Ancillary diagnostic tests for detection of human papillomavirus infection

A variety of ancillary tests useful in the diagnosis of HPV infection are currently at the clinician's disposal. Use of 5% acetic acid for detection of inapparent HPV infection is a simple procedure that can be performed in any office setting. Colposcopy is useful alone or in combination with the use of acetic acid but may not be as readily available. Use of laboratory-based tests is gaining popularity as an adjunctive measure, particularly in combination with Papanicolaou smears, for the detection of cervical carcinoma or intraepithelial neoplasia. Although the most readily available ancillary laboratory tests are the immunologically based tests, they suffer from lack of sensitivity. The more sensitive and specific DNA hybridization tests, such as the dot blot and the Southern blot, are being adapted for general clinical use. These hybridization tests will allow routine screening of patients for infection with potentially oncogenic HPV types. The PCR is perhaps the most exciting new development in hybridization technology. This technique is the most sensitive technique available, allowing amplification of amounts of HPV DNA as small as a single copy. With further development and automation of this technique, the clinician will soon have an almost unlimited ability to diagnose occult HPV infection.