Human Papillomavirus (HPV)

Introduction

The human papillomavirus (HPV) belongs to the group of papillomaviruses, which are DNA viruses. More than 100 different types are known. The virus enters into the host cells via microlesions of the epidermis or mucosa.

Infections with papillomaviruses can lead to the appearance of warts of the skin (verrucae vulgaris, transmission in the swimming pool possible). From the clinical point of view they are of low interest since they often disappear spontaneously or are removed surgically. Genital infections (sexually transmitted) as well as larngyeal papillomas caused by papilloma virus are of high importance.

The incubation time of the virus is one to eight months, on average three months. HPV infections of the genital tract are frequent in the age group of 20 to 30 years; the epidemic rate in the population is more than 10%.

An association of specific HPV infections and carcinoma of cervix, vulva and penis has been described repeatedly. HPV16-DNA (high risk) is detected in 50% of these carcinomas. Up to 20% of the cancers contain HPV18-DNA (high risk). 15% of the cancers contain DNA sequences, which cross-react with papilloma viruses and which have not been identified so far. In bowenoid papulosis (intradermal thorn cell cancer of the skin) HPV18-DNA is detected in 80% of cases.

Indication

Suspicious cytology, condyloma acuminate

Benefit

FML now offers HPV genotyping twice weekly. This test has improved sensitivity and specificity and provides a more accurate tool for diagnosis of HPV than direct hybridization methods. One sample can be used for cytology and HPV genotyping.

Background

There are various types of the human Papillomavirus and most types are transmitted sexually. Many of these do not show symptoms, do not cause disease and disappear after 1-2 years. Of the types of HPV, some carry a high oncogenic risk, others a low oncogenic risk. Some of the high-risk HPV types (HR-HPV) may progress to pre-cancerous lesions and invasive cancer.

HR-HPV are the cause of nearly all cases of cervical cancer and cervical intraepithelial neoplasia.

Material

Genital swab, brush or liquid cytology sample

Method

PCR

Results

The following relevant HPV genotypes are detectable:

High oncogenic risk

16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69,73, 82

Low oncogenic risk

6, 11, 40, 42, 43, 44, 54, 61, 70

Preanalytics

Standard dry swab (cotton) or dried brush (from conventional Pap smears) in a dry transportation tube for PCR examination (without additional substances or liquids), no freezing!

Liquid cytology solution (Thinprep, Surepath etc.) can be used as well if Liquid Based Cytology is requested simultaneously. Please note that Liquid based Cytology and HPV genotyping can be performed out of one Liquid Based Cytology Solution vial!

Sample Reports

Download HPV Genotyping Sample Report