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Urine nucleic acid amplification tests for the diagnosis of sexually transmitted infections in clinical practice

Gaydos, Charlotte Aa; Quinn, Thomas Ca,b

Current Opinion in Infectious Diseases: February 2005 - Volume 18 - Issue 1 - p 55–66
Sexually transmitted diseases and uninary tract infections

Purpose of review With the advent of highly sensitive and specific nucleic acid amplification assays, this report will demonstrate that self-collected genital specimens, such as urine or even vaginal swabs can be accurately used to diagnose sexually transmitted infections.

Recent findings Use of self collected samples can eliminate the necessity of a clinician to perform a pelvic examination for women or collect a urethral swab for men, thus extending the diagnostic capability for sexually transmitted infections to non-clinic screening venues. As many sexually transmitted infections are asymptomatic, this ability to use self-sampling greatly increases the numbers of patients that can be screened, and has the potential to augment public health programs designed to control the epidemic of sexually transmitted infections in the community. Patient collected samples are highly acceptable, highly accurate, and are becoming widely used. Self-sampling also allows clinicians to easily screen patients in the clinic, who are not presenting for pelvic or urogenital examinations, for sexually transmitted infections.

Summary Highly accurate molecular tests and easily obtained self-collected urogenital samples represent the ideal combination for obtaining the public health goal of decreasing the sexually transmitted infection epidemic among sexually active persons in the United States today.

Abbreviations CDC: Centers for Disease Control and Prevention; CIN: cervical intraepithelial neoplasia; EIA: enzyme immunoassay; FDA: Food and Drug Administration; HPV: human papillomavirus; NAAT: nucleic acid amplification test; PCR: polymerase chain reaction; PPV: positive predictive value; STD: sexually transmitted disease; STI: sexually transmitted infection.

aJohns Hopkins University School of Medicine, Baltimore

bNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to Charlotte A. Gaydos, DrPH, Associate Professor, 1159 Ross, 720 Rutland Avenue, Baltimore, MD 21205, USA Tel: +1 410 614 0932; fax: +1 410 614 9775; e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.