HPV Test

HPV Overview: 

The human papillomavirus (HPV) is the most common cause of sexually transmitted diseases that spread sex with a person who has the virus. Some types of HPV cause papilloma’s or warts, while the other "high-risk HPV" can cause cancers of the cervix, vagina, vulva, penis, anus, parts of mouth, and throat. These include the HPV 16 and 18 strains. 

Types of HPV: 

HPVs are of two types:

• The cutaneous (skin) type causes warts on the skin of the arms, chest, hands, and feet.
• The Mucosal (genital) type causes cauliflower-shaped warts on or around the genitals and anus (low-risk) and cancers (high-risk types. 

Clinical Symptoms of HPV infections: Most people with HPV show no symptoms and won't experience health issues, as the immune system usually clears the infection within about 2 years for both high-risk and low-risk HPV types. However, HPV infections are occasionally not removed by the body. Such Infections with a high-risk HPV type over many years may develop into cancer. 

Contracting a low-risk HPV type infection can lead to the development of genital warts, which may emerge within weeks or months following contact with an infected partner. These warts manifest as small bumps or clusters in the genital region, varying in size and texture. Genital warts might remain or not or might increase in size or number. Generally, such warts rarely cause cancer.

Transmission of HPV: Mucosal (genital) HPV primarily spreads through direct skin-to-skin contact during vaginal, oral, or anal sexual activities with an infected individual who may not exhibit symptoms. The immune system usually clears off the infection, but certain long-standing high-risk types can only cause infections. 

HPV does not spread through activities such as hugging or holding hands, using common toilet seats, swimming in pools, sharing food or utensils, or being unhygienic. The HPV tests use a sample of cervical cells to confirm signs of infection with high-risk HPV, causing cervical cancer.

Indications of HPV test:

The following people are at risk of developing HPV infection and hence need an HPV test: 

• Anyone who Had an abnormal Pap smear test result. 
• Anyone who has a suspicion that HPV caused abnormal changes in your cervical cells.
• People between the ages 30 and 65 are recommended An HPV test alone or an HPV/Pap test every five years if they have had normal test results.
• People between the ages of 21 and 29 should undergo a pap smear every three years and get an HPV test if there are abnormal pap results. 
• People above the age of 25 years should get an HPV test every five years. 
• Individuals at risk of cervical cancer should undergo regular HPV testing. 
• HPV tests are also done as part of routine pelvic examinations. 

The FDA has approved tests on individuals with cervix as positive tests can be tested repeatedly and managed accordingly. 

Use of HPV Test: 

This test is used to screen and check for high-risk HPV for signs of infection that can lead to cervical cancer. It is also used to decide treatment options for oropharyngeal cancers. Healthcare professionals use this test to detect any precancers as prevention of precancers can reduce the risk of developing cancers. 

The various HPV tests: 

HPV tests mainly look for cervical cell infections caused by high-risk viruses. This can be done along with a pap smear test, during which abnormal cells are looked for. Self can do this, called the primary HPV Test, or as a Co-test (along with pap smear).  The primary HPV test is the preferred cervical cancer screening method for individuals aged 25-65. Co-testing is performed every 5 years, or a pap test every 3 years if the primary HPV test is unavailable. Abnormal cells are examined in a lab for any changes.

Procedure: For cervical cancer screening, the patient lies on an examination table. A speculum widens the vagina to expose the cervix. Cells are collected using a soft brush or swab and dispatched for lab testing. At-home kits are also available, where a special swab is used to collect a sample of cells from the cervix and vagina to send to a lab. In those having oropharyngeal cancer, biopsy samples are sent to the lab for HPV testing. Efficacy of the HPV test: 

Preparation for the test: 

HPV tests should not be done during the menstrual cycle (periods). Two days before the test, one should not use tampons, birth control foam, jelly, creams, or medicines in the vagina, Douche (rinse the vagina with water or other fluid), or have vaginal sex. 

Risks of HPV test: There are no known risks for HPV tests except for mild discomfort or bleeding during and after the test. 

Results of HPV test: 

The results of the HPV test, along with the past tests, are taken into consideration to determine the risk of developing cervical cancer. 

• Negative/Normal: high-risk HPV was not found in the sample. 
• Positive/Abnormal: high-risk HPV were found (HPV 16 or HPV 18)

It should be noted that a positive test does not mean cancer. It only means an increased risk of developing cervical cancer.   

Conclusion: 

HPV testing is vital for detecting human papillomavirus infections, which are mainly high-risk and can cause cervical cancer. This also helps to identify individuals at high risk of developing cervical cancers, detect oropharyngeal cancers, and guide in management strategies and preventive measures. As it is effective in screening infections and precancerous changes, HPV testing is recommended for various populations based on their age and risk factors.