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HPV Testing

Although genital warts are a common infection in the UK, testing for HPV has been mainly limited to specialist gynae-oncology practices.

As such, the diagnosis and management of genital warts is often presumptive and can have an extreme psychological impact, difficulty in one’s relationships as well as the development of troublesome lesions and possible cancers.

Recent advances in molecular diagnostics allows us to provide greater insight to those faced with problems of HPV and Genital warts. In turn, this has made for a massive difference in the well being, relationships and sexual health of our patients.

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When is a HPV test recommended?

Patients may like to know their HPV status in the following situations:

  • Those who are concerned about being HPV carriers (no symptoms, possible warts contact, abnormal smears in the partner)
  • Those who have non-specific lesions but worried about HPV/warts (reassurance and helps in resuming / rebuilding relationships)
  • Those who have suspected/confirmed genital warts but would like to know their HPV status
  • Partners of those who have suspected/confirmed genital warts but would like to know the types of HPV they have.
  • Those who have had abnormal smear test results

In place of cervical screening (High Risk HPV screen preferred over the cervical smear).

Overview of HPV tests

Before carrying out any tests, we will first conduct a thorough consultation, discussing your sexual, general, medical history, any symptoms or concerns you may have, as well as an examination (if appropriate).

Based on this, the clinician will recommend which tests are appropriate for you, and samples can be taken during the same appointment.

Prices below include a consultation with one of our specialist nurses.

HPV-Wart (Testing)

*This pricing was updated on 01/04/2021 upon finding a new laboratory to process these tests.

What samples do you require for HPV testing?

It is essential to get a good quality sample when testing for HPV, in much the same way with a cervical smear.

On a more technical note, HPV is a systemic mucocutaneous infection and thus pooled samples from multiple sites screens from multiple sites for complete reassurance.

For men
We do not recommend a urine sample to test for HPV as there is inadequate cellular material in the sample (in rare cases we can centrifuge the urine before testing).

We will ideally require a swab from an area of sub-preputial moisture/wetness.

For men without a foreskin (or with rather dry glans and coronal sulcus) can be wet-swabbed (i.e. the swab is dipped in a liquid before swabbing).

We may also take a throat/anal swab as and where appropriate.

For women
We require a High vaginal swab +/- throat/anal swab.

What is the incubation period for HPV?

The incubation period (or window period) for HPV is not well established, but thought to range between 2 weeks to 8 months in most cases.

The concern about window period does not routinely arise in patients accessing our services for HPV testing, in my experience.

What does a negative HPV test result mean?

This information is for general guidance only. Any positive results will be discussed with your clinician with the full awareness of your individual circumstance

(a) If you are concerned about being HPV positive and have no symptoms
Low Risk – Negative
A negative low risk HPV test should be very reassuring for you and allow you to continue with life as normal, without concern of passing the infection to your partner.

High Risk – Negative
A negative high risk HPV test should be very reassuring for you and allow you to continue with life as normal in the confidence that you are not at an increased risk of getting a HPV-associated cancer, without concern of passing the infection to your partner.

(b) If you have non-specific lesions
Low Risk – Negative
A negative low risk HPV test should be very reassuring for you and allow you to continue with life as normal, without concern of passing the infection to your partner.

High Risk – Negative
A negative high risk HPV test should be very reassuring for you and allow you to continue with life as normal in the confidence that you are not at an increased risk of getting HPV associated tissue abnormalities or cancers, without concern of passing the infection to your partner.

(c) If you have suspected/confirmed genital warts
Low Risk – Negative
In most cases of suspected/confirmed genital warts, your HPV test will detect at least one strain of Low Risk HPV. In the event you receive a negative result, there might be three things to consider:

There are false negative test results due to an extremely low amount of viral material.
You may have residual (keratotic) genital warts after the virus has become inactive or cleared.
You may have another skin condition mistaken for genital warts e.g. molluscum contagiosum, skin tags, seborrhoeic keratosis, lichen sclerosus, herpetic lesions, blocked sebaceous glands, localised cysts or scarring.

That is why histopathological examination, in conjunction with the HPV tests, gives a more comprehensive picture of what is going on with a patient.

High Risk – Negative
Ruling out High Risk HPV in genital lesions should reassure both yourself, your partner(s) and your clinician as the lesion does not have the potential to grow into a precancerous or cancerous growth.

(e) If you have had abnormal smear results
Low Risk – Negative
A negative low risk HPV test indicates that abnormalities in your smear is not being caused by Low Risk HPV, and this should allow your clinician to focus on other causes for such changes.

High Risk – Negative
A negative high risk HPV test indicates that abnormalities in your smear is not being caused by High Risk HPV, and this should be immensely reassuring as the risk of cancer developing there in the absence of such virus is very low.

(f) My partner is HPV positive
Low and High Risk – Negative
This is good news. It is possible that you have not yet been exposed to the infection or that your immune system has prevented you from getting the infection in the first place or contained it well enough. You should consider receiving an HPV vaccine to protect yourself from the specific HPV type your partner has, or boost your HPV immune defences in general.

Do I still need a smear if my High Risk HPV is negative?

Almost 20% of cancers of the cervix are not caused by HPV and can only be picked up by a cervical smear.

Can I have more than one type of HPV?

Yes. Whilst not common, some HPV types are thought to act either competitive or cooperatively together.

Is there an antibody test for HPV?

HPV antibody tests are used for research purposes and in evaluation of HPV vaccine efficacy. They are not currently available in clinical practice.

Can men also test for HPV?

Yes. Men can be tested for HPV like women. However, this is available only with specialist clinicians who understand the nuances of this test, its appropriate use and the correct interpretation of the results.

Some of the reasons for lack of testing of HPV in men include:

  1. Diagnostic companies have focused their HPV tests on the female markets because of HPVs role in cervical cancer
  2. It can be difficult to obtain the right quality sample from men, especially as a simple urine sample does not have the adequate cellular material and few labs offer this test.
  3. Routine HPV screening before symptoms show is not routinely recommended for anal, penile, throat cancers in men.

You can read some of the studies published documenting the use of HPV DNA testing in men here: Study 1, Study 2 and Study 3.

Cervical smear

For the detection of changes on the cervix (often invisible) that may develop into cancer.

HPV vaccine

An easy way to protect yourself against 9 types of HPV strains for boys, girls, men and women.

HPV information

Read our answers to questions patients commonly ask about HPV symptoms, causes & management.

Page reviewed by Dr. Manoj Malu (Clinical Director)

Last reviewed date: 3 March 2020
Next review due: 3 March 2023

Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.