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Suggest Treatment For HPV Infection

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Posted on Mon, 8 Aug 2016
Question: I have girlfriend who lives in Ukraine and does not think she has access to accurate medical advice. She tested positive for HPV 16 and as I read there is no treatment for this. Is that true? What advice would you offer on the subject? Is this something that may go away over time? What advice does the medical community offer to a woman who has this type test result?

2nd, as a man how do I know if I have HPV (no symptoms) and regular exams. However exams I take routinely do not check for HPV. I guess there is a specific test I can request from my dr? Asked for std test a year ago and report came back negative for chlamydia but other than that did not have other results that I remember.

below is an excerpt from her test result: translated from Russian to English. I do not know if it is useful at all. I could send the entire report but it is in Russian.
Pack №153 ( PLR.VPL - 16 genotypes )
PCR. HPV WRC ( genotyping , quantitative
definition)
16 5,42 Lg HPV genotype / 10 * 5
cell
<3 LgVPL / 10 * 5 cells , clinically insignificant
3 Lg - Lg HPV 5 /10 * 5 cells , clinically meaningful
> 5 LgVPL / 10 * 5 cells: Clean . vysokoznachusche
Analytical sensitivity : 10 * 3 copies / ml
Linear range: 1x10 * 3 - * 1x10 8 copies / ml

Although my questions are general if you think I should share this with a specialist I will do so. Thank you.
doctor
Answered by Dr. Tushar Kanti Biswas (8 hours later)
Brief Answer:
HPV iinfection

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

A variety of treatment modalities are available for various HPV infections, but none has been proven to eliminate HPV from tissue adjacent to the destroyed and infected tissue.
Treatment efficacies are limited by frequent recurrences (presumably due to reinfection acquired from an infected partner), reactivation of latent virus, or autoinoculation from nearby infected cells.
The goals of treatment include prevention of virus transmission, eradication of premalignant lesions, and reduction of symptoms.

HPV-16 is particularly virulent and causes 50% of cervical cancers.

However most HPV infections are controlled by the immune system and cause no symptoms or disease. Some infections lead to genital warts and cervical precancers. Genital warts can be treated for cosmetic reasons and to prevent spread of infection to others. Even after resolution of genital warts, latent virus can persist in normal appearing skin or mucosa and thus theoretically can be transmitted to uninfected partners. Precancerous cervical lesions should be treated to prevent progression to cancer.
HPV infects the female vulva, vagina, and cervix .

Women with HPV infection should be under regular medical surveillance .Treatment will depend on the type of lesions developed.

Virions are assembled in the nuclei of differentiated keratinocytes and can be detected by electron
microscopy.HPV infects the the male urethra,penis, and scrotum.
If you have some lesion in anal or uro-genital area tissue samples or smears can be taken for virological examination for this purpose.
The only way to avoid acquiring an HPV infection is to abstain from sexual activity, including intimate touching and oral sex. For you practicing safe sex ( condom use) may lower the likelihood of HPV transmission.



Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tushar Kanti Biswas (1 hour later)
Thank you. I have heard that as the population ages that a high percentage of us humans will test positive for hpv. If that is the case to what extent is a woman at a significantly higher than normal risk? I saw this quote on one of the sites: Worldwide, HPV is the most common sexually transmitted infection in adults.[6] For example, more than 80% of XXXXXXX women will have contracted at least one strain of HPV by age fifty.

Do the hpv test results vary for the same individual as the test may be taken at various times over a period of years? Or typically not?

How does a man determine if he is positive for hpv even if he exhibits no symptoms? Is a test for men recommended?

Assuming a man and a woman are in a monogamous relationship is it possible to develop a relatively safe strategy whereby the couple can enjoy unprotected intimacy including kissing, oral and sex?

is a woman who tests positive for hpv likely to have normal pap smear test result?
are the two related (HPV positive and normal pap)?

I read this quote and I think it is about 5 years old: In the United States, most of the approximately 11,000 cervical cancers found annually[15] occur in women who have never had a Pap smear, or not had one in the previous five years.

Not trying to minimize the HPV finding in the female. The quote above suggests that even if a woman is positive for hpv assuming she receives routine gynecologic care it appears her risk is reduced. Would you agree with that?

Thank you for your participation in this discussion.
doctor
Answered by Dr. Tushar Kanti Biswas (4 hours later)
Brief Answer:
HPV iinfection

Detailed Answer:
Most sexually active adults will be infected with HPV during their lives.Most HPV infections are controlled by the immune system and cause no symptoms or disease. Some infections lead to genital warts and cervical precancers.Why only certain HPV infections eventually lead to malignancy is not clear. Biomarkers that can predict which women will develop cervical cancer are not available.

Worldwide, HPV-16 and HPV-18 cause 70% of cervical squamous cell carcinomas and 85% of cervical adenocarcinomas. Oncogenic types other than HPV-16 and HPV-18 cause the remaining 30% of cervical cancers

Detection:
1.Natural HPV infection of the genital tract gives rise to a serum antibody response in only 60–70% of individuals because there is no viremic phase during infection.
2.HPV targets basal keratinocytes after microtrauma has exposed these cells to the virus. The HPV replication cycle is completed as keratinocytes undergo differentiation. Virions are assembled in the nuclei of differentiated keratinocytes and can be detected by electron microscopy.
HPV testing is not generally recommended for partners of women with HPV.

