as the result of the reporter oligomer used in hybridization, rather than the consensus amplimer pair used. Amplification of a broader range of HPVs is seen on gels or using the restriction digest as confirmation of HPV infection. Both ViraPap and PCR methods of detection gave about a 10% rate of uninterpretable results. PCR methods indicated about 1.7 times as many positives, while showing overall agreement of 77.6% with ViraPap. Agreement on types ranged from 67% to 100%. All methods indicated large fractions of untypable HPVs).
Determinants of genital human papillomavirus infection in low-income women in Washington, D.C.
OBJECTIVES: To confirm the risk factors for genital human papillomavirus (HPV) infection. GOAL OF THIS STUDY: To investigate risk factors for HPV detection independent of the correlated risk factors for cervical neoplasia, in a high-risk population. STUDY DESIGN: We investigated 404 cytologically normal women attending medical assistance clinics in the Washington, D.C. area. Risk factor information was obtained and a cervicovaginal lavage was collected and used for HPV detection and typing by a PCR-based technique. RESULTS: The point prevalence of HPV was 33.7%. This contrasts with the 17.7% and 44.3% observed in the companion reports published in this issue of the journal. HPV prevalence decreased with age and increased with greater numbers of sexual partners. Moreover, more recent sexual behavior was a better predictor of current HPV detection than lifetime number of sexual partners. Numbers of pregnancies and current pregnancy were positively associated with HPV prevalence and there was an indication that current oral contraceptive users had a higher prevalence of HPV compared to never users. Smoking was not associated with increased HPV prevalence. CONCLUSION: Findings support the sexual route of transmission of HPV and confirm the association of HPV detection with age, suggesting the host's ability to clear infection or the virus' ability to become latent.