Inconsistencies with HPV information

[trevo2002]

Hi,

I've read that HPV infections typically clear from the body within 2 years (for 90% of people). For the other 10%, it is my understanding that the infection could take longer to clear.

However, there are cases where women, who have been in mutually monogamous marriages for 10+ years, have tested positive for HPV infections.

My questions are as follows:

1) Do these women have persistent infections that last 10+ years? Do some HPV infections never clear?

or 2) Is the infection the result of a virus that was dormant for all of those years?

3) If HPV can lie dormant, then is it more common for an outbreak/infection to occur at the *moment* of transmission? In other words, is it safe to assume that one is cleared of HPV after two years of the initial *exposure* (NOT the infection)?

I apologize if these questions seem repetitive, but I did not see answers to these specific questions elsewhere. Thank you for your time.

[Edward W Hook, MD]

Yes, I would assume the IF you acquired HPV 1.5 years ago it would have resolved by now.  

In women, PAP smears allow the small proportion of women who would have progressive infection (this is a subset of those in who the infection is persistent) to receive preventitive treatment to avoid progression.  EWH

[Edward W Hook, MD]

Welcome back to our Forum. I know from review of some of your other 30+ posts and our prior interactions that you are concerned about viral STDs.   The questions you raise about HPV are good ones and the answer lies on your perspective. Dr. Handsfield addressed this issue in some detail in an earlier post which I have copied into this reply.  

"Many HPV biologists believe HPV DNA usually or always persists indefinitely.  However, even with the most sensitive tests available in research labs, the virus becomes undetectable, typically over several months to a year or two -- longer for the high-risk (cancer-associated) HPV types, shorter for low risk and wart-causing strains like HPV-6 and -11.  After that, it is uncommon for that particular infection to reactivate -- i.e. recurrent warts or newly abnormal pap smears are infrequent -- and subsequent transmission to sex partners is rare.  So for practical purposes, the infection is completely resolved and can be considered cured.  "Uncommon" doesn't mean these things never happen; they do, but infrequently.

So you can understand how some experts interpret these issues into conflicting messages:  "Most HPV infections are cured by treatment and/or the immune system" versus "HPV persists and is never really cured".  My own perspective is the first of these:  people should consider themselves cured when all signs of their HPV infection are gone and there is no recurrence within a few months."

I do not know if you have a wart or your question is based on your persistent concerns.  I would add however that if you do not have warts at the present time, it is nonetheless likely that you have HPV if you have been sexually active for more than a year or two.  That said, while HPV is, for all practical purposes, a “fact of life”, it is not something to worry about.  If you develop a lesion or problem, you should have it evaluated by a trained medical professional who can help you to deal with it.  The same goes for your sexual partners.  If you follow this course, there is virtually no risk of adverse effects from a HPV infection.   I hope this reply is some help however.  EWH

[trevo2002]

Thank you for the reply Dr. Hook. I believed I had asked you a question regarding HSV about a year and a half ago, because I was worried about my positive IgM result at the time. According to the HSV IgGs that I had done some months later, it turns out it was (not surprisingly) a false positive.

But moving on to today's post, you mentioned that you share the following belief:

"Most HPV infections are cured by treatment and/or the immune system"

And this process, from what I understand, happens within two years. So from the experiences that I described to you 1.5 years ago, would it be safe to assume that an HPV infection would have (likely) been cured by now?

And just for informative purposes, why is it really necessary for women to get pap smears if the immune system can fight off the HPV infection? I had asked this same question in the community forum, but I would like to get your perspective as well.

I realize that HPV is nothing to really worry about, but I just wanted to ask about this to clear up my confusion.

Thanks again.

[trevo2002]

Thanks again for your helpful insights, Dr. Hook.