THE LABORATORY REPORT Spring 2014 Page 5 New Tests Available from Houston Methodist Diagnostic Laboratory Central nervous system infections are an important cause of human morbidity and mortality. Viral meningitis and encephalitis occur most commonly in pediatric, elderly, and immunosuppressed patients. Although many infections are asymptomatic or result in mild flu-like symptoms, others can rapidly become life threatening. Cytomegalovirus (CMV), enteroviruses, herpes simplex viruses 1 and 2 (HSV-1 and 2), and varicella-zoster virus (VZV) account for most cases. Diagnosis of these infections is challenging to the clinical laboratory because traditional viral cultures require several days to complete and have low sensitivity. To improve patient care at all hospitals in the Houston Methodist System, the Molecular Diagnostics Laboratory has validated a panel of real-time PCR assays to detect CMV, enteroviruses, HSV1, HSV2, and VZV infection. As early diagnosis and treatment are crucial for best outcomes, the viral meningitis/encephalitis panel is performed daily. Testing for West Nile Virus by real-time PCR and bacterial pathogens by culture is also available. Human papillomavirus (HPV) testing is an ever-expanding area of interest for cancer screening, diagnosis, and prognosis. HPV infection causes the vast majority of cervical cancers. It is also implicated in anogenital tract squamous carcinomas and squamous carcinomas of the oropharynx and esophagus in men and women. To date, more than 150 HPV types have been identified. However, evidence suggests that only a few of them, or so-called “high risk” genotypes, such as HPV-16 and HPV-18, confer a significant risk for developing cancer. The Molecular Diagnostics Laboratory at Houston Methodist has validated a Multiplex Ligation-dependent Probe Amplification (MLPA) assay to detect the presence of HPV-16, HPV-18 and 12 other high-risk HPV genotypes. The assay is FDA approved for screening patients age 21 and older with abnormal cervical cytology results and for assessing the presence or absence of high-risk genotypes in women 30 and older. Recently, the Medical Devices Advisory Committee recommended that the assay could be used as a primary screening tool for cervical cancer. The HPV test can be performed on all cervical specimens. Validation studies for testing formalinfixed, paraffin-embedded tissue are underway. Rapid Viral Meningitis and Encephalitis Molecular Test MLPA Assay to Detect and Identify HPV Genotypes For more information on these assays or any Molecular Diagnostic Laboratory test, please contact: Ms. Heather Hendrickson (HLHenderson@houstonmethodist.org) Dr. Bryce Portier (BPPortier@houstonmethodist.org) or Dr. Randall Olsen (RJOlsen@houstonmethodist.org).
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