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Old 03-11-2010, 01:50 PM   #1
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HPV genotype/Abnormal Pap

Hi,


I'm 29. I got a call from the ObGyn, and I got my first abnormal pap result in 10 years of annuals. I also tested positive for HPV this time.

I'm guessing I have the high risk type(s) since my Pap came back abnormal with inflammation. She didn't say ASC-US. She just said "inflammation." Whatever that means. She said if they see anything strange during colposcopy, they will do a biopsy.

I wanted to know how bad the Pap result was so when I asked her about Bathesda system, she was clueless. LOL. She couldn't tell me more. Sigh. When I told her, I read in magazines that most people clear HPV from their system within 2 years, she said "no, it's a virus, you have it forever." Then I said, what about a common cold or the flu? Those are viral infections also, but you clear those out of your system. She said, "ahhh...I have no idea." She sounded ignorant.

The nurse acted annoyed and brushed me off when I asked questions about HPV, cervical cancer, and pregnancy. She was eager to hang up. I had to educate myself online.

Anyhow, where and how can I get a HPV genotype test?
I would like to know which strain I have. If I have HPV 16 or 18, I will need to keep an eye out for head and neck cancer. I've never had anal sex, but I guess I'll have to watch out for anal cancer also.

I suspect that I have the persistent HPV type since my body apparently hasn't cleared or suppressed it after many years. Maybe it's my age. My T-cells and B-cells are slacking off. I read that HPV 16 can be very elusive and hide from the host's immune system for a long time.

I also got off my BC. I hear BC can increase your cervical cancer risk possibly because 1. decreased folate levels and/or 2. people who use BC are less likely to use protection.

BTW, I have an excellent immune system other than this surprise HPV. I don't even get a common cold. I've never smoked but drank socially in college. I don't drink now. I eat uber healthy, and I'm fit.


I'll update on my colposcopy experience. I believe they will do ECC since the nurse said the best time to have colposcopy is right after I finish my period because the cervix will be more open.

An interesting note:

I had one questionable pap 4 years ago, but when they re-tested the sample, it came out normal. I was trying to get my BC refilled last minute and couldn't get an appt with the regular ObGyn and went to Planned Parenthood even though I had sex the night before.

I heard that having sex the night before a Pap can make your result come out abnormal. Is that true? Can anyone answer these questions?

Sex can cause abnormal pap results because (after coitus interruptus or condom use, obviously if sperm was found on your pap, that would look abnormal):

1. Cervical trauma from thrusting? - tears your cervix? increased WBC? Downstream cell signaling and immune response to damages? why would the cells look abnormal?
2. Pre-ejaculation fluid? - changes your cervical cells to make the environment more suitable for sperm?

Thx.

Last edited by Noria; 03-11-2010 at 01:52 PM.

 
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Old 03-12-2010, 12:30 PM   #2
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Re: HPV genotype/Abnormal Pap

I'm in the same boat as you. I just turned 30 and I had my first abnormal pap after 11 years of annual normal pap results. My doctor explained to me that HPV can be dormant in our systems for decades.

When you test positive for HPV that means you tested positive for the high-risk strains. There is no test for the low-risk strains of HPV. At this time my doctor said there is no technology/test to determine which specific strain we have in our systems (and we can have multiples strains all at one time).

Having sex the day before your period CAN bring forth an abnormal pap. In addition to sex, being on your period can also make the results inaccurate...however, now some doctors have newer technology where they are able to perform an accurate pap while being on your period.

After my pap results came back ASCUS and positive for HPV they scheduled me for a colposcopy. I got the colposcopy done 1 month ago and they found 2 areas that looked abnormal so they took 2 biopsies. My colposcopy and biopsies were painless although there is some discomfort, just like a pap. They called me and discussed my colposcopy results. 1 biopsy showed low-risk dysplasia (CIN I) and the other biopsy showed moderate dysplasia (CIN II). The next step was going in and getting a CYRO procedure done where they actually freeze off the bad cells in your cervix. I had this procedure done this past week and it was painless as well. For the next year I have to have paps done every 3 months until everything looks back to normal. The good news, according to my doctor, is that the "freezing" process gives me a 90% chance of never having an issue with HPV again.

