Vinegar testing for HPV

Vinegar is sometimes used to identify areas of HPV infection. It is used in a 5% acetic acid concentration as white vinegar available in most pharmacies. Vinegar misses 78% of HPV infections, but when whitening occurs on the skin after application of vinegar, it very accurately suggests HPV 90% of the time. In other words, there are many false negatives (low sensitivity) but few false positives (high specificity) with this test.

Obstet Gynecol 1997 Nov; 90(5):744-7:

Acetowhitening of the cervix and vulva as a predictor of subclinical human papillomavirus infection: sensitivity and specificity in a population-based study.

Jonsson M, Karlsson R, Evander M, Gustavsson A, Rylander E, Wadell G Department of Family Medicine, University of Umea, Sweden.

“Objective: To evaluate acetowhite changes of the cervix and vulva as a predictor of human papillomavirus (HPV) infection.

Methods: In this population-based study all women aged 19, 21, 23, and 25 years and registered as living in a primary health care area within the city of Umea, Sweden were eligible for inclusion. Each participant underwent a gynecologic examination with sampling of epithelial cells for HPV-DNA detection and Papanicolaou smear. Colposcopy was performed 5 minutes after application of 5% acetic acid. A two-step polymerase chain reaction (PCR) technique was employed for HPV-DNA detection.

Results: Colposcopy and sampling of epithelial cells could be performed in 535 women. The sensitivity of detection of HPV infection by the acetowhitening of the cervix was 22% (95% confidence interval [CI] 18%, 26%). The specificity of detection of HPV infection by the acetowhitening of the cervix was 90% (95% CI 87%, 93%). The sensitivity of detection of HPV infection by cytology was 13% (95% CI 10%, 16%), and the specificity was 99% (95% CI 98%, 100%). The combination of acetowhitening and cytology did not improve the diagnostic value.

Conclusion: Acetowhitening of the cervix and vulva has low sensitivity as a predictor of HPV infections as determined by PCR.”

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