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Sunday 3 March 2013

Human Papillomavirus (HPV) Test



A Human Papillomavirus (HPV) test is done to find a high-risk HPV infection in women. An HPV test checks for the genetic material (DNA) of the Human Papillomavirus. Like a Pap test,  an HPV test is done on a sample of cells collected from the cervix.

There are many types of HPV. Some types cause warts that you can see or feel. Other types do not cause any symptoms. Most people do not know they have an HPV infection.

This test will identify whether a high-risk type of HPV is present. In women, high-risk types of HPV (which I mentioned in the past posts) cause changes in the cells of the cervix that can be seen as abnormal changes on a Pap test.  Abnormal cervical cell changes may resolve on their own without treatment. But some untreated cervical cell changes can progress to serious abnormalities and may lead to cervical cancer over time if it is not treated.

Although HPV is found in both men and women, this test is not used on men. Also, your doctor can usually diagnose visible genital warts with a physical exam, so this test is not used to diagnose genital warts caused by low-risk types of HPV.



Why is it done


An HPV test is done to:

·         Check for high-risk types of Human Papillomavirus (HPV) in women who had a Pap test that showed abnormal cervical cells called atypical squamous cells.   An HPV test can help look for one or more high-risk types of HPV. If an HPV test shows that high-risk types of HPV are present, further testing, such as a colposcopy or cervical biopsy, may be recommended.

·         Check for HPV in women older than age 30 as part of screening for abnormal cervical cells.

·         To help check for abnormal cervical cells after treatment of a high-risk HPV infection.

·         The HPV test may be done at the same time as the Pap test. The results of this test can help doctors decide if further tests or treatments are needed.



How to prepare for the HPV test


·         Before an HPV test, do not douche, use tampons, or use vaginal medicines for at least 48 hours.

·         You will be asked to empty your bladder just before the test, both for your own comfort and to help with the examination.

·         Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean.



How is it done


An HPV test can be done in a doctor's office or clinic by:

·         A gynecologist

·         An internist

·         A family medicine physician

·         An urologist

·         A physician assistant (PA)

·         A nurse practitioner

For this test, you need to remove your clothes below the waist and drape a paper or cloth covering around your waist. You will then lie on your back on an examination table with your feet raised and supported by stirrups. This allows your doctor to examine your vagina and genital area.

Your health professional will insert an instrument called a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.

Your health professional will then use a cotton swab or a small brush to collect several samples of cells from the cervix. Cells are collected from the visible part of the cervix as well as cells from inside the opening of the cervix (endocervical canal). The samples are then placed in collection tubes and sent to a laboratory for analysis.

An HPV test can also be done on a cell sample taken during your Pap test if a technique called a liquid-based Pap test was used. For a liquid-based Pap test, cells are collected by rotating a plastic brush on the cervix. The samples are then placed in a jar of solution and sent to a lab for examination. If you have this type of Pap test and it shows abnormal cells, an HPV test may be done later on the same sample.


How does it feel


You may feel some discomfort when the speculum is inserted, especially if your vagina is irritated and tender or if it is narrow. You may also feel pulling or pressure when the sample of cervical cells is being collected.


Risks


There is very little chance of a problem from an HPV test. You may worry or feel frightened if you need more testing.


After the procedure


·         You may have a small amount of vaginal bleeding or gray-green discharge after this test, and you may want to use a pantyliner to protect your clothes from any spotting.

·         Do not have sex until your doctor tells you it is safe to do so.


Results


A Human Papillomavirus (HPV)  test is done to find a-high risk HPV infection in women. HPV test results are generally available in 1 to 2 weeks.

Human Papillomavirus (HPV)
Normal:
High-risk HPV is not found.
Abnormal:
High-risk HPV is found. If high-risk HPV is found, you may have a higher chance of having precancerous cervical cell changes. Further testing-including repeat Pap or HPV tests, colposcopy or cervical biopsy  -may be recommended by your doctor, depending on your medical history and the results of this test.




What affects the Test


Reasons you may not be able to have the test or why the results may not be helpful include:

·         The use of douches, tampons, and vaginal creams or vaginal medicines within 48 hours before the test.

·         A cervical cell sample that is too small.

·         Your Pap smear shows abnormal cells that are already known to be caused by a high-risk type of HPV.



What to think about


·         A Human Papillomavirus (HPV) test is not routinely used to diagnose genital warts. It is usually done to find out whether an abnormal Pap test result may be caused by one or more high-risk types of HPV.

·         An HPV test may be done along with a Pap test in women age 30 and older. It may be done as a follow-up test after treatment for an abnormal Pap test.

·         A positive HPV test does not mean that you have cervical cancer. It may mean that you are infected with one or more high-risk types of HPV, which increases your chance of having precancerous cervical cell changes. Your doctor may recommend repeat testing or further testing, such as a colposcopy and cervical biopsy, to find out whether precancerous changes are present. The type of testing recommended will depend on your medical history and the findings of the HPV test.

·         An HPV test is highly reliable for finding HPV when it is present. But an HPV test may come back positive when you do not have an HPV infection. This is called a false-positive test result.

·         An HPV test is done only for women. Currently, an HPV test for men is done only in a research setting.

·         If you are age 26 or younger, you can get the HPV shot. The vaccines Cervarix and Gardasil protect against two types of HPV that cause cervical cancer. Gardasil also protects against two types of HPV that cause genital warts.


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