Richard Hopley, M.D. | 03/06/2022HPV: What Do We Know?
While Human Papillomavirus, HPV, is one of the most researched and highly understood viruses in the medical community, there is no one-size-fits-all clinical presentation. Quite often, healthcare providers are faced with unique and unconventional cases.
HPV is transmitted sexually; however, there is growing information describing a risk for nonsexual transmission. This can occur via routes of mother to infant during birth, surfaces and objects carrying infection, transfer of infection from one part of the body to another, and hospital-acquired infection (Ryndock & Meyers, 2014).
The Transient Infection
Women generally test positive for HPV at some point in their lives. However, most of these positive findings do not develop into serious medical conditions. Around 10-20% of HPV findings are considered persistent infections with the likelihood of advancing to various diseases. The understanding that HPV leaves the body in the same way that common viruses do, is a faulty one. Instead, when a woman’s HPV result changes from positive to negative, this suggests that HPV is not currently detected but does NOT imply that HPV is completely absent from the woman’s body.
To better understand HPV, one can explore the natural cycle of a virus which includes dormant and active stages. For example, herpes viruses can cause outbreaks of cold sores and shingles during its active stages that occur at times of altered immunity brought on by natural aging. On the other hand, the same virus may remain dormant (causing no symptoms) in the nerves for decades before reactivating.
The Common Misconception
A widespread misconception is that this resurgence of HPV is due to a new partner or a new infection; however, the existing HPV virus can reappear in older patients in the same way herpes can. This can also be the case for younger patients going through stress and other environmental factors. It is likely that the levels of the virus were below detection previously and then resurfaced to allow for detection.
The take-home message: an unexpected positive HPV finding does not indicate a new infection, new partner, or false positive. Instead, it indicates that a routine follow up is recommended at a later appropriate time.
Sources:
- Eric J Ryndock & Craig Meyers (2014) A risk for non-sexual transmissionof human papillomavirus?, Expert Review of Anti-infective Therapy, 12:10, 1165-1170, DOI:
10.1586/14787210.2014.959497
- Shanmugasundaram, Srinidhi, and Jianxin You. “Targeting Persistent Human Papillomavirus Infection.” Viruses vol. 9,8 229. 18 Aug. 2017, doi:10.3390/v9080229