Now, if you have inflammation and your biopsies show low-risk dysplasia most likely they will suggest you get a pap in 3-6 months because the virus will clear itself out of your system. HPV can flare up due to stress, a low immune system etc.

Hope this helps....

 
Old 03-13-2010, 10:43 AM   #3
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Re: HPV genotype/Abnormal Pap

Thank you for responding Sulli. It's a comfort to know that there are others like me.

Can anyone answer my questions?

I see that the general consensus on clearance/suppression of HPV (even for high-risk types) for a person with a normal immune system is 6-24 months.

Is that from initial exposure or upon finding out that a person has an active HPV infection?

Apparently HPV can stay dormant for 5, 10, or 20 years in some women and become "active" during times of stress, weight loss, pregnancy and/or lowered immune system (while excluding new infections).

Those women would have tested negative during the dormant period, right?
If they had been given HPV tests despite normal pap results, would they have tested positive for HPV? Does dormant equal to undetectable HPV DNA levels?

Does anyone know if HPV 16 and 18 are the types that persist? I know HPV 16 and 18 cause 70% of all cervical cancers.
Someone might respond and say 50% of women who have cervical cancer did not have regular pap screenings, and cancer could have been prevented with regular screening.

But the problem still remains. Their bodies did not clear HPV within 2 years of infection or discovery. HPV apparently persisted and caused cancer. Even if HPV does not cause cancer, it seems to cause enough and recurrent abnormal cell changes that some people have to have REPEAT procedures such as LEEP, Cryo, Cone Biopsy, and Laser Ablation.


Some women deal with HPV infection and subsequent recurrent cervical dysplasia symptoms without cancer for years if not for decades. Are the majority of these cases caused by HPV 16 and 18? There must be a study or a literature on this.

I know HPV testing is not recommended for women under 30 unless their pap comes back abnormal because most of them will test positive anyway, but I wish I had known earlier.

Can anyone chime in? Upon finding out that you have HPV, how long did it take you to test negative again?

Last edited by Noria; 03-13-2010 at 10:43 AM.

 
Old 03-13-2010, 11:21 AM   #4
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Re: HPV genotype/Abnormal Pap

From what I've read, many doctors do not retest after it is confirmed that a woman is HPV positive. And just because a woman no longer tests positive for high risk HPV, doesn't mean the virus isn't still active. It may just mean that her viral load is too low to be detected. The same can be said about how long it takes to test positive; it depends on the viral load being high enough to be detected by the test.

I hope that answers some of your questions.

 
Old 03-13-2010, 12:24 PM   #5
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Re: HPV genotype/Abnormal Pap

Thx Pickle. I'll browse around PubMed.

Hologic Corporation's HPV High-Risk tests were approved by the FDA.

Cervista high-risk HPV test and Cervista HPV 16/18 genotyping test are available.

I need to find out where I can get Cervista testing.

Seeing that the ObGyn nurse who called me was clueless about HPV strain typing, I'll have to look for a new doctor.

 
Old 03-13-2010, 06:48 PM   #6
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Re: HPV genotype/Abnormal Pap

Dear ladies who are familiar with colposcopy,

I'm not being an alarmist, but while researching HPV related health issues, I found out that HPV can also cause Vulvar Dysplasia.

Does the doctor examine the vulva area during colposcopy?
Any suggestions on questions to ask while I'm at the doctor's office?

I want to make sure they check all my female parts.

Thx.

Last edited by Noria; 03-14-2010 at 10:17 AM.

 
Old 03-18-2010, 02:37 PM   #7
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Re: HPV genotype/Abnormal Pap

I'm updating my High Risk HPV, Abnormal Pap, Colposcopy, and Biopsy experience for future readers.

The doctor told me that my pap result came back "atypia." I asked her to put that on the Bethesda system scale. She said it means ASCUS.

