Ask the doctor: I’ve been told I have HPV virus. What does this mean?

By | July 27, 2021

Q. I recently had my smear test and was informed that I had the HPV virus and would need close monitoring. Thankfully, no abnormal cells were found. Can you explain exactly what this means? What should I be looking out for in terms of cancers?

Dr Grant replies:  There are more than 200 types of HPV (human papillomavirus) which infect only humans. They are subdivided into cutaneous, meaning skin or mucosal, meaning anything with a mucus membrane, depending on which tissue type they infect. Approximately 15 HPV types are associated with cancer (carcinogenic).

Different types — they are all given numbers — have a propensity to infected various parts of the body. For example, benign anogenital warts are most often caused by HPV types 6 and 11, while plantar and common warts tend to be caused by HPV types 1, 2, and 4. It has been estimated that 80pc of sexually active people have been exposed to HPV at least once in their lifetime.

During a HPV infection of the cervix, low-grade cell abnormalities may be detected on smear testing during screening, but these cell abnormalities are usually transient. However, carcinogenic HPV infections that persist beyond 12 months increase the likelihood of pre-cancerous or cancerous lesions, although not all persistent infections progress. Thankfully, in your case, no abnormal cells were detected even though the HPV virus was.

The recent news you received simply means you are in a higher risk category for now, meaning you need a repeat smear test in 12 months which is sooner that would ordinarily be indicated — usually every three to five years depending on your age.

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The hope is that your body will clear the infection within a year. Most people with a healthy immune system will clear the HPV virus within 18 months, without the need for any treatment. You should also quit cigarette smoking (if that applies to you) as smoking significantly increases the risk of developing cervical cancer. Rest assured that most HPV infections, including those of the carcinogenic types, typically resolve within 12 months. Even if the HPV virus persists in your case, the next step is to attend a colposcopy clinic in your local hospital to have a closer look at the cervix with a special digital microscope.

Having the HPV virus does not mean you have cervical cancer as it generally takes 10 to 15 years from first infection to the development of cancer. When it comes to squamous intraepithelial lesions and/or carcinoma of the vagina, vulva, cervix, anus, or penis, HPV 16 is the most common and is associated with the highest risk of progression to cancer.

Globally, cervical cancer is the fourth most common cancer among females with HPV 16, accounting for about 50pc of cases and HPV 18 for about 20pc. Breast cancer is the leading cause of cancer deaths in women worldwide, followed very closely by lung and then colorectal cancers.

Routine HPV screening tests of other sites such as the vagina, penis, or anal margins is not performed apart from in a few special situations in specific countries around the world. Besides, most HPV infections are transient and can come and go in the interval between HPV testing. There are more than 40 HPV types that infect the entire lower genital tract, including the vagina.

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Since the advent of the HPV vaccination there has been a statistically significant reduction in HPV associated cancers.

Dr Jennifer Grant is a GP with Beacon HealthCheck

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