[Question #1056] HPV after 8 years of marriage?

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93 months ago
Hello, Doctors. Thank you for the wealth of information you have posted on these and other forums.

As you have pointed out, information about HPV can be confusing and sometimes contradictory. I'm hoping you can help me solve this one.

My wife and I have been married for 8 years. She is 42 and has been tested each year since age 30 by pap smear and HPV test. In all cases, both results have been normal/negative. This month, for the first time, she tested positive for high-risk HPV (but normal pap). Her doctor stated that given my wife's regular HPV tests over the years, she believed this is a new (within the last year) infection that came from me. Of course this led to the conversation about monogamy, etc. and whether I have been with any other partners since we were married. I have not. I know she also has not.

I've read that this virus can leave the body after two years; I've also read that it can remain dormant forever. Do you have any thoughts which might explain how she could test positive for HPV now for the first time after 8 years of monogamous marriage and two successful pregnancies? Of course we both had other sexual partners before marriage, but how could these tests be continually negative for 8 years while we were together and all of a sudden now show up positive? The statistics I've seen make this scenario seem unlikely, but it's true. It has now become a strain on our relationship, and I am really looking to find an explanation of how this most likely happened.

Please let me know what further information I may provide. I thank you for your response.

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H. Hunter Handsfield, MD
93 months ago
Welcome to the forum. Thanks for your question. I can help, and hope you find my thoughts reassuring as they are meant to be.

Your question describes two errors:  that "this scenario seem[s] unlikely", i.e. that a positive HPV test after 8 years is more likely to be a new rather than reappearance of an old infection; and your wife's doctor's statement that this implies she has a new infection that has implications for sexual fidelity. In fact, in the majority of couples with no obvious evidence of sexual infidelity, "new" HPV infections are not new at all and have no implications for new partnerships. It's an STD, so it's not unreasonable for that possibility to come up for discussion. But if there is no other evidence of it, the appearance of HPV doesn't make the case for infidelity. 

It is true that HPV typically is cleared by the immune system within a couple of years, at least to a point at which it cannot be detected and is not transmissible. However, it is also true that HPV DNA often (usually?) persists and that late recurrences sometimes happen. When it does, there is no obvious explanation or reason:  it appears to be random, just bad luck. Rare things happen, and when they do we tend to look for explanations, but usually there are none. The scenario you describe indeed is unlikely if looked from the position of all people who have (or had) HPV. But when a rare thing happens, you can't usually look back and define a particular reason. Being struck by lightning is rare, but it happens; and despite the occasional person who points his golf club at the sky during a storm, most happen with no obvious reason. So I'm afraid I cannot give you "an explanation of how this most likely happened". Just bad luck.

There is really no way to know whether your wife's current HPV is reactivation of a distant past infection that she has been carrying; or if the virus recurred in you and then was transmitted sexually to her. But neither of these scenarios has implications for outside sexual exposures.

I hope this has helped. Let me know if anything isn't clear. Best wishes--   HHH, MD