[Question #6741] hpv concerns

11 months ago

In past have tested positive for high risk hpv & had abnormal Pap smears indicating cin1/2. Most recent tests were normal pap & hpv neg. However, was recently diagnosed w/ bacterial vaginosis (bv). (End of Feb) I have read online that bv can cause hpv infections to reactivate & cause cin. Is this accurate? This info made me a little nervous, as I think that I have had the bv infection for awhile before starting on antibiotics & I don’t think that they are clearing the infection. Would multiple bv infections be cause for concern with hpv reoccurring? Also had it back in May but was not treated due to fact was trying to get pregnant. (Don’t know if it went away or if had it entire time). If it does how fast could it progress to cancer? I am now getting tested once per year. Is that enough? Also, warning on the antibiotic for the bv states that in mice & rats longterm use has been linked to cancer. Would this cause the hpv to reactivate? 

 

I have 3 children & also had a miscarriage at 6 weeks. Would this cause hpv to reoccur? Some sites indicate that multiple births increase cervical cancer risk.

 

I bled for three days after last Pap smear (at 6 week follow up appt After 3rdpregnant):  dr said it would not be due to hpv or cervical cancer as pap was normal & hpv test was negative. Is she correct that hpv/cervical cancer would not be cause for bleeding? She said no matter what symptoms I have that may indicate cervical cancer that the hpv test & Pap smear prove no hpv/cancer present

Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to our Forum and thanks for your question.  I’ll be glad to comment.  Your history of having HPV and CIN 1/2 is characteristic of the natural history of HPV.  Please remember that HPV is exceptionally common and that well over 80% of unvaccinated women will have HPV infections at some time but that only 1 or 2% of those will progress to cancer and that nearly all of those cancers can be detected early and treated early with regular check-ups.    In nearly all persons in your situation the infection and related PAP smear changes will resolve without therapy.  In a minority of women there may be subsequent transient reactivations characterized by transient repeat detection of HPV but the infection does not typically progress. 

 

On occasion the inflammation associated with BV or other genital tract infections can be associated with repeat detection of HPV but this may be coincidence more than anything else.  BV does have a tendency to recur in some women as well. 

 

If HPV was going to progress to cancer (remember, this occurs in only 1-2% of women with HPV, it typically does so slowly, taking years or even decades to progress.  Thus annual re-checks and PAP smears are fine. 

 

I would not worry that your miscarriage or multiple pregnancies putting you at risk for cancer.  As long as you have your regular GYN check-ups as recommended by your own doctors, you should be fine. 

 

Similarly, I would not worry about any risks associated with the medications you took for your BV. 

 

I agree with your doctor that that hpv/cervical cancer would not be cause for bleeding? She said no matter what symptoms I have that may indicate cervical cancer that the hpv test & Pap smear prove no hpv/cancer present


I hope that this information is helpful. EWH

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11 months ago
Thank you so much for your reply. I was also wondering if stress could cause HPV to reactivate?
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
That’s a good question but, unfortunately there are no data to prove or disprove it.  Given that your recent PAP smear was normal however, it really is not something to worry about.  EWH---
11 months ago
Thank you for your replies. I have been bleeding and spotting off and on for a few weeks (I will bleed for a few days  then it will stop then I will have some bloody disharge then it will stop then I will bleed for a few days then spot etc). In addition, I have had discharge, some of which is gray and clumpy, in addition to a burning sensation when going to the bathroom, and the bv. My dr is still adamant that my Pap smear/hpv test on Feb 26th of this year means I do not have hpv or cervical cancer. All of the bleeding and discharge and bv diagnose came after these tests. You mentioned before that you agreed with her. Does this additional bleeding I have been having in addition to the clumpy discharge and bv change your answer? I want to trust my dr but I want to make sure I take the necessary steps if I do need to follow up with this.
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

On occasion a procedure or antibiotics can lead to or predisposed to BV or other disruptions in normal flora and in this way cause discharge and be recognized as BV.

I should add that a single PAP smear is not perfect for detecting HPV-related changes but when carried out at regular, recommended intervals, their reliability increases dramatically.  In general the HPV tests are more sensitive than a single PAP smear.  Your combination of tests indicate that you need not worry about HPV at t his time. 

I hope what i just said above did not confuse you, it IS complicated. The combination of test results that you have is better than a single PAP smear.  I really would not be concerned at this time.  EWH

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11 months ago
Thank you, doctor. One last question---the bv medicine I was on was metronidazole 500mg 2 times a day for 7 days. While on the medicine, I had some dark urine, nausea, lack of appetite and dry mouth. Would I be correct in saying that those side effects are related to the antibiotic and not in any way a sign of hpv/cervical cancer?
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Correct.  All of those side effects are classic side effects of metronidazole (it tastes bad too) and are not signs of HPV nor of cervical cancer.

As you know, we provide up to 3 responses to each client.  This will be the final response as part of this thread.  Please don’t worry.  Take care.  EWH
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