Aptima® HPV & Aptima® HPV 16 18/45 Genotype Assays

When it comes to HPV Testing, Trust mRNA.

Studies have shown the mRNA tests identify the presence and activity of a high-risk HPV infection. HPV DNA tests only identify the presence of any of the 14 high-risk HPV types.1,2

DNA vs. mRNA Assays3,4

Aptima Table

E6/E7 Targeting1-2, 5

E6/E7 mRNA expression is indicative of the HPV infections most likely to lead to disease. The Aptima HPV Assay targets E6/E7 mRNA.

CCS Progression Illustration

Clinical Relevance of the Aptima HPV Assay3,6-19

CIN2 and CIN3 Detection

Compared with validated DNA assays, APTIMA mRNA was similarly sensitive, but more specific for CIN2+. The Aptima HPV assay also provides the same excellent sensitivity you’ve come to expect from DNA-based tests for CIN3.

HPV Test Clinical Sensitivity Data for ≥CIN3

CIN3 Screening. Population Graph 1

HPV Test Clinical Sensitivity Data for ≥CIN2

Choose A Targeted Approach with Aptima 16 18/45 Genotype Assay

A targeted, evidence-based approach ensures timely and effective interventions, improving patient outcomes while safeguarding against overtreatment. Aptima HPV 16 18/45 detects all 14 high-risk HPV Genotypes.3

14 High-risk
HPV Genotypes

14 High-risk 
HPV Genotypes

Aptima HPV 16 18/45
Genotype Assay

Aptima HPV 16 18:45 Genotype Assay

Few HPV+ Cases Will Progress to CIN320

HPV Clearance Progression

HPV 16, 18, and 45 Make Up the Majority of Cervical Cancer Cases

Cervical Cancer Cases chart

HPV type 16 associated with24:

  • Up to 62% of Squamous Cell Carcinomas
  • Up to 45% of Adenocarcinomas

HPV types 16, 18 & 45 associated with24:

  • Up to 80% of Squamous Cell Carcinomas
  • Up to 92% of HPV-related cervical Adenocarcinomas

HPV type 4524,25:

  • Third most common HPV type in invasive cervical cancer
  • Identifies more women at risk for Adenocarcinoma, with minimal impact to colposcopy

The Stakes are High for HPV Testing

An optimal screening strategy should identify cervical cancer precursors likely to progress to invasive cancers, while avoiding detection and unnecessary treatment of transient HPV infection and its associated noncancerous lesions.7

ASCCP Does Not Prioritize Extended Genotyping Over Other Tests26

Pooled detection of non-16/18 genotypes is sufficient.27 ASCCP deemed extended genotyping as “acceptable,” meaning it is one of several options for managing positive HPV results—specifically, it is considered acceptable when evidence shows that another approach is superior, or when there are no data supporting any single option.26,28

“The current recommendations are intended to guide clinical management among those choosing to use extended genotyping assays; they do not constitute a preference or recommendation for one test or combinations of tests over others. Several alternatives are currently available for risk stratification of individuals who test positive for HPV, including dual stain, cytology, and partial genotyping.”
-ASCCP

Clinical Management for HPV Primary Remains Virtually Unchanged from Today

16/18 immediate colposcopy*

Guidance is to triage to cytology as part of 12 other types with no change to today’s current clinical practice.

No data available to support treating any of
the 14 hr-risk types as low-risk

Cytology remains important: 16/18 are still the highest risk with recommendation for immediate colposcopy. Almost all other cases require cytology as a triage regardless of genotype.

* As described in the 2019 ASCCP guidelines, collection of cervical cytology at the colposcopy visit is recommended because additional diagnostic testing and surveillance are required

In certain circumstances, patients who test positive for HPV 59, 56, or 66 may be referred to one-year follow-up without cytology/dual stain triage

Let’s Connect

Have a question or need to talk to a Hologic team member? We’re here to help.

1.Tinelli A, et al. HPV viral activity by mRNA HPV molecular analysis to screen the transforming infections in precancer cervical lesions. Curr Pharm Biotechnol. 2009;10(8):767-771.

2. Cuschieri K, et al. Human Papillomavirus Type Specific DNA and RNA Persistence–Implications for Cervical Disease Progression and Monitoring. J Med Virol. 2004;73(1):65-70.doi:10.1002/jmv.20062.

3. Aptima HPV Assay [package insert]. AW-12820, Rev 004. San Diego, CA: Hologic, Inc.; 2020.

4. Rebolj M, et al. Extension of cervical screening intervals with primary human papillomavirus testing: observational study of English screening pilot data BMJ 2022; 377 :e068776 doi:10.1136/bmj-2021-068776

5. Doorbar J. Molecular biology of human papillomavirus infection and cervical cancer. Clin Sci (Lond). 2006 May;110(5):525-41. doi: 10.1042/ CS20050369. PMID: 16597322

6. Rebolj et al. A daunting challenge: Human Papillomavirus assays and cytology in primary cervical screening of women below age 30 years. EU J of Cancer (2015) 51, 1456-1466.

7. Saslow D, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer.Am J Clin Pathol 2012;137:516-542.

8. Wu R, et al. Human papillomavirus messenger RNA assay for cervical cancer screening: the Shenzhen Cervical Cancer Screening Trial I. Int J Gynecol Cancer. 2010;20(8):1411-1414

9. Ratnum S, et al. Aptima HPV E6/E7 mRNA test is as sensitive as hc2 Assay but more specific at detecting cervical precancer and cancer. J Clin Microbiol. 2011;49(2):557-564.

