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HPV returned after 14 years
Dear Dr. HHH,
I was diagnosed and treated for genital warts 14 years ago. I had laser therapy of the cervix, vaginal area and areas on the vulva as well. I had several follow ups with the doctor over the course of the year and was considered "cured". I have had normal paps and exams every year since and I have also had two children--no problems whatsoever. This past May I ahd an annual exam with a new doctor. She said I was perfectly healthy. My pap came back ASCUS, so they did an HPV test which came back positive with low viral levels. She did a colposcopy and found two suspicious areas on the cervix. She said the areas were very difficult to see and reach. Biopsy results came back as "HPV related changes". The doctor said this meant I had warts. I was shocked since I have been free of problems with this for 14 years and I have been married for 12 years. The doctor believes I may have had this all along on my cervix and maybe it was not picked up by any pap smears. I went back to this doctor for cryotherapy--she said my cervix was too damaged from the previous laser to do anything like the LEEP. I asked her at the time of the cryo if she could see anything with the naked eye and she said "no". I asked if this meant that I had "sub-clinical infection" and she said that all warts on the cervix are subclinical. I did not think that was true. I am very concerned about passing warts to my husband. We have been exclusive for 14 years and I cannot imagine what he would think if I suddenly passed this on to him out of no where! mY questions are 1) Do my biopsy results definitely mean warts?
2) Is it possible to have had them go undetected all of this time having gone to the doctor every year for 14 years? 3) Do I have to worry about this becoming a full blown infection or will it stay in the cervix? 4) Should I be concerned about my husband developing warts?
Thank you so much for your time.
I was diagnosed and treated for genital warts 14 years ago. I had laser therapy of the cervix, vaginal area and areas on the vulva as well. I had several follow ups with the doctor over the course of the year and was considered "cured". I have had normal paps and exams every year since and I have also had two children--no problems whatsoever. This past May I ahd an annual exam with a new doctor. She said I was perfectly healthy. My pap came back ASCUS, so they did an HPV test which came back positive with low viral levels. She did a colposcopy and found two suspicious areas on the cervix. She said the areas were very difficult to see and reach. Biopsy results came back as "HPV related changes". The doctor said this meant I had warts. I was shocked since I have been free of problems with this for 14 years and I have been married for 12 years. The doctor believes I may have had this all along on my cervix and maybe it was not picked up by any pap smears. I went back to this doctor for cryotherapy--she said my cervix was too damaged from the previous laser to do anything like the LEEP. I asked her at the time of the cryo if she could see anything with the naked eye and she said "no". I asked if this meant that I had "sub-clinical infection" and she said that all warts on the cervix are subclinical. I did not think that was true. I am very concerned about passing warts to my husband. We have been exclusive for 14 years and I cannot imagine what he would think if I suddenly passed this on to him out of no where! mY questions are 1) Do my biopsy results definitely mean warts?
2) Is it possible to have had them go undetected all of this time having gone to the doctor every year for 14 years? 3) Do I have to worry about this becoming a full blown infection or will it stay in the cervix? 4) Should I be concerned about my husband developing warts?
Thank you so much for your time.
A related discussion, How long can HPV stay in your body was started.
Thank you very much for your response. I feel a little bit better now. Your help on this website is really wonderful and I hope you continue to help all of us out here.
MEDICAL PROFESSIONAL
As I have said many times on this forum, most cases of HPV regress and stay regressed or even cured. But I also have said recurrence is possible and try to remember to use such qualifiers as "most", "usually", etc. Whether this is the epxlanation in your case, or whether you might have been infected more recently with a new HPV strain, I cannot say.
Your doctor is using atypical terminology. Most experts, including I, would not call it a wart if we can't see anything and only have a biopsy report. On the other hand, some clinicians call such lesions "flat warts" or "subclinical warts". The terminology isn't the main issue; the fact is you have asymptomatic HPV infection of the cervix.
Don't worry about passing this on to your husband. Since your infection likely has been present for 14 years, and reactivated for at least several weeks or months, you can safely assume he already has been (re)exposed. Indeed, he likely has long since been infected by it and now immune to catching this particular strain again. The bottom line is that it is unlikely he will develop active infection or visible warts. And if he does, it doesn't require extramarital sex to explain it all. (However, you undoubtedly know the statistics; many apparently faithful married people in fact have other partners. This does not mean I suspect your husband has done so; you are a much better judge of that than I can be. But as an STD expert, this possibility is always on my mind. There is no way I can know whether your husband brought your current infection into the relationship from another recent partner.
Specific answers to your questions:
1) Does biopsy result mean warts? See above; it is a matter of terminology.
2) Long term undetected infection possible after 14 years? Yes.
3) Most likely your infection will remain localized to the cervix, but I cannot predict with certainty whether you might develop external genital warts.
4) Husband and warts: See above.
Good luck-- HHH, MD
Your doctor is using atypical terminology. Most experts, including I, would not call it a wart if we can't see anything and only have a biopsy report. On the other hand, some clinicians call such lesions "flat warts" or "subclinical warts". The terminology isn't the main issue; the fact is you have asymptomatic HPV infection of the cervix.
Don't worry about passing this on to your husband. Since your infection likely has been present for 14 years, and reactivated for at least several weeks or months, you can safely assume he already has been (re)exposed. Indeed, he likely has long since been infected by it and now immune to catching this particular strain again. The bottom line is that it is unlikely he will develop active infection or visible warts. And if he does, it doesn't require extramarital sex to explain it all. (However, you undoubtedly know the statistics; many apparently faithful married people in fact have other partners. This does not mean I suspect your husband has done so; you are a much better judge of that than I can be. But as an STD expert, this possibility is always on my mind. There is no way I can know whether your husband brought your current infection into the relationship from another recent partner.
Specific answers to your questions:
1) Does biopsy result mean warts? See above; it is a matter of terminology.
2) Long term undetected infection possible after 14 years? Yes.
3) Most likely your infection will remain localized to the cervix, but I cannot predict with certainty whether you might develop external genital warts.
4) Husband and warts: See above.
Good luck-- HHH, MD
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