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STDs  (Expert Forum)
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Confused..HPV positive
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Confused..HPV positive

by jj_jane, May 08, 2008 07:29PM
Doctor:


I got my results today from my annual gyno exam. I tested positive for HPV but my pap smear was negative.

My doctor would like me to return to do a biopsy in 8 weeks. This has me concerned.

What does a positive hpv result mean??

Am I at risk for developing cervical cancer?
What about genital warts?
Is there any way to know if an HPV infection is recent?


thank you for taking the time to address my concerns.

by Edward W Hook, MD, May 09, 2008 03:08AM
The topic of HPV and genital warts is a complex one.  I will try to provide some facts.  For addition information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA)..

Now, on to HPV.  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears (not all women get abnormal PAP smears due to HPV and those who do not are not at markedly increased risk for cervical cancer).  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-10 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  With this as background, if this is your first HPV test, I and your PAP smear is normal, unless I am missing something (and I.we may be - you should get more information from your doctor), I doubt that there is an immediate need for a biopsy. Rather, most gynecologists would repeat the PAP smear in 6 months or so.  I would discuss this further with your GYN.  EWH
Member Comments (5)

by jj_jane, May 08, 2008 07:30PM
I forgot to mention that I am 29 yrs old.

by jj_jane, May 09, 2008 04:16AM
thank you for the clarification. It was my first hpv test. My gynecologist said it was nothing serious or to worry about at this point but would like to do the biopsy as a starting point.

4 follow up questions:

I recently had a child( 6 weeks ago), does pregnancy have any effect on HPV?

At this point should I ask my gynecologist about finding out which strain it is?

Why is it that hpv tests are only recommended for women over 30? Is that because so many women under 30 carry the virus?

how many genital strains of hpv exist?

thank you for your help with this.

by jj_jane, May 09, 2008 04:22AM
I'm so sorry one more thing. Many months ago I had an unprotected encounter with someone other than my partner. I would like to make sure I do the responsible thing.
Is it necessary for me to let that male know about the positive hpv result or will that not do any good???

by Edward W Hook, MD, May 09, 2008 04:55PM
Straight to your questions:

1.  Pregnancy can make HPV more evident than the non-pregnant state.
2.  At this time, there is little benefit to knowing what strain it is.  If it does not go away that might help.
3.  Yes, they are most common in women under 30.  We estimate that over 85% of women will have gential HPV at some time in their lives.
4.  At least 30-40
5.  Congratulations on your desire to do the right thing.  Little to be gained on your partner's part from disclosure however.  
EWH
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