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Re: GYN: HPV Testing From: Joanne Bulley, MD (jbulley@cheshire.net) Mon Mar 27 05:16:28 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Myer Bornstein: "Re: GYN: HPV Testing" Previous message: Dib Abdalla Chacur: "Help" In reply to: Myer S. Bornstein, MD, CPE, FACOG: "Re: GYN: HPV Testing" Next in thread: Joanne Bulley, MD: "Re: GYN: HPV Testing" Reply: Joanne Bulley, MD: "Re: GYN: HPV Testing" But in this day of cost concious medical care - is this the right way to triage? I would like to have something like Aldara available - rather than resorting to 5FU. IF ther becomes something we CAN do (that works) for the HPV, then I would consider typing it out! Otherwise it is still good medicine and likely costs less to do that 6 month repeat Pap to see who has resolved and who still has ASCUS or SIL. At Sun, 26 Mar 2000, Myer S. Bornstein, MD, CPE, FACOG wrote: > >I went to a meeting this weekend on Innovations in the Diagnosis and >treatment of HPV, (slightly biased put on by 3M and Digene) > > However, the message made sense. One HPV and its continuance is probably >immunity related and that people in some impairment of their immune response >become chronic HPV carriers and have more of a chance of progressing to CIN >and Cervical CA. They are now in trial with Aldora intra-vaginally to see >if it can release cytokines and interferon to resolve the virus and the CIN. > >The algorithm for HPV testing for the triage of ACSUS test results is: ASCUS >Pap test results do HPV test, if negative for High-Risk types return to >routine screening, if positive colposcopy and treatment if indicated. >However, those people need to be followed very closely since they will >develop HGSIL within 3-5 years. > >Myer So - is your "follow very closely" doing Paps every 6 months? If so - what have you gained by doing the HPV screen? You would (I assume) do the following - ASCUS - repeat 6 months - if ASCUS or SIL - colpo. If not ASCUS return in 6-12 months (to coincide with her needed medical care) - and she would not be lost to follow up. I use any abnormal Pap to re-educate that women need to never NOT go for their "annuals"... So not a lot is gained by knowing the HPV type - until we do have a treatment to offer to reduce the viral load.... or some such! -- Joanne Bulley, MD Keene, NH, USA Next message: Dr. Myer Bornstein: "Re: GYN: HPV Testing" Previous message: Dib Abdalla Chacur: "Help" In reply to: Myer S. Bornstein, MD, CPE, FACOG: "Re: GYN: HPV Testing" Next in thread: Joanne Bulley, MD: "Re: GYN: HPV Testing" Reply: Joanne Bulley, MD: "Re: GYN: HPV Testing"

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