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I just found out I had a positive hpv test. The pap was normal.

 
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  • Answered by:Dr. Lawrence
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I just found out I had a positive hpv test. The pap was normal. I have been married and monogamous for twenty years. Should I be concerned or is it likely a false positive?

 

Optional Information:
Gender: Female
Age: 42

Submitted: 105 days and 21 hours ago.
Category: OB GYN
Value: $29
Status: CLOSED
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Expert:  DrThomasMd replied 105 days and 21 hours ago.

Hello
It is not likely a false positive.
You should simply continue your screening.
You should ask them to have the lab identify which strain this is and see if it is a high risk strain.
good luck

Let me know if you have further questions, details or need clarification, just use reply.......

Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Customer replied 105 days and 21 hours ago.

Why is it not likely a false positive? I couldn't have been exposed to anything

Customer replied 105 days and 21 hours ago.

Why is it not likely a false positive? I couldn't have been exposed to anything. How dangerous is a high risk strain if the pap was normal

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Expert:  DrThomasMd replied 105 days and 20 hours ago.

The HPV test is at least 95% sensitive.
the pap alone is only about 60 in dedecting HPV related lesions that might eventually deveop into dysplasia.

good luck again


Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Customer replied 105 days and 20 hours ago.

That doesn't answer my question. How dangerous is it to have a positive hpv

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Expert:  DrThomasMd replied 105 days and 20 hours ago.

Ok i am going to opt out here as I think another expert can help you

Customer replied 105 days and 20 hours ago.

Relist: Answer quality.
I want someone to actually answer what I'm asking

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Expert:  Dr. Owen replied 105 days and 20 hours ago.

Hello, and I am pleased to help, use of my answers are for educational purposes only.
HPV test on a PAP is not usually a false positive.
And, MOST likely you have had the HPV for years, it was dormant and then it became active possibly due to Stress - and this is WHY we still recommend PAP smears in Monogampous relationships - your friendly ob/gyn.
Please click on ACCEPT, thank you

Customer replied 105 days and 20 hours ago.

If it is positive, do I have to be worried about cancer? The pap was normal and my doctor thinks it is most likely a false positive hpv

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Expert:  Dr. Owen replied 105 days and 20 hours ago.

NO, you do not need to worry about - cancer - but this depends on the nature of the PAP - we can TREAT this if there is a dysplasia (such as a moderate to severe dysplasia) - so JUST because you have HPV, this does not mean you have cancer - just make sure you follow up with your ob/gyn.
Please click on ACCEPT and if you have follow up questions, please ask
Thank you

Customer replied 105 days and 20 hours ago.

I don't understand your answer. The pap was normal so what do I do? The doctor wants to repeat the hpv tomorrow because he thinks it's false positive. What do I do?

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Expert:  Dr. Owen replied 105 days and 20 hours ago.

PAP is normal - you do NOTHING - you get another pap in 1 to 2 years, that is all.
UNlikely it is a false positive.
If you want further information then go to the Society for Colposcopists or the American Congerss of Ob/Gyn - this is where you will find the exact protocols to follow for all PAP smears.
Take care.

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Expert:  Doctor replied 105 days and 20 hours ago.

Greetings

 

I want you to firstly understand the relationship between Human papilloma virus and cancer

The corelation between HPV and cancer of the cervix was one on those pivotal moments in medicine in which a causative organism was directly related to a cancer

However there are still gray areas in that correlation

Some persons with Cancer of the cervix never had HPV virus

Some persons with HPV virus do not necesarily end up with cancer of the cervix

 

This is important so you can be reassured that your negative PAP smear is good, but it needs to be followed up.

Read the abstract below to understand this.

http://www.ncbi.nlm.nih.gov/pubmed/17826171.

