HPV Testing Here's What you Still Need to Know

November 8, 2018

 

1. The HPV is a double stranded DNA virus that wraps into the DNA of infected cells and stays there quietly. Those quiet infections, called latent, can last very long, but stress or other poorly understood factors can cause the infections to resurface.  HPV tests are considered useful and their use has expanded. The FDA has expanded the use of HPV testing for what they are calling primary HPV screening.

 

2. HPV 16 and 18 cause over 65% of all cervical cancers and over 80% of all HPV related cancers, including genital and oral cancers in men.

 

3. Keep your immune system healthy, and you are likely to resolve the infection in 6-18 months.

 

4. There are HPV tests of the actual HPV DNA and there are HPV tests based on the mRNA it induces when it becomes more active. Likely your gyno refers to each as an 'HPV' test, and the differences are quite complex. Neither is completely accurate, but it seems that the DNA tests are the best for now.

 

5. One test is not enough, regardless of the result. Follow up testing is important. Knowing which virus you have been infected with can help predict risk: those with HPV 16 or HPV 18 have the greatest risk of developing advanced, or severe, precancerous changes. It seems clear that most infections won't resolve in weeks or even a few months. But many HPV infections can take years to develop. In one study conducted by Elfgren it was shown that everyone who's infection persisted for 7 years developed advanced preccancerous or cervical cancer. And NONE of the women who cleared their HPV infection during this time actually developed these changes!

 

 

In the past two years gynecologists, backed by data from large studies including, The Addressing the Need for Advanced HPV Diagnostics (ATHENA) trial that Dr. Trupin was a Primary Investigator for, gynecologists have been testing young ladies from 25-29 primarily for HPV. If that test is positive for HPV 16 or 18 the microscopic test and biopsy called colposcopy is used. If you test negative for 16 and 18 on the primary HPV test, but positive for one of the other high-risk types (31,33, 45, 51, 52, 56, 58, 59, 66, or 68) you then get a traditional pap test which looks for changes in the cells of the cervix. For those who test positive for the pap test, they will get their cervix evaluated by colposcopy. Women over 30 can be tested with a pap plus an HPV test together. The goal is early detection for less invasive therapies.

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