[Question #1547] Low risk hpv contribute to abnormal paps?
73 months ago
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Edward W. Hook M.D.
73 months ago
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Welcome to the forum. I'll be pleased to try to help. You are doing everything right, i.e. you got the vaccine, you are having correct follow-up in terms of repeat PAP smears and colposcopy.
In answer to your question, low risk HPV types (6 and 11) certainly can cause abnormal PAP smears as well as genital warts. This it is possible that some of your abnormal PAP smears were due to the prior infection that caused your warts. On the other hand, there is still a fair chance that your LSIL will resolve.
As far as symptoms are concerned, other than visible lesions, HPV infections tend to be asymptomatic.
Going forward I would recommend doing just what you are already doing i.e. getting regular PAP smears.
I hope these comments are helpful. EWH
73 months ago
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Edward W. Hook M.D.
73 months ago
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After I responded I continued to think about your question and wondered if you were assuming that your LSIL was due to thee same virus which cause your warts so many years ago. I see that you have and apologize for missing the implication in your question. While the FACT is that low risk HPV can cause LSIL, in your case this is unlikely for the following reasons:
1. Your warts did not recur
2.Your PAPs in 2011 and 2012 showed no evidence of HPV (ascus is non-specific and can certainly be caused by other, benign things rather than HPV.
3. When you have had positive HPV tests this has corresponded with HR types- many (but admittedly not all HPV tests do look for LR types as well)
4. Resolution of your original infection certainly corresponds with what we know about the natural history of HPV infections.
My advice to you is no different than what you found in our older posts on the MedHelp site- I see no reason to disclose to partners, past or future. Nearly everyone who is not vaccinated has or will have HPV and the infection will be of no consequence. Trust your immune system and do not over think this. You are doing precisely the right thing for your help by following up as you describe and you are not putting partners at undue risk by not disclosing to them. I urge you to let the past stay in the past.
Sorry for missing the implication of your earlier question. I hope that this follow-up is helpful. If not, please let me know. EWH
73 months ago
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Edward W. Hook M.D.
73 months ago
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1. No idea what the NHS does. it would not surprise me if they only focus on high risk HPV types. As for your how would persistence of your prior wart-related HPV, it is logical to believe that had your therapy been inadequate or the infection recurred, it would have been most likely to manifest itself as recurrence warts and not as an abnormal PAP smear later. There is little chance that you are going to spread the infection you had which was treated and has resolved to subsequent partners. I would not worry about this.
2. while your HPV infection dis generate some degree of antibody response, the response to the HPV vaccine is typically greater and does a bet job of protection. I would have confidence in your level of immunity at this time.
3. Statements regarding the duration of HPV vaccine protection are based largely on the length of study follow-up. I would presume that the protection is more long-standing.
I hope these comments are helpful. As I suspect you know, we are limited to three responses to clients and this is my 3rd response. this thread will be closed tomorrow. In the interim, I urge you not to worry about the possibility of a persisting low risk-wart associated HPV. EWH.
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