A novel tailed primer nucleic acid test for detection of HPV 16, 18 and 45 DNA at the point of care

Sci Rep. 2023 Nov 21;13(1):20397. doi: 10.1038/s41598-023-47582-y.

Abstract

Cervical cancer is a leading cause of death for women in low-resource settings despite being preventable through human papillomavirus (HPV) vaccination, early detection, and treatment of precancerous lesions. The World Health Organization recommends high-risk HPV (hrHPV) as the preferred cervical cancer screening strategy, which is difficult to implement in low-resource settings due to high costs, reliance on centralized laboratory infrastructure, and long sample-to-answer times. To help meet the need for rapid, low-cost, and decentralized cervical cancer screening, we developed tailed primer isothermal amplification and lateral flow detection assays for HPV16, HPV18, and HPV45 DNA. We translated these assays into a self-contained cartridge to achieve multiplexed detection of three hrHPV genotypes in a disposable cartridge. The developed test achieves clinically relevant limits of detection of 50-500 copies per reaction with extracted genomic DNA from HPV-positive cells. Finally, we performed sample-to-answer testing with direct lysates of HPV-negative and HPV-positive cell lines and demonstrated consistent detection of HPV16, HPV18, and HPV45 with 5000-50,000 cells/mL in < 35 min. With additional optimization to improve cartridge reliability, incorporation of additional hrHPV types, and validation with clinical samples, the assay could serve as a point-of-care HPV DNA test that improves access to cervical cancer screening in low-resource settings.

MeSH terms

  • DNA, Viral / genetics
  • Early Detection of Cancer
  • Female
  • Genotype
  • Human papillomavirus 16 / genetics
  • Human papillomavirus 18
  • Humans
  • Nucleic Acids*
  • Papillomaviridae / genetics
  • Papillomavirus Infections* / diagnosis
  • Point-of-Care Systems
  • Reproducibility of Results
  • Uterine Cervical Neoplasms* / diagnosis

Substances

  • Nucleic Acids
  • DNA, Viral

Supplementary concepts

  • human papillomavirus 45