Analyzes for the human papillomavirus: how to surrender, decipher

The human papillomavirus is a serious danger. Diagnosis is necessary to determine the strain of infection and the risk of its oncogeneity. Such information allows to make the most suitable and effective treatment plan.

Qualitative diagnosis is carried out by several specialists at the same time. The main indications for examination are:

• Active sex life and frequent change of sexual partners.
• Itching, burning in the genital area, atypical discharge.
• Appearance on the skin and mucous membranes of neoplasms in the form of papillomas, warts and condylomas.

Diagnosis of papillomavirus consists of a set of laboratory and instrumental methods:

• Visual examination and collection of anamnesis - the doctor examines the lesions and questions about when the first eruptions or other signs of HPV. Assesses the appearance and shape of tumors. In the presence of anogenital growths, the cervix is examined, urethroscopy is performed.
• Cytology of smears and scrapings - is performed to establish morphological changes at the cellular level associated with HPV. The accuracy of this method depends on the technique of sampling and the qualification of the laboratory technicians.
• Colposcopy - examination of the mucosa to identify subclinical forms of infection. The diagnosis is confirmed if there are such factors: leukoplakia, mosaic, puncture, anomalous transformation zone.
• A biopsy is a fence of a small volume of affected tissue for microscopic examination. As a rule, it is carried out with suspicion of cervical damage.
• Histological examination - biopsy-derived material is sent to a laboratory study to identify precancerous conditions and other cell abnormalities.
• PCR - conducted to identify individual types of HPV. For diagnosis, use blood, urine, mucus and other tissue fluid.
• Digene test is one of the most reliable diagnostic methods. Has a high sensitivity to Human papillomavirus. It allows to determine the genotype and its belonging to a highly oncogenic or low-coagulogenic group.

To date, there are many methods that can detect the infection of HPV and determine the degree of its aggressiveness.

Screening of human papillomavirus

A mandatory analysis for patients with a predisposition to malignant processes in the body is screening. The human papillomavirus also serves as an excuse for undergoing this laboratory test.

The first screening is recommended for women aged 30 years. The analysis is necessary to detect not only papillomavirus, but also to prevent erosive lesions of the cervix associated with HPV.

Most often, patients are assigned such types of screenings:

• Cytological PAP test - a cervical scraping, placed in a liquid medium, is used for the study. Promotes the detection of oncological strains of HPV at an early stage of development.
• Advanced - defines genotypes with high oncogeneity and their concentration in the body.
• Polymerase chain reaction - has a high diagnostic value, because it allows to identify all types of Human papillomavirus.

Screening of HPV is carried out both in the diagnosis of the disease, both during therapy and to evaluate the results of treatment.

Analysis for human papillomavirus

When suspected of papillomavirus, all patients are prescribed a set of diagnostic procedures. The HPV test is a definition of the type of virus in the laboratory. Various biological fluids and tissues are used for the study.

Most often for the analysis take a swab from the genitals. Collection of material from this area is necessary even in the absence of visual symptoms of papillomatosis. The resulting biopsy is studied under a microscope for altered epithelial cells. The diagnosis determines the type of infection and the risk of its oncogeneity.

Mandatory analysis for papillomatous infection must be submitted when planning pregnancy, to determine the causes of infertility and abnormalities of gestation. In this case, the analysis is assigned to both partners at once. This is due to the fact that the virus is transmitted by intimate affinity. Based on the results of the study, the doctor can prescribe additional diagnostic methods and draw up a treatment regimen.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11],

Quantitative analysis for human papillomavirus

To identify papillomavirus, determine its type and degree of activity, quantitative analysis is carried out. There are several methods for determining HPV, consider them:

1. Polymerase chain reaction - PCR is the standard for the diagnosis of HPV. The analysis is based on an increase in the number of copies of the viral DNA in the biopsy. Such a technique allows to identify with high accuracy even single types of the virus.
2. Digene test - a feature of this method is the reliable detection of genotypes with increased oncogeneity. Various biological fluids and materials are used for the analysis.
3. Determination of the presence of viral antibodies - the analysis reveals specific proteins of the immune system. Each viral agent that enters the body contributes to the production of unique immunoglobulins. If antibodies to Human papillomavirus are found in the serum, this indicates an infection of the body.

For the quantitative analysis, use capillary blood (from the finger), scrapings from the skin and mucous membranes, tissue biopsies. 12 hours before the test, stop taking antifungal, antiviral, antimicrobial and other medications, including contraceptives. On the day of diagnosis you need to take a shower and wash the intimate places thoroughly, if they take scrapes. Also 2-3 days before the procedure should refrain from sexual intimacy.

Interpretation of the results is provided by the attending physician. The doctor takes into account not only the data of the performed diagnostics, but also clinical manifestations of the disease. Otherwise, the interpretation of the results is erroneous.

Human papillomavirus DNA, PCR

One of the most common and reliable methods of detecting the DNA of human papillomavirus is PCR. Various biological materials are used to carry out the polymer chain reaction: blood, urine, smears with mucous membranes, amniotic fluid. Analysis allows you to determine the presence of infection, even with its latent flow in the body.

The principle of this diagnostic method is based on the isolation of human and viral DNA. Any deoxyribonucleic acid consists of four nucleotides:

• A is adenine.
• T-thymidine.
• G - guanine.
• C is cytosine.

