HPV Infection with Negative Pap Smear Results

HPV infection but Pap smear is negative?

Hello Doctor, I recently had my annual health check-up, which included a routine Pap smear and an HPV test.
The health center reported that my Pap smear results were negative and normal, but I tested positive for HPV type 16 (with a single sexual partner).
I do not have any uncomfortable symptoms.
Should I go to a major hospital for further examination? Is the procedure a direct biopsy? Is HPV type 16 considered high-risk for cancer? Will it be transmissible to my husband? Thank you for your answers, Doctor.

YI, 40~49 year old female. Ask Date: 2022/09/03

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, a biopsy is likely not necessary.
It is recommended to have a Pap smear for follow-up every six months instead.
The impact on males is minimal.
Wishing you good health.

Reply Date: 2022/09/03

More Info

Understanding HPV Infection with Negative Pap Smear Results
Hello! Thank you for your question regarding your recent health check-up results, specifically the combination of a negative Pap smear and a positive HPV test for type 16. It's great that you are proactive about your health, and I’m here to provide some clarity on your situation.

Firstly, it’s important to understand the implications of your test results. A negative Pap smear indicates that there are no abnormal cells detected on your cervix at this time. This is a reassuring result, as it suggests that there are no signs of cervical cancer or precancerous changes. However, the positive HPV test for type 16 is significant because HPV type 16 is classified as a high-risk strain associated with an increased risk of cervical cancer.

Given that you are asymptomatic and have a negative Pap smear, the next steps can vary based on your healthcare provider's recommendations. It is generally advisable to follow up with your healthcare provider, who may suggest further monitoring rather than immediate invasive procedures like a biopsy. The standard protocol often involves regular Pap smears and HPV testing every 3 to 5 years, depending on your age and health history. If your healthcare provider feels that further investigation is warranted, they may recommend a colposcopy, which is a procedure that allows for a closer examination of the cervix, and if necessary, a biopsy can be performed during this procedure.

Regarding your concern about the risk of developing cervical cancer, while HPV type 16 is indeed associated with a higher risk, it is essential to note that not all individuals with HPV will develop cancer. The immune system often clears the virus naturally within a couple of years. Regular monitoring and follow-up are crucial in managing your health and ensuring that any potential changes are detected early.

As for the transmission of HPV to your partner, HPV is primarily transmitted through intimate skin-to-skin contact, including vaginal, anal, and oral sex. Since you mentioned that you have a single sexual partner, it is possible that you could transmit the virus to him. However, if he has been vaccinated against HPV, particularly with the Gardasil vaccine, he may have some level of protection against the strains covered by the vaccine, including HPV type 16. It is advisable for your partner to consult with a healthcare provider about HPV testing and vaccination status.

In summary, while your Pap smear results are reassuring, the positive HPV test for type 16 warrants careful monitoring. It is crucial to maintain open communication with your healthcare provider regarding follow-up testing and any necessary procedures. Regular screenings are key to early detection and prevention of cervical cancer. Additionally, discussing HPV with your partner and considering his health and vaccination status can help manage the risk of transmission.
If you have any further questions or concerns, please do not hesitate to reach out to your healthcare provider for personalized advice and guidance. Your health is important, and staying informed is a significant step in managing it effectively. Thank you for your inquiry, and I wish you the best in your health journey!

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Hello, as you mentioned above. Wishing you good health.