HPV 18 Positive Results: Next Steps for Cervical Health

Cervical cancer

Hello Dr.
Wu, my friend, a 59-year-old woman, has been working in mainland China with her husband.
On October 8 of this year, she tested positive for HPV type 18 (human papillomavirus) during a health check-up.
She consulted three well-known hospitals regarding the positive HPV 18 result.
The Western medicine doctors all recommended a colposcopy biopsy to confirm whether it is cancer, while the Traditional Chinese Medicine practitioners suggested starting medication first and rechecking in three months.
If HPV 18 still shows infection, then a colposcopy should be performed.
I am unsure how to proceed and would appreciate your advice.
Thank you!
[Additional information: 1.
Tocology shows normal atrophic changes; gynecological transvaginal ultrasound shows intrauterine fluid accumulation; alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and 153, cytokeratin fragment 211, neuron-specific enolase, squamous cell carcinoma-associated antigen, EB virus copy number, and EB virus nucleic acid testing are all normal.
2.
The patient has had normal annual health check-ups (the last one was in early December 2020).]

rewendy, 50~59 year old female. Ask Date: 2021/11/10

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
A positive result for Human Papillomavirus (HPV) type 18 does not indicate cervical cancer.
2.
It is recommended to consult with a specialist in obstetrics and gynecology for further discussion.
3.
In cases of abnormal cervical cytology with a positive HPV result, it is advised to perform colposcopy with biopsy (for diagnosis) or cervical conization (for both diagnosis and treatment).

Reply Date: 2021/11/10

More Info

When dealing with a positive HPV 18 result, particularly in a 59-year-old woman, it's essential to understand the implications and the recommended next steps for cervical health. Human Papillomavirus (HPV) is a common sexually transmitted infection, and while many types of HPV are harmless, types 16 and 18 are classified as high-risk due to their association with cervical cancer.
In your friend's case, the recommendation from Western medicine to undergo a colposcopy and biopsy is standard practice. A colposcopy allows for a detailed examination of the cervix, and if any abnormal areas are identified, a biopsy can confirm whether there are precancerous changes or cancer present. This approach is proactive and aims to catch any potential issues early, which is crucial since cervical cancer can develop silently over time.

On the other hand, Traditional Chinese Medicine (TCM) suggests a different approach, advocating for a wait-and-see method with herbal treatments for three months before re-evaluating the HPV status. While TCM can offer supportive care and may help improve overall health and immune function, it is essential to recognize that HPV infections, especially high-risk types, require careful monitoring and management.
Given that your friend's previous health screenings have been normal, and considering her age, it is prudent to follow the Western medical advice. The colposcopy and biopsy will provide clarity on whether there are any precancerous lesions or cancerous changes that need to be addressed. If the results of the biopsy are negative for dysplasia or cancer, then monitoring can continue with regular Pap smears and HPV testing as recommended by her healthcare provider.

It's also worth noting that HPV infections can sometimes clear on their own, as the immune system can eliminate the virus. However, this is not guaranteed, especially with high-risk types like HPV 18. Therefore, taking a proactive approach is vital.

In summary, while both Western and Eastern medical approaches have their merits, the potential risks associated with untreated high-risk HPV infections necessitate a thorough evaluation through colposcopy and biopsy. This will ensure that if any abnormalities are present, they can be addressed promptly. After the results are obtained, your friend can then consider additional supportive therapies, including TCM, to enhance her overall health and immune response. Regular follow-ups and screenings will be essential in managing her cervical health moving forward.

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