What is the role of lab testing in the diagnosis of human papillomavirus (HPV) infection?
Role of Lab Testing in HPV Diagnosis • Colonoscopy Acetic acid test is recommended for • immunosuppressed transplant recipients • HIV positive women • positive cervical cytology • two consecutive tests reporting mild dyskaryosis • three consecutive tests reporting borderline nuclear change in squamous cells • Acetic acid test In this test, the suspected lesions on the genital parts are soaked with 3-5% acetic acid. The neoplastic areas turn acetowhite. However, false positive results are common occurrence too. It is not a routine screening test hence the indications must be noted. • Biopsy Biopsy follows colonoscopy. When colonoscopy reveals abnormal areas then biopsy is recommended. Biopsy shows pre-malignant status or dysplasia. It can be mild, moderate and severe. Excisional biopsy is recommended when colonoscopy demonstrates high grade abnormality or low grade abnormality with severe dyskaryosis. • Hybrid capture HPV DNA Test 2 Hybrid capture HPV DNA Test 2, or simply HC2, is an efficient diagnostic test. It is the best standardized HPV detection test because of good reproducibility and simple handling. Moreover, this laboratory test tends to detect a minute amount of 1 pg of HPV DNA/ml. The specificity and sensitivity of HC2 is comparable with PCR-based detection methods. FDA approves HC2 with Pap smear test. • Polymerase Chain Reaction (PCR) PCR-based detection test of HPV is indicated in primary screening with Papanicolaou (Pap). It is also a stand-alone test for women over the age of 30. • Pap smear test Pap smear test, or simply pap test, detects malignant changes and viral infection such as HPV and herpes. Positive pap smear tests needs further validation by conducting colonoscopy, DNA technique and cervical biopsy.
