HPV test: which test truly provides answers?
The Dutch standard test only tells you if you have HPV. But not which type, not how much virus, and not if it is getting worse. There is another test.
The problem with the Dutch standard test
There are two important HPV tests used by gynecologists and general practitioners (GPs). In the Netherlands, it is primarily the Aptima test. This test gives a simple answer: positive or negative. The test determines a mix of high-risk HPV types simultaneously, without specifying which type you have.
Dutch test vs. Belgian test
HPV Test Comparison
| Feature | Dutch test (Aptima) | Belgian test (RIATOL qPCR) |
|---|---|---|
| Result | Positive or negative | Quantitative viral DNA per type |
| Genotyping | None (mix of types) | 18 individual HPV types |
| Viral load | Not measured | Exact amount of virus |
| Genes detected | mRNA | E6/E7 oncogenes per type |
| Monitoring possible | No | Yes, viral load progression |
| Experience | Since NL screening program | 15+ years routinely in Belgium |
| Technology | mRNA detection | Multiplex PCR |
The Belgian RIATOL qPCR test has been used routinely in Belgium for more than 15 years. It is a multiplex PCR test that measures quantitative viral DNA and individually detects the E6/E7 oncogenes of 18 different HPV types. PCR technology is very specific and sensitive: it also picks up low concentrations of the virus.
Same smear test, two completely different results
To make the difference concrete: the same smear test can lead to completely different results in the Netherlands and Belgium.
Case study: same smear test, two laboratories
| Dutch lab | Belgian lab | |
|---|---|---|
| Smear test | PAP 1 | PAP 1 |
| HPV result | HPV negative | HPV 59 present in <1.0 in the cells |
| Consequence | Return to 5-yearly screening program | Monitoring and follow-up |
In this case, HPV 59 was not picked up by the Dutch test, while the Belgian lab did detect the virus. The consequence is significant: based on the Dutch result, this woman would not be tested again for another 5 years. In that interval, the viral load can increase and abnormal cells can develop.
Another example of a test result. This woman, over 60 years old, had CIN 1 and was HPV-positive. We see that there are 2 high-risk viruses and 1 low-risk virus. After treatments (escharotic and LLL Low Level Laser), all viruses are no longer detectable.
of the viral load precedes the development of CIN 3+. By monitoring the viral load, you can identify a worsening sooner.
Why genotyping and viral load matter
The quantitative HPV test offers two crucial advantages over the standard test:
1. Genotyping: which HPV type do you have?
Not every HPV type is equally dangerous. HPV 16 and 18 are the most aggressive types and are responsible for the majority of cervical cancer cases. Knowing which type you have helps determine the risk and the urgency of treatment.
2. Viral load: how much virus is there?
The amount of virus in your cells is an important indicator. A steady increase in viral load precedes the development of serious abnormalities (CIN 3+). By regularly measuring the viral load, you can follow the progression and intervene in time.
If HPV is not detected while it is present, you may be incorrectly sent back to the 5-yearly screening program. In those years, the virus can continue unhindered. This is a risk you can avoid with the right test.
The HPV test via HPV Health
At HPV Health, we work with the quantitative PCR test. This gives us and you the information needed to create a well-informed treatment plan:
- Exactly which HPV type you have (out of 18 types)
- How much virus is present (viral load)
- The possibility to monitor progression with follow-up measurements
Based on these results, we create an individual treatment plan focused on strengthening your immune system and targeted management of the infection.
Do you want to know which HPV type you have and how much virus is present?
The quantitative HPV test gives you the information you need. No more vague 'positive' results, but concrete data that we can use together.
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