[Question #2152] HPV mRNA E/6/E7 Detected
92 months ago
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I am 53. I had a pap smear on 1/31/17. My gyno's office left message all was fine. Just last week I saw that I hadn't printed out my test on the portal and when I did, I was shocked to read (Negative for Intrapithelial lesion or Malignancy) - but in red letters HPV mRNA E5/E7 detected. I still am shocked. I have been married 29 years. Neither my husband or I has had sex with anyone else. My gyno said he didn't say anything because there was "nothing to worry about" - but HOW DID I GET HPV? My husband and I are both beside ourselves, neither of us cheated. How could this be? He thought maybe in a hot tub? Prostate biopsy? Toilet seat? The man is a germaphobe. I took such pride in our fidelity, how could I have a sexually transmitted disease? It is very difficult to get answers to this. Twenty years of PAP smears, never once has this been indicated. My MD said you can get it through a hot tub. Please, please clarify what could be going on. Another dr. said it could be a false positive. I will re-do the PAP, but I'm completely at a loss. Can HPV be gotten in other ways? Through a hot tub? I await your reply. Thank you.
Edward W. Hook M.D.
92 months ago
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Welcome to our Forum. I'll try to help. Over the past 30 years our understanding of the role of HPV in causing genital cancers has evolved quickly and led to improved cancer screening and a vaccine which is highly effective for prevention of HPV infection. There remains much to be learned however and your situation is one of those circumstances that occurs from time to time and is poorly understood. There is no doubt that HPV detection tests are quite sensitive but they are not perfect, yielding both false positive and false negative test results. As your doctor has told you there is a chance that your test is falsely positive. If that is the case, I would anticipate that a repeat test would be negative. In addition to this, there are infections that physicians encounter from time to time that have not been transmitted sexually. It has been suggested that HPV can be transmitted in less than optimally cleaned gyms, doctors offices, or off other contaminated surfaces (hot tubs have not specifically been suggested but why not?). I suspect this is probably true but the precise frequency of such mechanisms I not known. Finally and while this may not be relevant to your situation. most authorities agree that HPV can be transmitted in the context of non-penetrative interpersonal contact (i.e. petting").
I would urge you not to question your relationship based on this finding. These sort of things do happen. The firt step for you is to get the tet repeated.
I hope these comments will help. EWH
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92 months ago
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Thank you Dr. It was actually my previous Dr. two told me it could be a false positive, as my current doctor (who I am about to leave for many reasons), was unavailable for over a week, and the fact he did not tell me was not acceptable to me, that I tested positive for this. In your expertise, is it possible that either me or my husband got this before we were married? (in the 70s or 80s)? -- Both Drs did say that it could lie dormant for literally decades. Although the fidelity of my husband has never been in question so that's not the concern, I still remain perplexed, but I am seeing another dr. next week and will definitely get this pap repeated. My original dr. said repeat in 6 months (but his story changed from 3 to 6) - what is the timeframe you would recommend for repeating the test? From your message it seems that the frequency of transmitting by non intercourse is less than what they're saying so I still remain perplexed, but will wait....so my belief that this is a "sexually transmitted infection" is pretty accurate!? One more question (I guess this makes it 2) - is there a way to have my husband tested? thanks much.
Edward W. Hook M.D.
92 months ago
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HPV can certainly persist for many years and more recent data suggest that persons with the infection can periodically shed the virus, leading to detection from time-to-time by chance. Certainly most infections are sexually transmitted but as I mentioned above, the term "sexually transmitted" in this instance does include non-penetrative sexual activity. As I also said, there are also occasional infections that are inexplicable based on current knowledge- "most common route of infection" is by no means the same as "always".
In answer to the other question, at this time, there are no recommended tests for detection of HPV infections in men.
I hope these further comments are helpful. If there are further questions, Forum guidelines to permit one more clarifying questions and a response. EWH
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92 months ago
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Thank you. What percentage of the population has HPV? If your patient had my same results, would you tell them of the findings? (my dr. said they didn't say anything because he wasn't worried). How long would you wait to "re-do" the pap smear? I have no symptoms at all. What are the symptoms of HPV? (in case I do have it)? I understand this is the last round, thank you. Debbie
Edward W. Hook M.D.
92 months ago
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Good questions.
1. Estimates are that over 80% of Americans will acquire HPV at some time in their lives. We used to think that the infections then went away/resolved entirely but I think that current understanding is that it is more accurate to assume infections become quiescent but that from time to time infected persons may shed the virus. This does not appear to be a health risk for progression of infection to cause cancer. On the other hand, if the PAP smear is abnormal AND the virus is present and being shed, then the patient should be followed more closely because some (but not all) will progress to pre-cancerous lesions. In your case with normal PAP smears, you really have little to worry about.
2. If you were my patient I would tell you just what your doctor has said- that this was there and warrants a repeat test but that it is not something to worry about. After all, the beauty of PAP smears and HPV testing is that they allow problems with the potential to progress to be watched closely and intervened upon if needbe. This is a good thing.
3. Precisely how soon to re-do the PAP smear varied. My recommendation would be in 3-6 months at a time that is convenient for you.
4. HPV symptoms. Most HPV infections are asymptomatic and only detected through testing.
I hope this is clear. If any of my responses are unclear, I will squeeze in one further response but if I do not hear from you in the next few hours the thread will be closed. Either way, I hope my comments are helpful to you. EWH
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92 months ago
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Thank you very much. You helped to clear things up. My only open question is just to confirm that "it is not 100% certain, as to where people can get HPV"......meaning, could be some incidences where there is no easy explanation, and research is still ongoing? (as opposed to Syphillis) Other than that - I'm good! Thx again for your time.
Edward W. Hook M.D.
92 months ago
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Precisely- there are simply some HPV infections that we have no good explanation for. Research is ongoing.
Glad I could help. this will complete this thread. Take care. EWH
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