Salivary oral rinse offers a noninvasive method to detect oral human papillomavirus infections on the GeneXpert system

BACKGROUND: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing, and human papillomavirus (HPV)-associated OPSCC is contributing substantially to this trend. Salivary HPV testing enables early detection of HPV-driven OPSCC. The GeneXpert system (Cepheid) is an automated polymerase chain reaction (PCR)-based diagnostic platform designed primarily for cervical cancer screening using vaginal swabs. Our goal was to adapt this platform for HPV testing using salivary oral rinse (SOR) samples to enable early detection of HPV-driven OPSCC. METHODS: Patients suspected of having any type of head and neck cancers and people at higher risk of acquiring HPV infections were recruited (n = 67). A volume of 5 to 10 mL of SOR samples was tested using the GeneXpert system. Genomic DNA was extracted from the same SOR samples and analyzed using quantitative real-time PCR for human papillomavirus type 16 (HPV-16). The detection status of HPV-16 was used to evaluate the efficiency of HPV detection using the GeneXpert system. RESULTS: The GeneXpert system had excellent specificity of 100% and sensitivity of 72.09%. There was strong agreement with quantitative real-time PCR results (κ = .649). This confirms the suitability of SOR as a sample medium on the GeneXpert system to detect oral HPV with minimal bias. CONCLUSIONS: The GeneXpert system can effectively detect HPV in SOR samples. It offers rapid HPV detection, helps identify people at high risk of developing HPV-associated OPSCC, thereby holding promise for the early detection of HPV-driven OPSCC. PRACTICAL IMPLICATIONS: The results of this study showed the feasibility of using SOR samples on the GeneXpert platform as a scalable, noninvasive screening approach for the early detection of patients at higher risk of developing HPV-associated OPSCC.