HPV infection may develop in a monogamous person whose partner is infected.
The only way to avoid acquiring an HPV infection is to abstain from sexual
activity, including intimate touching and oral sex.
Practicing safe sex ( condom use) may lower the likelihood of HPV transmission.


The time from HPV infection to cervical cancer diagnosis may exceed 20 years.
Persistent carriers of oncogenic HPV types are at greatest risk for high-grade cervical dysplasia and cancer.The primary method used for cancer screening is cervical cytology via Pap smear.Women 21–29 years old with a normal Pap smear should have the test repeated every 3 years .

Subclinical cervical HPV infections are common, and the cervix
may appear normal on examination.Patients who develop cervical cancer arising from HPV infection may present with a variety of symptoms. Hence after HPV infection occurs, prevention of HPV-associated disease relies on screening.


Regards

Dr. T.K. Biswas M.D. XXXXXXX







Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Tushar Kanti Biswas (4 hours later)
Dr., Again thank you for your answer. One point I like you to elaborate on is the comment below:

The primary method used for cancer screening is cervical cytology via Pap smear.Women 21–29 years old with a normal Pap smear should have the test repeated every 3 years .

In regards to a 35 year old woman is the preventive screening care the same?
As years pass is it likely the hpv test result will have the same result?

Also, I am curious to ask 2 other questions. Does testing positive for hpv have any effect on a routine pregnancy in the event a woman desires to become pregnant?

2nd, Obviously any type of a negative diagnosis causes some stress and consternation. In regards to the woman's mental reaction to this diagnosis is it possible to comment on what is a healthy and realistic way for her to think about the fact that she has tested positive for hpv?

Kindest regards, XXXXXXX XXXX

Reading your answer again I have one more question. Re the comment below:

Persistent carriers of oncogenic HPV types are at greatest risk

What is a persistent carrier ?

doctor
Answered by Dr. Tushar Kanti Biswas (4 hours later)
Brief Answer:
HPV iinfection

Detailed Answer:
Women 30–65 years of age should have a Pap smear every 3 years if testing for HPV DNA is not performed.The screening interval for women in this age group can be extended to every 5 years if co-testing results are negative.Every 3 years Pap smear is justified as your wife is presently positive for HPV .

Most HPV infections are cleared up by most people without treatment .Clearing an infection does not always create immunity if there is a new or continuing source of infection.A number of instances indicated apparent reinfection [from partner] after viral clearance.

Highest risk of cervical cancer is with HPV types 16, 18.Persisting infection is concerned with carcinogenic types remaining persistently positive i.e not cleared by natural course of the infection.


You should inform the obstetrician about her HPV infection during pregnancy.
No link has been found between HPV and miscarriage, premature delivery, or other pregnancy complications.Also, the risk of transmitting the virus to the baby is considered very low.Since she is positive for the high-risk types of HPV (16) associated with cervical cancer, the obstetrician will monitor her during the pregnancy to watch for cervical tissue changes.

One has to take the diagnosis of HPV diagnosis sportingly,as she will be under regular surveillance for cervical caner,the only ominous risk.
Human papillomavirus infections of the genital tract are extremely common in sexually active populations (greater than 40 per cent).Most of these infections are found in women with normal cervical cytology and undoubtedly resolve without leaving a trace. We call them carriers.
Only a small proportion of infections progress to squamous intra-epithelial lesions and then to invasive cancer.So relax.



Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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Suggest Treatment For HPV Infection

Brief Answer: HPV iinfection Detailed Answer: Hi, Thank you for your query. I can understand your concerns. A variety of treatment modalities are available for various HPV infections, but none has been proven to eliminate HPV from tissue adjacent to the destroyed and infected tissue. Treatment efficacies are limited by frequent recurrences (presumably due to reinfection acquired from an infected partner), reactivation of latent virus, or autoinoculation from nearby infected cells. The goals of treatment include prevention of virus transmission, eradication of premalignant lesions, and reduction of symptoms. HPV-16 is particularly virulent and causes 50% of cervical cancers. However most HPV infections are controlled by the immune system and cause no symptoms or disease. Some infections lead to genital warts and cervical precancers. Genital warts can be treated for cosmetic reasons and to prevent spread of infection to others. Even after resolution of genital warts, latent virus can persist in normal appearing skin or mucosa and thus theoretically can be transmitted to uninfected partners. Precancerous cervical lesions should be treated to prevent progression to cancer. HPV infects the female vulva, vagina, and cervix . Women with HPV infection should be under regular medical surveillance .Treatment will depend on the type of lesions developed. Virions are assembled in the nuclei of differentiated keratinocytes and can be detected by electron microscopy.HPV infects the the male urethra,penis, and scrotum. If you have some lesion in anal or uro-genital area tissue samples or smears can be taken for virological examination for this purpose. The only way to avoid acquiring an HPV infection is to abstain from sexual activity, including intimate touching and oral sex. For you practicing safe sex ( condom use) may lower the likelihood of HPV transmission. Regards Dr. T.K. Biswas M.D. XXXXXXX