[Question #7493] How common hpv false positive rate? Contesting

4 months ago
Hi 
I am a 47 year old happily married for 25 years peri menopausal woman. Both my partner and I were virgins when we got married and I completely trust my husband and he trusts me it almost feels ridiculous to defend his fidelity or mine . I have struggled with chronic utis and this can go up with age I am told. However I was shocked to get a csll from my doctor to say my pap was normal but I got hpv  result after never testing positive right through our 25 year marriage! My doctor actually asked me to question my husband about his past relationships which is completely insane if you met my husband! He i known for his integrity to extent he’s almost prudish It’s extremely bizarre and my husband is not fussed at all because he says it’s obviously a false result and retesting in a year will show that . I however was completely floored by this weird result and cannot take it as rationally as my husband. I booked for retest tomorrow which is unpleasant and annoying since I know neither of us would cheat . Can peri menopausal changes or my chronic utis / vaginitis be responsible for positive hpv if neither of us have had other partners? I know Hpv very common but if it’s only sexual transmission as my doctor said and I have never had positive results ever before how on earth could this happen? And could I get a second false positive  within a week of testing? Could it be lab or doctor error ? Fomite transmission ? as we had a ton of fertility treatments? Please help me understand what’s going on? Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
Welcome to the forum. Thanks for your confidence in our services.

This is a very common situation:  women with abnormal pap smears and/or posiive HPV testing who are not seemingly at risk for HPV or other STDs re common in the experience of all gynecologists, primary care providers, and STD specialists. This obviously is a reactivation of an infection acquired in the distant past. Although HPV usually is sexually transmitted and acquired, there have always been exceptions, i.e. unexplained infections in women who have no history of sexual exposure. Some undoubtedly were actually sexual, e.g. repressed memories (think of childhood sexual abuse, long forgotten0; sexual activity without intercourse (some infections -- not many, but a few -- may be acquired during heavy peatting, e.g. hadn-genital contact or oral sex); and similar evetns. A few may have resulted from acquistion of the virus from her mother's genital infection during vaginal delivery, with lifelong carriage.

False positive HPV test? Hard to know how likely this is. Most experts believe this is extremely rare, if it occurs as well. I can't say it never occurs, but it is very unlikely, especially if your test was done in a reliable laboratory, e.g. one of the national labs used by most doctors' offices (Quest, Labcorp, and others).

Until ~20 years ago, when the sexually transmitted nature of HPV first came to be generally accepted and understood, events like this didn't generate anxiety. And that should be your perspective now. This doesn't necessarily have any implications about your husband's sexual fidelity (or yours) or his or your truthfulness. Having said that, of course some such cases indeed result because one or the other partner (usually both) had previous sex partners in the distant past; or perhaps more recently. You're the only one who can make this judgment about your husband -- but it sounds like you're confident and that he is not discussing it with guilt or apparent evasiveness. If so, you should believe him and stop worrying. Some HPV infections are simply unexplained.

The important thing now is to follow your doctor's advice about follow-up testing and/or pap smears. Since your pap itself is normal, probably it will remain that way; and most likely repeat HPV testing would be negative once again.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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4 months ago
Dear Dr Handsfield 

Thanks for your thoughtful and comprehensive response. I know health should be my main concern but still feel there is still zero explanation for me to suddenly test positive.!  I strongly doubt I could have got it in birth but could I have got it through IVF ? Or hormonal changes?  I can’t believe there is so little information on false positives and also on unexplained results. It just doesn’t ring true for us . I told my sister and  two friends and I felt unfairly the shame and humiliation never mind the anxiety which goes with this result. All these people who know us well we’re just as shocked and said it just doesn’t add up...!I know righteous indignation should not be my response but I do feel unfairly diagnosed and also Nic I feel this way I can’t be the only one .. I found this on the internet because nothing is making sense at all . No heavy petting for either of us. . My husband is from a religious family and did not want to engage in any intimate acts before marriage .  we were both  totally inexperienced and So could hormones vaginitis or inflammation or even medication result in false positive? There actually could be no traditional cause here other than fomite transmission. I am really floored by the inauthenticity of this result because it’s impossible if they say sexual transmission either past or present is responsible. Should I ask for a different hpv test or maybe co testing is to blame for this . I ask as a truth seeker never mind that it’s not great to consider how this could affect my health if by some means I retest positive again. It just doesn’t feel right or ring true any of this how could false positive be rare if it happened to us of all people? I also emailed the Urogynecologist I see for utis and she said virgins , young kids can have it too ??? Without the heavy petting etc you mentioned My mother too very old fashioned , how on earth could she of all people contracted and given to me ? I couldn’t even ask her she would be so galled at the intimation . Is there a definitive hpv test I should request tomorrow? 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
I'm sorry, but the answereds to all this simply are not known for either of your two main questions (Where did it come from? Why was it detected now and not earlier?).

There is no evidence to support any of the theories you are asking about. it simply is not known why these things happen. HPV reactivation is very common, and is not apparently associated with immune deficiency of any kind or any other health influences. Smoking increases the risk of progression of HPV to pre-cancerous lesions and cancer itself; it may have an effect on HPV reactivation, but it isn't a major influence. No other biological explanations are known. Your gyn is correct about occasional HPV diagnosis in virgins; and when HPV appears in a child, it is not considered evidence that would trigger investgation of sexual abuse (unlike STDs like gonorrhea, chlamydia, etc).

I'm afraid you're never going to know why this happened or where it came from. But I hope it will reassure you that you are not alone-- the identical situation has arisen in millions of women over the years and, as a wild guess, probably tens of thousands of women every year in the US.

My final advice is to be careful continuing to search the internet about these issues. Medical mysteries -- whether about HPV or anything else -- always generate extensive online discussion and claims unburdened by any attrempt at scientific evidecne. You will be able to find support for any theory you can think of, and probably some you can't until you read them. I advise either ceasing online research on it, at least until you have come to accept your situation and are no longer hyper-anxious about it; of if you continue, limit to scientifically based and professionally moderated websites (like this one, CDC, and many academic medical centers, public health sites, etc.). Especially avoid sites run by and for people with HPV or worried about it.
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4 months ago
Hi Dr Handsfield
Just wanted to follow up on my retest result for HPV. As you  know I was completely stymied and traumatized by my positive HPV result  . Also there is not much information on the false positive rate and you yourself told me to accept that it’s true and move on ... Today I got a call from my Obgyn for the results of my retest Pap-HPV I went one week after the first test for a retest  as I was not prepared to wait out the year as was suggested by my doctor. Anyhow it turns out my result was indeed a false Positive for HPV !! Just putting that out there for your readers that even though it’s rare it can happen and I would hate for others to go through the needless anxiety and emotional upset that I experienced.  And it could also lead to unnecessary procedures! While I am grateful for the good news more should be done to ensure that testing is accurate and more sensitivity is given when relaying needs that is pretty traumatizing to patients.
Thanks again fir your help.
Wishing you all a good, happy and  healthy 2021
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
Thanks for the follow-up. I'm glad to hear of your negative repeat HPV test. Best wishes and have a happy new year!---