[Question #7819] High Risk HPV & waiting period to “clear”

 
13 days ago

Hello! I’m a 40 year old heterosexual female and just had my triennial pap and HPV test last week and was disheartened to hear my HPV test was positive; however it was not positive for strains 16 & 18. I’m still awaiting the pap results and am certain it will be a normal result or ASCUS  I’ll just be told to wait 12 months and that will be that. 

I have not had any type of sexual contact in 2.5 years and would think if I had contracted HPV from that last partner it would have “come and gone” in that 2.5 year period. Frustratingly, I’m now learning one can be haunted by HPV acquired decades ago. Given that fact, the part that is really throwing me off is what I’m hearing about how long it typically takes for HPV to no longer be detectable on a test (or, for lack of a better word, for it to “clear”). I’ve heard it can take anywhere from 8 months to 2 years. 


My question is this: when does the 8 months to 2 years “start”? Is it 8 months to 2 years from the date of the positive test?  Seems that would have to be how it is calculated since apparently it can take years or decades for an old infection to pop up on a test and if this really was HPV from, say, the year 2003, would it not have had 18 years to “clear”? Or does it have to first become detectable on a test and THEN the 8 month to 2 year waiting period begins? Thank you for your help! 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 days ago
Welcome. Thanks for your confidence in our services.

Yours is a very common situation. Almost everyone gets one or more (often several) genital HPV infections. HPV DNA can persist for years, perhaps for life, with a potential for reactivation to a level that can be detected by DNA testing. As you already understand, that's what's going on here. It is entirely possible, and happens frequently, that newly diagnosed HPV actually represent infection acquired 10, 20, or even 30 years earllier. Indeed, the large majority of newly diagnosed infections in women over age 35 are believed to be reactivations, not newly acquired infections.

The 8 month to 2 year clearance period you cite is after initial infection; this is the outcome in a number of studies of relatively young persons (often university students) who are followed with repeat testing over the years after initial diagnosis. However, the time to clearance in your situation -- detection of a longstanding, reactivated infection -- has not been well studied. The large majority of women with cervical HPV detected during routine pap testing become DNA negative, often within a couple of months, but some undoubtedly persist longer. If not persistent -- i.e. if DNA testing becomes negative -- there is potential for additional reactivations in the future. However, this likely is uncommon:  most women in your situation have no further positive tests and their pap smears remain normal.

So the important thing now is to await the Pap result, then follow your doctor's advice about next steps and follow-up. But that's all.  You don't mention your current sexual lifestyle. If you are sexually active with a single partner, for sure there is no need to change anything. If you're dating or otherwise likely to be having new partners, some would advise notifying them of your recent test results. But even that is optional:  such partners have little or no increased risk of getting a new HPV infection from you or any other female partner of similar age.

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

HHH, MD
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12 days ago
Good Morning Dr. Handsfield,

I really appreciate the speedy reply and all of that was very clear. What a great resource you all provide here—thank you for your time and take good care. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 days ago
I'm glad to be of help. Thanks for the thanks -- that's why we're here!

I'll leave the thread open for a few days in case any final issues about it come to mind.
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