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Provide advantages related to increased acceptance regarding sample-taking, adherence and following-up

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Provide advantages related to increased acceptance regarding sample-taking, adherence and following-up women, especially those having some form of immunological compromise [14,15]. Specimen tampons, vaginal swabs and urine samples have been studied as self-sampling methods; such sampling methods are also used for detecting other sexually-transmitted pathogens affecting the cervical area [9,16], urine samples being the easiest to obtain and having had the greatest acceptance in the population. However, they do have some limitations, including low cellular load and they are not taken directly from the HPV infection site; this could mean that the results Eltrombopag (Olamine) obtained from this type of Elbasvir sample might not reflect the real clinical state of an infection [14]. In spite of their limitations, using urine samples as a test for detecting HPV-DNA presence could facilitate frequent sampletaking due to their practicality and greater acceptance among women. This could be useful in studies involving a large number of samples and a pelvic examination is also not required, meaning that sample-taking will not affect the natural history of HPV infection as there is no risk of micro-lesions being produced, nor will inflammatory reactions occur [15]. Despite of multiple studies available in the literature that have evaluated HPV-DNA detection from urine sample [15], a few number of these have been described the diagnostic performance of this sample in HIV-positive women population. Furthermore those who have done it had included a limited number of individuals [9,17]. In Colombia high prevalence of HPV infection and co-infection in healthy women population have been reported, using cervical samples [18,19]. However haven’t be evaluated HPV DNA detection from urine samples neither in HIV-positive women population. This study aimed at identifying the infection, coinfection (defined here as being infection by more than one type of HPV simultaneously) and type-specific distribution profile of six highrisk HPV (HR-HPV) types and two low-risk (LR-HPV) types, from paired cervical and urine samples of women diagnosed with HIV/ AIDS, confirmed by Western blot. Finally, we evaluated the diagnostic performance of urine samples compared to cervical samples for detecting HPV infection.Sample size was calculated assuming an estimated 80 HPV infection rate in HIV-positive women [4,17,20], according to data reported in the literature. Estimators were calculated using 0.05 precision along with 95 confidence intervals (95 CI) using STATA9 software sampsi command.Collecting and processing cervical and urine samplesAll the women enrolled in the study were informed about the research objective; they signed an informed consent form and filled in a questionnaire to facilitate collecting socio-demographic data and information regarding their sexual habits and other risk factors related to acquiring HPV infection. Each woman’s urine and cervical samples were taken on the same day; the first sample from a midstream urine specimen was self-collected, kept at 4uC and processed within 72 hours after being collected. The second sample taken from cervical cells was obtained during Papanicolau test, following Colombian obligatory health plan guidelines regarding cervical cancer detection and control programs in Colombia [21]; these cells were preserved in 95 ethanol [22,23] and kept at 4uC until being processed. The histological findings were reported following the Bethesda classification [1.Provide advantages related to increased acceptance regarding sample-taking, adherence and following-up women, especially those having some form of immunological compromise [14,15]. Specimen tampons, vaginal swabs and urine samples have been studied as self-sampling methods; such sampling methods are also used for detecting other sexually-transmitted pathogens affecting the cervical area [9,16], urine samples being the easiest to obtain and having had the greatest acceptance in the population. However, they do have some limitations, including low cellular load and they are not taken directly from the HPV infection site; this could mean that the results obtained from this type of sample might not reflect the real clinical state of an infection [14]. In spite of their limitations, using urine samples as a test for detecting HPV-DNA presence could facilitate frequent sampletaking due to their practicality and greater acceptance among women. This could be useful in studies involving a large number of samples and a pelvic examination is also not required, meaning that sample-taking will not affect the natural history of HPV infection as there is no risk of micro-lesions being produced, nor will inflammatory reactions occur [15]. Despite of multiple studies available in the literature that have evaluated HPV-DNA detection from urine sample [15], a few number of these have been described the diagnostic performance of this sample in HIV-positive women population. Furthermore those who have done it had included a limited number of individuals [9,17]. In Colombia high prevalence of HPV infection and co-infection in healthy women population have been reported, using cervical samples [18,19]. However haven’t be evaluated HPV DNA detection from urine samples neither in HIV-positive women population. This study aimed at identifying the infection, coinfection (defined here as being infection by more than one type of HPV simultaneously) and type-specific distribution profile of six highrisk HPV (HR-HPV) types and two low-risk (LR-HPV) types, from paired cervical and urine samples of women diagnosed with HIV/ AIDS, confirmed by Western blot. Finally, we evaluated the diagnostic performance of urine samples compared to cervical samples for detecting HPV infection.Sample size was calculated assuming an estimated 80 HPV infection rate in HIV-positive women [4,17,20], according to data reported in the literature. Estimators were calculated using 0.05 precision along with 95 confidence intervals (95 CI) using STATA9 software sampsi command.Collecting and processing cervical and urine samplesAll the women enrolled in the study were informed about the research objective; they signed an informed consent form and filled in a questionnaire to facilitate collecting socio-demographic data and information regarding their sexual habits and other risk factors related to acquiring HPV infection. Each woman’s urine and cervical samples were taken on the same day; the first sample from a midstream urine specimen was self-collected, kept at 4uC and processed within 72 hours after being collected. The second sample taken from cervical cells was obtained during Papanicolau test, following Colombian obligatory health plan guidelines regarding cervical cancer detection and control programs in Colombia [21]; these cells were preserved in 95 ethanol [22,23] and kept at 4uC until being processed. The histological findings were reported following the Bethesda classification [1.

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