Questions from Readers: Paps and other tests

Jessica asks:  
Hello, I am 20 and was diagnosed with HPV and had a change in my cervical cells. Does that necessarily mean that these cells are pre-cancerous? Also will I always have an abnormal Pap smear for the rest of my life? And even if the virus is dormant, will it still be detected after a Pap smear exam?

Most of the time, HPV does nothing to your body and clears on its own. However, if the HPV persists, it can cause a spectrum of abnormalities called cervical dysplasia or also referred to as cervical intraepithelial neoplasia (CIN). Mild cervical dysplasia or CIN 1 is not precancerous and it will usually regress on its own; whereas high grade dysplasia is precancerous and would warrant treatment. A current abnormal Pap smear does not mean it will remain abnormal forever. Most of the time, in fact, it regresses to normal. The Pap test detects cervical cell changes, not the HPV virus. A separate test, called an HPV test, detects the presence of the HPV virus, when it is above a certain threshold of viral copies. The HPV test is used in only a small number of cases. When the virus itself is below the detection threshold (or latent or dormant), the HPV test would be ‘negative’.

Ashley asks:  
Ok, so 3 years ago my doc told me I had HPV. I was getting checked every 6 months.  The past 3 tests have all come back normal. Does that mean I’m ok for now? Does my friend have reason to freak out on me?

Yes, you’re ok for now. If your Pap tests have come back normal three times after an abnormal test, then that is a good indicator that your body has taken care of your HPV for now. It is important that you continue the schedule of follow-up that your doctor recommends. Sometimes the cleared-up abnormalities on the Pap smear can revert back to abnormal. Keeping your regular appointments with your doctor allows you to know what’s going on with your body and to catch any abnormalities early when they are easiest to deal with. Your friend should be happy and reassured that all is well with your health at this time.

April asks:  
Can the HPV DNA test detect dormant HPV? One year I was negative and the next year I was positive. Thanks

The change in your HPV diagnosis is likely due to one of two reasons.  Either you have a new HPV type, or there has been a reactivation of an HPV type that you had previously.  Non-specific HPV tests (the kind of HPV test you most likely had) cannot determine which HPV type you have; nor can your provider determine this.


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