HPV: Navigating Test Results and Follow-Up Care

Q: HPV: Navigating Test Results and Follow-Up Care

Hello： You have undergone transvaginal cervical biopsies at two hospitals of medical center level, and both reports are negative. <br>It is recommended that you have a follow-up Pap smear in three months. <br>Department of Obstetrics and Gynecology, Hsinchu Hospital.

HPV (Human Pap

Hello: I had a Pap smear at Chang Gung last year, which resulted in a score of 4.
I also underwent a colposcopy, during which the doctor applied acetic acid and observed white spots, indicating a problem, and a biopsy was performed.
The biopsy results came back as "negative." Consequently, I have been monitored with Pap smears every three months.
The second Pap smear result was 2, and the doctor recommended an HPV test.
On February 9, the HPV test result was "positive," with a viral load of 49,720, indicating that I am in a high-risk group.
Subsequently, on March 9, I underwent another HPV test at Cathay, which returned "negative." I also had a colposcopy, where suspicious areas were again noted, and a biopsy was performed, which also returned "negative."
I have the following questions:
1.
Is it possible for the virus to completely disappear within just one month? Is there a possibility of error in these tests?
2.
Why were suspicious points observed during both colposcopies, yet the biopsies returned normal results? Given that the doctor noted suspicious points, is there a possibility of lesions?
3.
Do I need to return to your hospital for another HPV test? How often should I follow up with Pap smears? Thank you.

LIBE, 30~39 year old female. Ask Date: 2007/03/27

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: You have undergone transvaginal cervical biopsies at two hospitals of medical center level, and both reports are negative.
It is recommended that you have a follow-up Pap smear in three months.
Department of Obstetrics and Gynecology, Hsinchu Hospital.

Reply Date: 2007/03/27

More Info

Understanding HPV and navigating the complexities of test results can be challenging, especially given the nuances of cervical health. Let's address your questions systematically.

1. Can the virus disappear in such a short time? Is there a possibility of testing errors?
It is indeed possible for HPV to become undetectable within a short period, particularly if the immune system effectively clears the virus. Many HPV infections are transient and can resolve on their own without treatment. However, the fluctuation in test results can also be attributed to the sensitivity and specificity of the tests used. Different laboratories may utilize varying methodologies, which can lead to discrepancies in results. Therefore, while it is plausible for the virus to have cleared, it is also essential to consider the possibility of testing errors or variations in viral load detection.

2. Why were there suspicious points observed during colposcopy, yet the biopsies returned normal results?
The presence of suspicious areas during a colposcopy does not always correlate with the presence of dysplasia or cancerous changes. Colposcopy is a visual examination, and the findings can sometimes indicate areas of inflammation or other benign changes that do not necessarily reflect significant pathology. Biopsies are the gold standard for diagnosing cervical lesions, and a normal biopsy result suggests that while there may have been atypical cells observed, they did not meet the criteria for a diagnosis of dysplasia (CIN). It is crucial to maintain follow-up and monitoring, as changes can occur over time.

3. Should you return for further HPV testing or follow-up Pap smears?
Given your history of abnormal Pap results and the presence of HPV, it is advisable to continue regular follow-up as recommended by your healthcare provider. The general guideline for women with a history of high-risk HPV and abnormal Pap results is to have Pap smears every 6 to 12 months, depending on the specific circumstances and your physician's recommendations. If your healthcare provider suggests further HPV testing, it may be to monitor for any changes or to ensure that the virus has not re-emerged.

In summary, HPV is a common virus, and many individuals will experience transient infections that resolve without intervention. Regular monitoring through Pap smears and HPV testing is essential for early detection of any potential issues. It is also important to maintain open communication with your healthcare provider, who can offer personalized advice based on your medical history and test results. If you have any concerns or experience new symptoms, do not hesitate to reach out for further evaluation. Your health and peace of mind are paramount.

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