[Question #5967] Hpv transmission in Mongomous partner
 |
71 months ago
|
Hello,
Recently I had a pap with cytology come up + for high risk HPV, there were no changes in my cells. I am a little concerned because previously I have always had negative hpv and negative pap. I had asked to be tested in 2017 for hpv and it was negative. Now, out of no where it is positive and I am in a monogamous relationship. I have been with my husband for 6 years. I am 99.9 percent sure he has been faithful but wanted your opinion as there are different types of information on the Internet that is scaring me. Is the only possible cause of my hpv result him being unfaithful? Or are there other reasons?
Also I did get the gardilsil shot about 15 years ago
Thank you
 |
Edward W. Hook M.D.
71 months ago
|
Welcome to our forum and thanks for your question. I'll do my best to help. Let me start by saying emphatically that a positive HPV test is not an indication of infidelity - there are many, many potential alternatives, several of the most common of which I'll list below.
1. About 15 years ago, we were using Gardasil 4 which covered the 4 most common HPV types (2 "high" risk, 2 "low" risk). Thus it is possible the you acquired an HPV type not covered in the vaccine you received or a non-vaccine HPV type that your husband had from a prior relationship.
2. If you were sexually active before you received Gardasil, you may have acquired HPV which could have reactivated. We know that HPV becomes quiescent over time in most women but we also know that it occasionally reactivates, particularly with immunosuppressive medications but also just as a chance occurrence.
I hope this information is helpful to you. with respect to this topic, I congratulate you for your plans to avoid the internet. I anticipate that whatever you might hear there is likely to be misleading. EWH
--- |
71 months ago
|
What are the chances I acquired it in the past and tested negative on my prior HPV test and now positive?
What are the rates for false positives for hpv tests?
In your experience, is reoccurrence common? If so how common?
Is there a chance my husband has always had it and my immune system was strong enough to fight it off until now?
Could It have laid dormant or below the cut off for testing positive on prior paps?
Thank you
|
Edward W. Hook M.D.
71 months ago
|
I'll go straight to your follow-up questions and then have another comment or two:
What are the chances I acquired it in the past and tested negative on my prior HPV test and now positive?
This would be quite possible. There are no specific figures on this so I will not give you a rate but this really is not uncommon. Both PAP smears and tests for HPV occasionally fail to detect infections because there are multiple possible sites of infection to sample. One of the great strengths of these tests however is that with repeated testing, after 3 or 4 tests, nearly all infections are detected.
---What are the rates for false positives for hpv tests?
Very low with current tests.
In your experience, is reoccurrence common? If so how common?
My own experience is not relevant as I see few patients in my clinic repeatedly for PAP smears and cervical HPV management. The bottom line however is that no experienced, well informed clinician would be surprised to see an infection which might have been missed in the past (please not, I did not use the word recurrence as you do not know how long you have been infected or when you got the infection that was detected.
Is there a chance my husband has always had it and my immune system was strong enough to fight it off until now?
I suppose this is a possibility but it is more likely that your infection has reactivated. Irrespective, it is not a reason to challenge you husband's fidelity. Rather it is something to manage (i.e. your HPV infection) and NOT to try to assign blame to.
Could It have laid dormant or below the cut off for testing positive on prior paps?
Sure, see earlier comments.
Final comment. Clearly your new diagnosis came as a shock to you. If there are not other problems in your relationship, I urge you not to use this event to have doubts about your marriage. When we have patients with newly discovered STIs, they have just three questions - who gave this to me? (you do not, and cannot know), how long have I have i?t (again, this question cannot be answered), and what can you do about it? (this is the big question. I presume you are working with your GYN to address your newly positive tests). Please do not overthink this. Be glad you found the infection and that with the help of a well informed GYN, it can be managed. EWH