The colposcopy exam took 10 minutes max.

She saw two places with mild changes after acetowhite staining. When she put Lugol's Iodine solution, she saw nothing of note. No abnormal vasculature pattern was seen. She biopsied two areas and performed Endocervical Curretage. The whole process was painless. I have yet to experience spotting.

Unless the biopsy result indicates otherwise, I'm due for a pap smear in 6 months. I hope that my acetowhite staining was nonspecific. I'm hoping for the best. Maybe the biopsy will come back negative for cervical dysplasia, and the doctor said this is pretty common. Schiller's test (Iodine test) is also nonspecific fyi.

She said 70% women she sees end up on the colposcopy table because of abnormal paps. While the normative aspect of HPV is comforting, the whole experience is disconcerting, and I am usually imperturbable.

Good luck everyone.

 
Old 03-18-2010, 04:50 PM   #8
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Re: HPV genotype/Abnormal Pap

Noria, I'm glad you came back to update us on how the appointment went. I'm hoping you get good results, too! Let us know the results, ok?

 
Old 03-31-2010, 07:13 PM   #9
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Re: HPV genotype/Abnormal Pap

Well, first you seem very informed. So let's see what I can do to help. I would find a new doctor that can answer questions. My pap came back High Risk and my primary care doctor called me and explained that it caused abnormal changes to my cervix and told me to see an OBGYN. He also emailed me references. When I went to see her, she told me that since this is so common, and my results were so minor, she wanted me to get the vacine and get a pap in 6 months.

I appreciate nurses but nowadays it a nurse only needs 2 yr degree and when some doctors aren't informed about HPV, it shouldn't surprise us that neither are some nurses.

Scientists are sure whether HPV clears itself and goes away forever of if it's similiar to Herpes and reactivates when the person is stressed. It's hard to tell since it may be that the person is infected because they were infected with a new strain and not the the old strain.

My personal view on b/c and the studied which relate it to HPV is that people that are on B/C tend to be less likely to use protection. I'm not so sure how effective B/C is for HPV because my OBGYN did tell me that they are not sure condoms protect against it. I'm taking Biology 2 so I've learned a little about things, and I've done further reading, and the virus is extremely small which I suppose means it can travel through condoms. Considering that so many people have it and men can't be tested for the high risk strain, it's not a surprise, since skin to skin contact can transmit it.


Yes, having sex prior to a Pap can result in an abnormal pap.

Hope this helped some. It can seem lonely, even though so many people have HPV but you have support here.

 
Old 04-02-2010, 05:10 PM   #10
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Re: HPV genotype/Abnormal Pap

I just got my pap results and have had HPV for ten years, but it's never shown up until now. Sex can throw off your test, and there is a specific test to know what type you have. I also have never had a break out.

 
Old 04-03-2010, 09:59 AM   #11
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Re: HPV genotype/Abnormal Pap

I know you're trying to help here but you seem to have been misinformed. I don't want wrong information to disseminate.

Quote:
Originally Posted by az2002 View Post
Well, first you seem very informed.
I have access to primary literature. I was pretty clueless about HPV and cervical cancer pathogensis before I got that dreaded phone call from the ObGyn. I was totally blindsided but learned about HPV/CIN quickly.

Quote:
Originally Posted by az2002 View Post
Scientists are sure whether HPV clears itself and goes away forever of if it's similiar to Herpes and reactivates when the person is stressed. It's hard to tell since it may be that the person is infected because they were infected with a new strain and not the the old strain.
I think you meant to say scientists AREN'T sure.

Quote:
Originally Posted by az2002 View Post
My personal view on b/c and the studied which relate it to HPV is that people that are on B/C tend to be less likely to use protection.
TRUE. I already stated this on my thread. This is one of the views on the use of hormonal contraceptives and HPV.

