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HPV reappearance: Need guidance, if possible.
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boopboopbeep posted:
So glad this community exists! I need some clarification (hopefully Jane can answer, but I feel like this is a common issue, so maybe a bunch of you will know).

I was diagnosed with HPV in 2010. I had on-and-off abnormal paps for the next year or so, got a colcoscopy in 2011. I don't remember the results, but I think it was mild dysplasia, if anything.

Shortly thereafter, everything went back to "normal"--no abnormal paps for all of 2012 and the beginning of 2013 (I was checked pretty often, though, just to be careful).

I then got an abnormal pap smear in May 2013, two months ago. I got a colcoscopy in June and it turns out I have high-grade dysplasia in a small area, and will likely need a LEEP, though I'm getting another colcoscopy in September to see how it's doing. I'm trying to change my diet, etc.

My issue is this: I have only had 2 boyfriends in the past few years--the first guy I definitely caught HPV from. I started dating the 2nd guy at the beginning of 2012 and had totally normal, frequent paps up until two months ago. We are still together.

My sister tells me that because my body stopped "showing" that I had HPV--i.e., normal paps for a year and a half--the kind I have now is a DIFFERENT strain than the one I caught in 2010. She explained that once the HPV stops showing up in tests, your body has adjusted to it, and it'll never appear as abnormal again.


I am really concerned cos at the beginning of my relationship with my current boyfriend, my paps were all normal, as I explained. So I feel afraid that he cheated on me and contracted a different HPV strain, which is the kind that's showing up on my current paps.

I told my doctor this and she said the same strain of HPV can reappear on tests, then not show up at all. It's not like it goes away, she explained, so the HPV I caught in 2010 is probably the same one I have now, and is the same one causing the problem. But my sister says this is not true.

So: can the same strain of HPV stop showing up on tests, then show up again? Or is it like, once it's gone, you don't see it ever again unless you contract a new kind?

Thanks!
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Anon_6061 responded:
HPV infections are very common and most types are transient and cause no problems especially in women under age 30. Types 16 and 18 are responsible for 70% of cervical cancers.

The transient nature of HPV and the fact that relatively harmless things (such as inflammation or various infections) can cause abnormal paps are the reasons that pap smear guidelines were revised to every 3 years versus every year starting at age 21. Too many women were being overtreated for abnormal paps that would have more than likely resolved on their own or weren't even abnormal cells. Not only is overtreatment costly, it can cause harm (such as reduced fertility and pre-term labor). Of course, any woman with a history of abnormal paps will require more frequent monitoring.

These links are helpful in understanding pap smears, HPV, and cervical changes:
http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing
http://www.cancer.gov/cancertopics/understandingcervicalchanges
http://www.cdc.gov/std/hpv/pap/
http://www.thehpvtest.com/about-hpv/high-and-low-risk-hpv-types/?LanguageCheck=1

Of course, if you do have high-grade dysplasia, it will need to be treated. Hope this helps!
 
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boopboopbeep replied to Anon_6061's response:
Thank you so much for this help! I really appreciate it. That's true about overtreating.

Question for you, more specifically: Can the same strain of HPV stop showing up on pap smears and then reappear? My sister told me after you get HPV and start testing negative for it, it'll never show up again. She says I'm testing positive for HPV again because I have a SECOND strain of it. Is this true? OR can you test negative for HPV, and then have it reappear, then have it disappear, etc...I'm just wondering if it appears to "come and go" on pap smears, or if it eventually stops appearing (testing negative) and only shows up positive when you get a brand new strain.

My doctor told me the same strain can disappear and reappear--i.e. you can test negative for it even if you have it, and have the virus show up again later--but I'm not sure.
 
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Anon_6061 replied to boopboopbeep's response:
Most HPV infections, especially in younger women, are temporary. Sure, just like any virus can come back so can HPV. It can come back as the same strain or a different one. Diseases/conditions of any type can lie dormant in us and oftentimes never cause problems. The same is true for most strains of HPV.

HPV testing is separate from pap testing. This link discusses the advantages of pap and HPV cotesting for women ages 30 http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing. It also lists the categories of abnormal cells, squamous and glandular. Lots of good info.
 
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boopboopbeep replied to Anon_6061's response:
Again, incredibly helpful. I'm not clear on whether or not CIN-2 is caused by HPV. What does it mean if you test negative for HPV, but positive for CIN2 (which is what my abnormal pap smear showed), but previously tested positive for HPV (2 years prior)?
 
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boopboopbeep replied to boopboopbeep's response:
P.S. Sorry for all the Qs--that's the last one, I promise! Just a bit confused as to how I tested positive for HPV, but only had CIN-1, then got a CIN-2 result two years later but negative for HPV. Probably the same strain of HPV from earlier? Or a new one? The website you linked is super informative but this is a confusing factor.


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