Irregular PAP

[VickyVail]

Dr.,

I'm a 28 year old married female.  I don't use birth control with my husband, and I've never been pregnant.  I received a call from my PCP this morning; my PAP showed abnormal cells, and he has ordered an HPV test.  I realize that there are a number of non-HPV related explanations for these vague results, and I will try to be patient and not jump to conclusions while I wait and get re-tested.  

In the mean time, I've been reading (of course...)  Can you please clarify the following questions regarding HPV:

1. What is the difference between an HPV wart, and a Herpes sore?  Is it possible for me to have a wart, and not realize it?

2. If your immune system is able to fight HPV without any symptoms, is that the same as "laying dormant?"  Or does it mean you have beaten it?

3. Will the test include ALL strands of HPV?  

4. If abnormal cells are found, what percentage of those PAP's end up coming back positive for high risk HPV, precancer, or cancer?

5. Based on my list of questions, is there any additional information that you think I might find valuable?

Thank you in advance for your help.

[auntiejessi]

If you had cancerous cells on your cervix, your pap would have reflected seriously abnormal cells, and can detect cervical cancer.  

Pap smears come back with levels of results, for lack of a better word, from mildly abnormal to severely abnormal, and cancer.  There are technical names to those, but I am not remembering them offhand.  You should ask your doctor what yours came back with, and that will give you an idea of where you stand.

And yes, you would be able to tell the difference between a wart and a herpes sore.  A genital wart looks much like warts anywhere else on your body, and herpes sores are either blisters, lesions, or paper-cut like sores, and usually have some pain involved.  Warts don't hurt, but might itch.

Aj

[VickyVail]

Thank you for your prompt response.  As far as my initial question is concerned, I realize that HPV and Herpes are different viruses, I'm sorry for not being clear.  My question, out of curiosity, is directed more toward the visual differences between an HPV wart, and a Herpes sore.  Would I, as a lay-person, be able to visually differentiate between the two?

Your response to my abnormal PAP was comforting, but I have to take into consideration that you don't have all the facts.  I haven't had a PAP smear in about 7 years.  

I realize that you can't give difinitive answers, but would a simple PAP (after 7 years of neglect) be able to show cancer?  From what I understand, it would only show "abnormal cells," which require more testing in order to diagnose.  

Thanks for your time!

[auntiejessi]

Hi there -

1 - HPV and herpes (hsv) are different viruses.  Think the cold and the flu.  HPV can cause genital warts, and herpes causes sores.  

It is possible for you to have a wart and not realize it, but if you have HPV-related abnormal paps, you have what's known as high risk hpv, and that kind of hpv doesn't produce warts.  There are dozens of strains of HPV - some cause visible warts, others cause abnormal cells on the cervix.

2 - If you have abnormal cell changes, then its not dormant.

3 - Yes, but depending on how the results are reported, it might just say "High risk HPV" or something.  They don't always give you the strain.

4 - If you have abnormal cells, that should always show up on a pap.  I don't know the % on pap tests, but we know that HPV causes 70% of cervical cancers.  If you have been getting your paps regularly, cancer isn't a concern right now, and I'm sure your doctor would have had a different message when he called.  If it came back as cancer, you'd be in his office, and he wouldn't be so worried about an HPV test as much as treating the cancer.

5 - You should check out www.ashastd.org, and our HPV forum here.

Aj