Human papillomavirus (HPV) is responsible for causing condyloma and dysplasia of the lower female genital tract. A proportion of patients with ASCUS cervical and vaginal lesions (Atypical Squamous Cells of Undetermined Significance) have HPV-induced lesions not detected by routine cytology; a test for human papillomavirus DNA can help triage patients into those requiring colposcopic examination and those who can be followed by routine Pap smear/ThinPrep alone.
A qualitative test for HPV DNA can be performed on the residual fluid of a ThinPrep specimen using DNA hybridization techniques. This test is capable of detecting 18 HPV types and will discriminate between HPV types associated with low-grade squamous intraepithelial lesions (LGSIL) and those associated with high-grade squamous intraepithelial lesions (HGSIL).
- This test can only be performed on ThinPrep specimens. It cannot be performed on routine Pap smears.
- The ThinPrep specimen should be collected in the usual way.
- The request for the HPV test should be made within 10 days of collecting the specimen.
- A request for the HPV test can be made in one of three ways:
- The HPV test can be ordered at the time the specimen is submitted, and a request can be made that the test be performed irrespective of the result of the routine ThinPrep result (for example, in the case where a patient has had previous ASCUS smears).
- The test can be ordered as a reflex test, meaning that our laboratory is authorized to perform the HPV test if the current ThinPrep specimen shows ASCUS. In this situation, you should mark the box “HPV if ASCUS”.
- The test may be ordered after you have received the ThinPrep report. In this case, call Calpath and request that the HPV test be performed. The Calpath staff will fax you an authorization form that you should sign and return by fax.