Quote:
Originally Posted by az2002 View Post
I'm not so sure how effective B/C is for HPV because my OBGYN did tell me that they are not sure condoms protect against it.
You seem to have misunderstood the relationship between cervical dysplasia and oral contraceptives. NO, BC is not effective against HPV. I was talking about studies that showed probable correlation between the incidence of cervical cancer/cervical dysplasia and the presence of HPV with the use of oral contraceptives. Apparently the use of oral contraceptives has been associated with lower folate levels. Some papers claim that lower folate level status is associated with HR-HPV infection and with a diagnosis of cervical dysplasia. According to an article, lower RBC folate levels increase the likelihood of having a persistent HR-HPV infection which can lead to CIN. None of these papers are definitive. Correlation does not mean causation.

Quote:
Originally Posted by az2002 View Post
Yes, having sex prior to a Pap can result in an abnormal pap.
I know. I wanted to know why sex prior to a pap smear sometimes causes an abnormal result.

MY BIOPSY RESULTS:

Endocervical Curretage: Clear
Exocervical Biopsies: Mild Dysplasia, due for a pap smear in 6 months.
Watchful waiting.

Best wishes everyone!

Last edited by Mod-S4; 04-08-2010 at 07:59 PM. Reason: This board is for peer sharing only.

 
Old 04-07-2010, 06:36 PM   #12
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Re: HPV genotype/Abnormal Pap

Ok, Noria, I think you misunderstood some of the things I said.

When I was speaking of b/c I was speaking of condoms not, oral contraceptives. Clearly, oral contraceptives don't provide protection against any STD or STI. I was referring to what my doctor advised me about condoms. And yes, I understand that you referred to the study as the correlation between oral contraceptives and reduced folate levels. My point was that when you're on oral contraceptives you're less likely to use a condom, which may not provide 100% protection against HPV, does provide some.

Your comment that I've been misinformed seems out of place. I'm with you, I don't want false information being spread and I'm not certain where in my post I included false information.


The reason why your pap can come back abnormal after having sex is because sex can change the normal chemistry which is something your doctor has probably told you.

Nothing in my post disagreed with you, which leads me to believe you're just looking for an arguement.

 
Old 04-08-2010, 05:11 AM   #13
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Re: HPV genotype/Abnormal Pap

Dear az2002,

Mea culpa if I misunderstood your post. Maybe I read it too thoroughly.

I extrapolated your point reading this text for example:

My personal view on b/c (pills) and the studied which relate it to HPV is that people that are on B/C (pills or birth control in general?) tend to be less likely to use protection(condoms). I'm not so sure how effective B/C (pills? or birth control in general?) is for HPV because my OBGYN did tell me that they are not sure condoms protect against it.

I didn't realize you were using b/c and B/C for birth control in general to encompass all birth control methods. Since B/C was contrasted with protection, I assumed that you were talking about oral contraceptive use vs. condom use. Maybe your small b/c is different from big B/C?

Forgive me. I was honestly alarmed.

Peace

 
Old 04-08-2010, 10:47 AM   #14
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Re: HPV genotype/Abnormal Pap

Hello Everyone,

I also have HPV, but used protection all of the time. You can get HPV, even when using a condom or any other contraceptive. I am on BC too, but I started using it for medical reasons.

Right now, I have CINI; however, I had another repeat pap and it is still abnormal. So, yesterday, I went in for my 2nd colposcopy and they had to do an ECC. I'm still waiting for these results. It will take about a week or so. I'm getting impatient. I want to know the results because I'm scared that it may have escalated.

Yes, HPV is a virus and my OB-GYN stated that in stages such as CINI, the body can get rid of it on its own...just like the common cold. It is unknown as to when. I'm a fit. I eat healthy and take vitamins, but it is unknown as to when this crazy monster will leave my body...

I hate being impatient...

 
Old 08-31-2010, 02:49 PM   #15
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Re: HPV genotype/Abnormal Pap

6-month re-pap update:

My pap result was normal! I'm so thrilled. Hopefully my cervical cells will stay normal.

I know that a normal pap result does not mean that HPV is gone/suppressed, but I'm still happy.

Good luck everyone!

Last edited by Noria; 08-31-2010 at 02:57 PM.

 
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