 

Therefore, rather than panic you must follow up closely on your PAP smears possibly every 6 months. There are no medications that can eliminate the HPV virus but guardasil can reduce the persistence and so your best choice is to follow up to make sure that if a change occurs in your cervix it is detected early

The arguement of whether your test is false positive or not can only be settled by repeating it, but as a physician that might give you a FALSE sense of security should the next test come out normal. So ACTIVELY follow up on your tests.

The risk is there but you are an example of the BEST case scenerio

Read the article below for further info

 

http://www.cancer.gov/cancertopics/factsheet/Risk/HPV

 

 

Doctor40946.0097133102

Accepted Answer

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Expert:  Dr. Lawrence replied 105 days and 18 hours ago.

I would like to provide some additional insight as a practicing gynecologist. As Dr. Owen indicated above, HPV is very unlikely to be a false positive. Most people in their lifetime have been exposed to HPV. Exposure to HPV is very common. It is typically cleared or kept under wraps by your functioning immune system and in most women, will never cause a problem. That fact that you now tested positive doesn't mean that you never had exposure in the past. If you have a monogamous relationship, this finding does not and should not undermine the trust that you have in your relationship. With that being said, I would like to add a few points. The appropriate screening for women 30 and over is a pap smear with High Risk HPV testing. If the HPV is positive and the pap smear is negative, then the appropriate follow up is to repeat both in 12 months (one year). The true risk of precancer or cancer of the cervix is with persistently positive HR (high risk) HPV. If either the repeat pap smear in one year is abnormal, or if the repeat HR HPV is positive, then you need a colposcopy (microscope view of the cervix with biopsies) to rule out any underlying abnormal changes to the cells of the cervix. Most likely, both will be negative next year. You do not need to do anything sooner for a few reasons. For one, you need to give you body time to clear the active HPV detected. Also, the time frame for any changes to the cells of the cervix is very slow, so there is not a significant risk associated with this delay. What I have presented are the current screening recommendations. Unfortunately, a recent study showed that less than 50% of practitioners currently follow the standard of care regarding this. That is likely why you doctor did not propose this. But, I would not repeat the HR HPV again sooner than one year as recommended by your Doctor. I also would not just repeat the pap smear without the HPV as the last expert indicated. I hope this is helpful

Expert TypeOB/GYN
Pos. Feedback: 98.2 %
Accepts: 224
Answered: 2/7/2012

Experience: Board Certified OB/GYN and accomplished educator

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Expert:  Dr. Lawrence replied 105 days and 18 hours ago.

Also, one more thing....the last expert mentioned gardasil..this is a immunization against the four most common types of HPV. It is recommended not as a treatment, but a prevention against exposure. Also, it is recommended between the ages of 9-26, so at 42, I do not recommend off label use of the vaccine. I hope this is helpful.

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Expert:  Dr. Lawrence replied 105 days and 18 hours ago.

Also, one more thing....the last expert mentioned gardasil..this is a immunization against the four most common types of HPV. It is recommended not as a treatment, but a prevention against exposure. Also, it is recommended between the ages of 9-26, so at 42, I do not recommend off label use of the vaccine. I hope this is helpful.

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Expert:  Doctor replied 105 days and 11 hours ago.

I think if you critical analyze the answer above you will find that there was no new fact or insight into the previous information

I did not say you needed to treat with guardasil, i only mentioned it as a modality of prevention. IT IS STILL GIVEN IN PERSONS ALREADY DIAGNOSED HPV positive.

Though MERCK was denied approval for patients 26-45 it was purely out of a meta-analytical data which is still not accepted by most Gynaecologists.

I am satisfied with the answer I gave and believe you have been infrmed, but the choice is still tours

Do not be in awe of medical qualifications, basic medical knowledge is universal and constant. Expand your own research and you will discover and understand fully that you need to be aggressive in the follow up. Or you become another statistics rather than best evidence based medical practise and outcome that I project.

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Expert:  Doctor replied 105 days and 11 hours ago.

Make sure you get your next PAP ASAP

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Expert:  Dr. Lawrence replied 104 days and 17 hours ago.

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