According to the rules of genetics, they have a certain order of combination: A + T, G + C. All living organisms have their own DNA, which can be distinguished. PCR recognizes fragments of pathogenic DNA, thus isolating the pathogen.

Advantages of PCR:

1. Universality - In addition to Human papillomavirus, many other pathogens of infectious diseases can be identified during the study.
2. High sensitivity - in addition to determining the presence of the virus, the method establishes its type and other characteristics.
3. Effectiveness - reliably reveals the necessary infection.
4. Speed - the results of the analysis can be obtained 24 hours after it is handed over.

Preparation for analysis:

• One week before the planned analysis, you should stop taking birth control medications, as they can distort the results.
• The study is not performed during menstruation and within 3 days after it.
• Two days before the test, you should exclude sex.
• Diagnosis is carried out on an empty stomach, the last meal should be 12 hours before the analysis. But you can drink water.
• On the day of delivery of PCR on HPV it is not recommended to conduct hygienic procedures and to go to the toilet in a small way two hours before taking the material.

The doctor should decipher the results obtained. The index to 3 Lg is an insignificant concentration of the causative agent, 3-5 Lg is a clinically significant concentration, and more than 5 Lg is a high concentration. Normally, all quantitative titles should be negative. But negative results do not always indicate absence of disease. Often, this is observed with low concentrations of the virus in the body and when it is suppressed by the immune system.

Despite all the advantages, PCR has a number of disadvantages. The analysis should be taken only in a modern laboratory to avoid obtaining false results. Particular attention should be paid to taking the material. Only the doctor should decipher the results, since positive results can occur after the recent treatment of the infection.

Scraping for human papillomavirus

To identify genital infection of HPV in men, scraping, that is Digene-test, is performed. The material is taken from the urethral canal with a special brush, in some cases, the tissues are taken from the glans penis. Before taking the test, you must take a shower and thoroughly wash yourself. Violation of personal hygiene negatively affects the results of the analysis.

In women, scraping is taken from the cervix with suspicion of dysplasia, erosion and other pathological processes caused by HPV. To take the material, the doctor removes the vaginal discharge and inserts a small brush into the organ, scrolling it around the axis in the cervical canal. After all the manipulations, the brush is placed in a test tube with medium and sent to the laboratory.

The received materials are sent for differential diagnosis by PCR, cytological screening is not performed. Results are ready 2-3 days after the analysis. The obtained data represent complete information on the type of the virus, its carcinogenicity and a number of other factors of the course of the disease. If the results are incorrect, then the study is conducted again. Repeated screening is necessary at the time of treatment and after therapy to determine its effectiveness.

A swab of the human papillomavirus

If a wart or condyloma is found during the gynecological examination in the genital area, the doctor takes a Pap smear. The doctor conducts a special brush on the affected tissues. The smear is taken from the uterine neck canal in women and from the urethra in men. The collected biopsy is sent to the laboratory for study.

Allocate such types of smears for suspected Human papillomavirus:

• PCR - reveals DNA infection. For this analysis, scraping is done in the urethra in men, in the vagina and cervical canal in women. Sperm or urine can also be used.
• Digene testing is the study of the collected material at the molecular level. Testing is the differentiation of two groups of papillomaviruses simultaneously - with high and low oncogeneity.

The above studies classify the results into 5 types:

1. Absence of abnormal cells.
2. The presence of altered cells due to the inflammatory process.
3. The minimum number of cells with an atypical structure.
4. Malignant cells.
5. A large number of oncogenic cells.

There is also a classification according to the Bethesda system. It consists of indicators of low and high degrees of change. In this case, the interpretation of the smear is represented by the following data:

• NILM is a normal epithelium.
• ASCUS - altered cells due to dysplasia, inflammation, sexual infection or HPV.
• ASC-H - abnormalities in the structure of squamous epithelium. This result indicates early stages of oncology or severe dysplasia.
• LSIL - there is a small number of altered cells in the smear. Indicates dysplasia or papillomavirus.
• HSIL - significant changes in the epithelium. Severe dysplasia and pronounced oncology. If this result is left without attention, then in 7% of patients 3-5 years later develops a malignant disease.
• AGC is an atypical glandular epithelium. Occurs in uterine cancer or dysplasia.
• AIS - the initial stages of oncology.
• High-grade SIL-squamous cell carcinoma.

From the chosen method of research depends the speed of obtaining the results of the smear. As a rule, the decryption is ready in 2-3 days.

[12], [13], [14], [15], [16], [17], [18], [19], [20],

Antibodies to human papillomavirus

To detect antibodies to HPV, an enzyme immunoassay is indicated. The principle of this study in determining the presence of immunoglobulins to an infectious agent. Diagnosis by ELISA indicates the immune response of the body to the virus. Depending on the detected antibodies, the following stages of the disease are distinguished:

• IgM - acute.
• IgG - chronic or recovery period.
• IgA - recurrence of chronic infection.

The results of the antibody test are ready in 1-3 days after it is taken. When deciphering the results, it should be borne in mind that Human papillomavirus may be an indirect trace, therefore, to verify the presence of infection, PCR and other tests are performed. In addition, the ELISA does not establish a genotype or risk of carcinogenicity of the virus.

[21], [22], [23], [24], [25], [26], [27], [28], [29], [30],