Name of the Procedure:

Infectious Agent Detection by Nucleic Acid (DNA or RNA); Human Papillomavirus (HPV), Types 16 and 18 Only, Includes Type 45 if Performed.

Summary

This procedure involves detecting the presence of Human Papillomavirus (HPV) types 16 and 18, and sometimes type 45, through nucleic acid testing. It analyzes a sample for the DNA or RNA of these specific HPV strains, which are known to be high-risk for causing cervical cancer.

Purpose

The procedure is used to identify infections with HPV types 16, 18, and occasionally 45. These types are linked to a significant risk of developing cervical cancer. Early detection assists in preventing progression to cancer and informs appropriate monitoring and treatment strategies.

Indications

• Routine screening for cervical cancer.
• Follow-up after an abnormal Pap smear.
• Patients with symptoms suggestive of HPV infection.
• High-risk individuals based on medical history.
• Post-treatment surveillance in patients previously treated for HPV-related issues.

Preparation

• No fasting required.
• Avoiding sexual intercourse, douching, or using vaginal medicines for 48 hours before the test.
• Scheduling the test when not menstruating for optimal sample quality.
• Informing the clinician about any current medications and medical history.

Procedure Description

1. Sample Collection:
   • A healthcare provider collects cells from the cervix using a swab or brush.
2. Nucleic Acid Extraction:
   • DNA/RNA is extracted from the collected cells in a lab.
3. Amplification and Detection:
   • The extracted nucleic acids are amplified using polymerase chain reaction (PCR) or similar techniques.
   • Specific probes or primers detect the presence of HPV types 16, 18, and 45.
4. Interpretation:
   • The results are analyzed and reported to the healthcare provider.

Duration

• The sample collection takes about 5-10 minutes.
• Lab analysis may take several days to a week.

Setting

• Typically performed in a gynecologist’s office or outpatient clinic.
• Lab analysis conducted in a medical laboratory.

Personnel

• Gynecologist or trained healthcare provider for sample collection.
• Lab technicians or molecular biologists for sample analysis.

Risks and Complications

• Mild discomfort during sample collection.
• Rare risk of infection or bleeding from the sample collection.
• Potential psychological impact of a positive result.

Benefits

• Early detection of high-risk HPV types.
• Personalized monitoring and treatment plans.
• Reduced risk of cervical cancer development.

Recovery

• No recovery time needed.
• Minimal restrictions post-procedure.
• Follow-up appointments based on test results.

Alternatives

• Pap smear to screen for cervical dysplasia.
• Co-testing with Pap smear and HPV DNA test as part of routine screening.
• Visual inspection with acetic acid (less common and less specific).

Patient Experience

• Mild, brief discomfort during sample collection.
• Anxiety awaiting results; supportive counseling available.
• Results typically available within a week, with follow-up based on findings.