[Question #10574] HPV Blood Testing

21 months ago

Hi doctors, I recently got a battery of HPV tests done and all were negative including HPV 16 and HPV 18 - my doctor kind of rushed me so I didn't get to ask all my questions......so I thought of you two. I have three questions (1) was wondering if HPV tests were antibody tests thus if you are negative does that mean you never had those strains or could those strains wane to undetectable as my immune system cured them thus they wouldn't be detectable anymore - but I might have had it in the past (2) I asked this because I noticed my husband and he had numerous skin tags on his groin area and some on his scrotom, a dermatologist a long time ago said they were all skin tags, but is it possible he infected me many years ago 10-12 years ago without knowing he had HPV or would the tests I just took discount that, as would the dermatologists diagnosis of him many years ago. (3) Is there any reason for him to go to a new dermatologist to have a physical exam or does past examinations and my negative test make that irrelevant. Thanks in advance for your kindness as always.

Edward W. Hook M.D.

21 months ago

Welcome back to our Forum and thanks for your questions. As you know, Dr. Handsfield and I share the Forum and on this occasion I happened to be assigned your questions. In preparing to respond I reviewed your earlier interactions with Dr. Handsfield and agree with all that he said. I see that these questions are on a somewhat different topic.

Detection of HPV typically relies on detection of HPV DNA is tissue specimens, most often swabs or scrapings taken at the time of genital gynecological examination (as women disproportionately suffer the rare consequences of HPV infections, nearly all testing for HPV is done in women. There are no routinely recommended tests for HPV in men.). Biopsies of lesions or skin lesions can also be tested for HPV is warranted. The only blood tests for HPV are research blood tests for HPV antibodies. These research blood tests are used to describe the epidemiology of HPV infections or studies of HPV vaccination but are not used in the context of routine care. With this background I'll go on and address your specific questions:

(1) was wondering if HPV tests were antibody tests thus if you are negative does that mean you never had those strains or could those strains wane to undetectable as my immune system cured them thus they wouldn't be detectable anymore - but I might have had it in the past .

Most (about 80%) sexually active persons will acquire HPV at some time in their lives, often more than one type of HPV. In the vast majority of persons the infected person's immune system suppresses the infection within a year or two so that they become undetectable. We continue to test for HPV over time because on rare occasions the virus can reactivate and become detectable again, a circumstance that then warrants somewhat closer follow-up but is not a concern.

(2) I asked this because I noticed my husband and he had numerous skin tags on his groin area and some on his scrotom, a dermatologist a long time ago said they were all skin tags, but is it possible he infected me many years ago 10-12 years ago without knowing he had HPV or would the tests I just took discount that, as would the dermatologists diagnosis of him many years ago.

As men and women get older skin tags begin to appear. The groin (including scrotum) are a common site although they can appear almost anywhere. Unless they become a problem (such as they are easily traumatized, they are mostly a nuisance. On rare occasions warts (HPV) infections can mimic skin tags but the approach is pretty much the same- unless they are a nuisance, they are of no concern.

(3) Is there any reason for him to go to a new dermatologist to have a physical exam or does past examinations and my negative test make that irrelevant.

Your negative test is good news. It is not a signal that he needs to be checked.

i hope this information is helpful. FYI our parent organization, ASHA has an excellent web site that provides lots of information on HPV. EWH

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21 months ago

just so you know my husband did a telehealth a few minutes ago - and the doctor confirmed what the dermatologist said - all skin tags - so I think question #3 is now irrelevant.

21 months ago

I have four followups: (1) I did have a DNA test now that I think about it - so does that mean since I was negative I probably never had any of the high risk strains: HPV 16, 18 and then others 31, 33, 35, 39, 45, 51, 52, 56, 57=8, 59, 66 and 68 is there a high probably of this? If not since I was negative then I could have had them and my immune system contained them and I am negative at this time then correct? (2) So based on your answer in #2 below then my husbands lesions are not a concern, even ones that may look like a skin tag but could be HPV - they are not a concern - why would that be because his immune system probably overcame the HPV and he is no longer contagious? (3) so you would not recommend my husband being checked based on what doctors have already seen with his lesions - many years ago when he first checked them and pictures of them by a doctor today and my negative tests - this would make it unnecessary in your medical opinion for him to be seen again by a dermatologist again. (4) HPV doesn't seem to be much of a problem for most people then based on what you state below that its rare when there are significant consequences of catching HPV then correct?

Edward W. Hook M.D.

21 months ago

1. You are correct. As I said earlier, most HPV infections resolve on their own without therapy. Your negative test means that you do not have detectable HPV. It does NOT mean that you've never had HPV.

2. His lesions have been identified by trained clinicians as skin tags. I see no reason to doubt that and no reason for concern.

3. Unless he wants his skin tags removed, I see no reason for him to seek repeat evaluation.

4. The vast majority of HPV infections are inconsequential. They resolve on their own. A small proportion- 1'2% perhaps, can persist and if not treated, may progress to abnormalities which require treatment. This process of progression takes years and is readily detected by the sort of regular gynecological check-ups you had recently, allowing management.

I hope this information is helpful. I know that the biology of HPV infections is complex. From what you say however, you have nothing to worry about. EWH

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21 months ago

Doctor hook - I just had one more follow up: in your answer to my question #4 you stated “The vast majority of HPV infections are inconsequential. They resolve on their own. A small proportion- 1'2% perhaps, can persist and if not treated” did you mean 1-2% and it was a typo or did you mean 12%?

Edward W. Hook M.D.

21 months ago

My original statement is correct- estimates vary but all experts agree that well over 95% of HPV infections resolve over time and without therapy. 1-2% persist and, if untreated would progress to cancer or advanced pre-cancerous lesions.

As you know, this will complete this thread. EWH

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21 months ago

okay thanks for your time doc

Edward W. Hook M.D.

21 months ago

Of course. I hope the information I've provided has been helpful. EWH---