HPV Questions

  • Why is HPV Genotyping so important to the management of a patient with positive HPV?
    • If you know the HPV genotype to start with, and then the patient has an HPV related lesion on follow up one can:

      • Determine that it is a new infection (which is good, because it carries with it a high likelihood of regression) or
      • Surmise that it is a persisting or integrated infection (which is bad, because it carries with it a higher likelihood of progression). Persisting infections accompanied by cytological atypia are more likely to eventuate in high grade lesions than are new infections; and this may effect the woman’s therapeutic options.

      Since there are many high risk genotypes of HPV, it becomes important to track the virus history to see if the woman is clearing the infection, if she is becoming re-infected, or if the infection is persisting and possibly becoming integrated. If the same HPV type is recurring, then it is likely that the virus has integrated into the woman’s DNA. This would be a state whereby any atypical lesion would have a greater chance of persistence or progression rather than spontaneous resolution. Thus, Gynecor’s HPV test offers PCR based genotyping, which gives the doctor important information that could be used at the time of patient follow up in determining appropriate treatment options for that woman.

  • What does ASC-US mean on a report?
    • ASC-US stands for Atypical Squamous Cells of Undetermined Significance. It can represent:

      • HPV disease without enough features to be morphologically definitive, or
      • Reactive changes that are not HPV related, or
      • A sample where there are abnormal cells but so few that we cannot hazard a definitive diagnosis
  • Can the physician receive HPV reports listing only the high risk strains?
    • No. We are required to submit all reports, regardless if the patient’s results are high risk or not. It is important for the physician to know if a previous infection has cleared or a new one is starting up. If the same HPV type is recurring, no matter if it is high risk or low risk, it is likely that the virus has integrated into the woman’s DNA and has a greater chance of progressing into cancer. PCR is the most advanced type of HPV test available and genotyping is automatically reported with this method.