Constant Worry about HPV!!!!

[soconfused033]

Hello Doctors

In nov 2010 I had a abnormal Pap smear-ASCUS with a positive hpv ASR test (the hpv DNA test was not done due to low sample cellularity according to the lab) so they used a non-FDA approved "home brewed test" and I also had a fungal (yeast infection) at that time. I had a colposcopy in 3/2011 my doctor said she saw a very tiny spot, sent a biopsy and results were benign with no dysplasia, viral effect or malignancy per the report. At this point my doctor was convinced that I had a false positive test and wanted to be sure by repeating paps every 6 months results as follows

9/2011- pap Normal hpv DNA neg
3/2012- pap normal hpv DNA neg
11/2012 pap normal hpv DNA neg

My doctor is convinced that I had a false positive test she has even contacted the lab and they no longer use that particular hpv ASR "platform" what ever that means? She now has me coming in yearly and my next pap is in 11/2013 as the date gets closer I get more and more anxious! I have tried to move forward but the thoughts of anal, vaginal, vulvar and oral cancer continue to plague my mind on a daily basis. I have suffered continued weight loss and anxiety because of this scare. I have had a head and neck ct scan for constant pressure and fullness in my face, ears and neck (anxiety?) I have had multiple pelvic exams in fear of developing vaginal or vulvar cancer. I am continuously examining myself for throat and genital lesions. I am at witts end and don't know where to turn.

A little personal background I'm 27 never had an abnormal Pap smear But this one time in 11/2010. I have had 2 sexual partners and the current one I have been monogamous with currently for 5 years and 4 years prior to that.

[Edward W Hook, MD]

Welcome to our Forum.  You have not followed our guidelines regarding length of post and by rights I should simply delete your question.  I have chosen to answer it and will do so to the best of my ability.  At the same time, I will be direct.  I hope you do not find my comments overly harsh.

I have to be honest and tell you that I think your fears and anxieties are misplaced.  As I have said innumerable times on this forum before "For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 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.  For men there is far less risk of any sort."  the reason I say this again and again is because it is true.  You have been carefully and repeatedly examined and have no evidence of HPV- time for you to believe the results and move forward with your life in a normal, fear-free manner taking part in recommended preventative health care which would include evaluation for HPV-related problems including cancer.  Further, I will presume that you have had the HPV vaccine. If not, you should.  This is the single most effective way there is to prevent HPV and its rare related consequences.  I will answer your questions now.

If I did have a true hpv cervical infection and it was transient (meaning I cleared it) what are the chances that I have also cleared it anally or orally if I was infected at those sites also? I have never had anal sex but I do know this is not required for anal infection. I am so concerned about developing associated cancer from this one time abnormal pap and positive test.

This is a "what if" question.  You have much information that you did not have HPV or if you did (based on a NON-APPROVED TEST!!!) it was transient.  this is true for all possible locations of infection as best we know.  

If this was a transient infection what are the chances of this same infection returning? My current partner was a virgin so I'm pretty sure he hasn't been infected prior to me.

Very, very low.

What are the chances that my hpv asr test was really false positive?

No way to say although as I noted, your test was not an approved test.  I suspect the chances are pretty high it was falsely positive.

My boyfriend and I perform oral sex on each other frequently and I am also concerned about his health. Neither of us smoke or drink and we love pretty healthy lifestyles. Should I continue to worry about this? I know that hpv 16 has been associated with oral cancer.

No you should not worry.  I have posted a long, detailed comment made by Dr. Handsfield on this topic here:       http://www.medhelp.org/posts/STDs/HPV-and-oral-sex/show/1515473
http://www.medhelp.org/posts/STDs/Oral-HPV-Cancer-Risk/show/1512873
  
Can I now move on without worry?

Yes, absolutely.  Your fears are entirely out of proportion to the facts and what we know about HPV and your risk.  I hope these comments are helpful to you.  EWH

[soconfused033]

My questions are:
If I did have a true hpv cervical infection and it was transient (meaning I cleared it) what are the chances that I have also cleared it anally or orally if I was infected at those sites also? I have never had anal sex but I do know this is not required for anal infection. I am so concerned about developing associated cancer from this one time abnormal pap and positive test.

If this was a transient infection what are the chances of this same infection returning? My current partner was a virgin so I'm pretty sure he hasn't been infected prior to me.

What are the chances that my hpv asr test was really false positive?

My boyfriend and I perform oral sex on each other frequently and I am also concerned about his health. Neither of us smoke or drink and we love pretty healthy lifestyles. Should I continue to worry about this? I know that hpv 16 has been associated with oral cancer.

Can I now move on without worry?

Thanks for your help! Sorry for the long post.

[Edward W Hook, MD]

As we discussed, seeing it is time to talk with a counselor.  We should end this thread now.  Continuuing will just feed your anxietites.  Take care. EWH

[soconfused033]

Thanks. For some reason I can't get pass this. It has completely taken over my life. I just need help and I'm glad to acknowledge it.

[Edward W Hook, MD]

Clearance is reported as the proportion of a large number of cases which would be expected to have cleared within a specified period of time.  Certainly some infections clear as soon as 4  months.  Sorry however, I do not have a specfic figure for the clearance at 4 months.  EWH

[soconfused033]

I just have oneast comment/question. The time between my abnormal pap and colposcopy was only 4 months. I know the average time of clearance is 8-24 months. Do you think this would have cleared that quickly? Only in 4 months?

Sorry to be back so soon.

[Edward W Hook, MD]

Great.  I think you will be pleased you hve.  EWH

[soconfused033]

Thanks I will definitely consider seeking a counselor.

[Edward W Hook, MD]

I'm pleased you found my comments helpful.  If I may, I would also suggest that if these concerns continue to plague you, it may be a good idea to discuss this with a counselor.  If you choose to do so, please feel free to share this exchange with them.  EWH

[soconfused033]

First I want to apologize for going over the character limit. I was so frantic and wanted to include all details I didn't read the rules. Please accept my deepest apologies... Thanks for not deleting my question and answering them to the best of your ability!

Thanks for your response. I will work very hard to move forward and no longer let this consume my life.

Thanks for your response!