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STDs (Expert Forum)
Misdiagnosed HPV?
Answered by
University of Washington
Seattle - WA
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.
Misdiagnosed HPV?
by confusedntx, May 19, 2006 12:00AM
My situation is the following:
August 2005 - annual pap for first time ever- ASCUS
September 2005 - re-pap and hpv dna testing for high and low risk
strains and I requested blood tests for herpes, etc. All negative.
Results of HPV testing all strains - NEGATIVE. Pap still ASCUS. At this point I have itching and discharge and bacterial vaginosis (gardernella) given clindesse, then metro gel twice because itching and discharge will not go away.
April 2006 - Pap again - still ASCUS, still itching but no bacteria
found. Scheduled for a colposcopy.
Colposcopy - cervix looks fine - no lesions. Cutterege done -
results say "suggestive of HPV koilocytes". Retested for HPV Dna High and low risk strains - all HPV tests come back NEGATIVE. Also tested for all other STD's (Herpes, etc..) all came back negative.
At this point, my doctor says I may be allergic to something and
that's why I itch sometimes. She says she's confident since my HPV DNA tests for high and low risk have come back negative in September and March that I DO NOT have HPV but I still have no real explanation for why I keep getting ASCUS paps or the cutterege said "suggestive of HPV". Needless to say I will be changing doctors.
What could be wrong with me?
August 2005 - annual pap for first time ever- ASCUS
September 2005 - re-pap and hpv dna testing for high and low risk
strains and I requested blood tests for herpes, etc. All negative.
Results of HPV testing all strains - NEGATIVE. Pap still ASCUS. At this point I have itching and discharge and bacterial vaginosis (gardernella) given clindesse, then metro gel twice because itching and discharge will not go away.
April 2006 - Pap again - still ASCUS, still itching but no bacteria
found. Scheduled for a colposcopy.
Colposcopy - cervix looks fine - no lesions. Cutterege done -
results say "suggestive of HPV koilocytes". Retested for HPV Dna High and low risk strains - all HPV tests come back NEGATIVE. Also tested for all other STD's (Herpes, etc..) all came back negative.
At this point, my doctor says I may be allergic to something and
that's why I itch sometimes. She says she's confident since my HPV DNA tests for high and low risk have come back negative in September and March that I DO NOT have HPV but I still have no real explanation for why I keep getting ASCUS paps or the cutterege said "suggestive of HPV". Needless to say I will be changing doctors.
What could be wrong with me?
Doctor's Answer
by H. Hunter Handsfield, M.D., May 19, 2006 12:00AM
, May 19, 2006 12:00AM
Well, I can reassure you--with high if not absolute confidence--that you don't have HPV. Roughly half of all ASCUS pap results are associated with HPV, so having one but not the other is common. But otherwise I can't help much. I am not an expert on interpretation of pap smears, the explanation of ASCUS in the absence of HPV, or management of persons in your situation.
Given all the negative tests for HPV, I agree with your doctor's assessment you don't have that infection. Aside from that, you'll just have to follow up with her advice. From your description, I can't see that she has done anything that would make you determined to change doctors. But if you're not happy with her, by all means find a new one, or ask for referral for a second opinion. With a little research, you likely could find a local gynecologist with particular expertise in management of women atypical pap smears.
Good luck--- HHH, MD
Given all the negative tests for HPV, I agree with your doctor's assessment you don't have that infection. Aside from that, you'll just have to follow up with her advice. From your description, I can't see that she has done anything that would make you determined to change doctors. But if you're not happy with her, by all means find a new one, or ask for referral for a second opinion. With a little research, you likely could find a local gynecologist with particular expertise in management of women atypical pap smears.
Good luck--- HHH, MD