10. Monsonego J, et al. Evaluation of oncogenic human papillomavirus RNA and DNA tests with liquid-based cytology in primary cervical cancer screening: the FASE study. Int J Cancer. 2011,129(3):691-701.

11. Iftner T, et al. GAST: German Aptima Screening Trial. Comparison of Aptima and hc2 in routine screening in Germany. Symposium presentation at EUROGIN 2012. 12. Cuzick J, et al. Comparing the performance of six human papillomavirus tests in a screening population. British J Cancer. 2013;108:908-913.

12. Nieves L, et al. Primary Cervical Cancer Screening and Triage Using an mRNA Human Papillomavirus Assay and Visual Inspection. Int J Gynecol Cancer. 2013;23:513-518.

13. Iftner T, et al. Head-to-Head Comparison of the RNA-Based Aptima Human Papillomavirus (HPV) Assay and the DNA-Based Hybrid Capture 2 HPV Test in a Routine Screening Population of Women Aged 30 to 60 Years in Germany. J Clin Microbiol. 2015;53(8):2509-2516.

14. Muangto T, et al. Experience of combined liquid based cervical cytology and high-risk HPV mRNA for cervical cancer screening in Thammasat University Hospital. Asian Pac J Cancer Prev. 2016;17(9):4409-4413.

15. Reid et al. Human Papillomavirus Oncogenic mRNA Testing for Cervical Cancer Screening. Am J Clin Pathol, 2015;144:473-483

16. Cook et al., Aptima HPV Assay versus Hybrid Capture® 2 HPV test for primary cervical cancer screening in the HPV FOCAL trial J. Clin. Virol. 2017;87:23–29

17. Cook et al. Cobas 4800 HPV and Hybrid Capture 2 comparison at baseline and 48 months in the HPV Focal trial. Poster presented at IPV 2017.

18. White C, et al. Performance of the HPV E6/E7 mRNA Aptima HPV assay combined with partial genotyping compared with the HPV DNA Cobas 4800 HPV test for use in primary screening: Results from the CERVIVA HPV primary screening study in Ireland [published online ahead of print, 2023 Aug 26]. Int J Cancer. 2023;10.1002/ijc.34685. doi:10.1002/ ijc.34685

19.  Pi R, Li T, Zhang H, Zhou H, Yang Y, Dai Y, Wu Z, Jiang M, Chen W, Zhu L. The Distribution of HR-HPV E6/E7 DNA and mRNA by Histological Grade and the Clinical Performance for Detection of Cervical Cancer and Precancer. J Med Virol. 2024 Nov;96(11):e70026. doi: 10.1002/jmv.70026. PMID: 39540331.

20. Adapted from: Schiffman M et al. Human papillomavirus testing in the prevention of cervical cancer. J Natl Cancer Inst. 2011;103(5):368-83. doi:10.1093/jnci/djq562

21. McCredie MR, et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol. 2008;9(5):425-34. doi:10.1016/S1470-2045(08)70103-7.

22. Stoler, et al. Stratified risk of high-grade cervical disease using onclarity HPV extended genotyping in women, ≥25 years of age, with NILM cytology. 2019;153(1):26-33. doi.org/10.1016/j.ygyno.2018.12.024\

23. Demarco, et al. A study of type-specific HPV natural history and implications for contemporary cervical cancer screening programs. EClinicalMed¬icine. 2020;22. doi: 10.1016/j.eclinm.2020.100293.

24. Wei F, Georges D, Man I, Baussano I, Clifford GM. Causal attribution of human papillomavirus genotypes to in­vasive cervical cancer worldwide: a systematic analysis of the global literature. Lancet. 2024 Aug 3;404(10451):435-444. doi: 10.1016/S0140-6736(24)01097-3. PMID: 39097395

25. Hopenhayn C, et al. Prevalence of human papillomavirus types in invasive cervical cancers from 7 US cancer registries before vaccine introduction. J Low Genit Tract Dis. 2014;18(2):182-189. doi: 10.1097/LGT.0b013e3182a577c7

26. Massad LS, Clarke MA, Perkins RB, Garcia F, Chelmow D, Cheung LC, Darragh TM, Egemen D, Lorey TS, Nayar R, Newman M, Risley C, Smith RA, Wentzensen N; Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee. Applying Results of Extended Genotyping to Management of Positive Cer­vicovaginal Human Papillomavirus Test Results: Enduring Guidelines. J Low Genit Tract Dis. 2025 Jan 10. doi: 10.1097/LGT.0000000000000865. Epub ahead of print. PMID: 39791481

27. Monsonego, et al. Prevalence of high-risk human papilloma virus genotypes and associated risk of cervical precancerous lesions in a large U.S. screening population: Data from the ATHENA trial. Gynecologic Oncology. 2015;137(1):47-54. doi.org/10.1016/j.ygyno.2015.01.551.

28. Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, Huh WK, Kim JJ, Moscicki AB, Nayar R, Saraiya M, Sawaya GF, Wentzensen N, Schiffman M; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020 Apr;24(2):102-131. doi: 10.1097/LGT.0000000000000525. Erratum in: J Low Genit Tract Dis. 2020 Oct;24(4):427. doi: 10.1097/LGT.0000000000000563. PMID: 32243307; PMCID: PMC7147428.