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So, how likely is it that my wife has had undetected HPV for nearly 20 years, despite yearly gynecological exams?
January 5, 2010 11:12 AM   Subscribe

So, how likely is it that my wife has had undetected HPV for nearly 20 years, despite yearly gynecological exams?

The answer I derive from google is "not very". But can I be certain? The biggest variable in my mind is that she doesn't have a cervix, due to a complete hysterectomy before we met, so I don't know that a doctor would routinely do whatever tests would indicate its possible presence.

I was told that "they just started testing for it", which I'm pretty sure is not accurate.

Thanks.
posted by anonymous to Health & Fitness (28 answers total)
 
is it possible that you had undetected hpv for 20 years and its just now surfaced, albeit in a way you didn't notice?
posted by ian1977 at 11:13 AM on January 5, 2010 [1 favorite]


Check out this healthboard discussion. One response says, "One reason this may have never been detected (and that you've had it a while) is because the test was only approved 4 or 5 years ago - and most doctors are just now beginning to use it for women over 30. Not all doctors use it yet.

HPV is not a good determiner of fidelity in a relationship. It can hang around for sooooo long without being identified. "
posted by Sassyfras at 11:17 AM on January 5, 2010


Very, very possible. Equally possible that you've had it that long and not known. Most people who have HPV have no symptoms at all, ever.

I was told that "they just started testing for it", which I'm pretty sure is not accurate.

I don't know whether this is universally true, but I know that there are several STDs that I've been offered tests for at my last one or two doctor's visits, but had never been offered tests for in the ~10 years before that. So I find this assertion plausible.

I'm not sure what you're really asking here. Is it a question about whether to trust your wife, or whether to trust a doctor? Are you simply worried, out of the blue, that one or both of you may have an STD, or is someone showing symptoms? In any case, I'd recommend asking a doctor if you want medical advice and asking your wife if you want to know what's up with her.
posted by decathecting at 11:18 AM on January 5, 2010


Generally women under 30 are not tested for HPV. It seems like your wife probably falls out of that range, but there could be other factors that would lead her doctor not to test for it. IANAD, but maybe the knowledge she was in a monogamous relationship could impact testing decisions?
posted by CharlieSue at 11:19 AM on January 5, 2010


It's quite possible. HPV is so very common, and like others, I was never even tested for it until about 6 years ago.
posted by Miko at 11:21 AM on January 5, 2010


Keep in mind that men can carry strains of HPV that are "undetected" because those particular strains only show symptoms in women (most notably, the ones that cause cervical cancer).
posted by so_gracefully at 11:22 AM on January 5, 2010


I was always under the impression that HPV could lie dormant for decades, and also that it is almost ubiquitous--that as much as 80% of people carry some strain of HPV.

Googling "dormant HPV" seems to indicate I'm not off the mark:

...it's just part of being human.
HPV has an indefinite incubation time.
HPV can lay dormant for years.

That's just the first three hits from googling "dormant HPV"; I don't know what search terms you used to come up with different information.
posted by padraigin at 11:23 AM on January 5, 2010


Also, building on the whole "the test is new" thing--it used to be detected when actual symptoms presented itself, not via a specific test. You'd find out if you had warts or an irregular Pap test. Otherwise, you'd have no idea.
posted by padraigin at 11:24 AM on January 5, 2010


Absolutely common, and very likely to have been undetected for ages.
posted by fish tick at 11:28 AM on January 5, 2010


It's extremely possible, particularly in women for whom there is no particular benefit in screening for it. Your wife isn't at risk for cervical cancer, because she doesn't have a cervix. Therefore, her GYN may well have decided that there was no point screening her for HPV because she's immune to its most significant risk.
posted by Sidhedevil at 11:29 AM on January 5, 2010 [2 favorites]


If this question is really "I just found out my wife has HPV after 20 years of supposedly monogamous marriage. Does this mean she got it from an affair?" the answer is NO. It is very possible to have asymptomatic HPV for decades.
posted by DarlingBri at 11:29 AM on January 5, 2010 [13 favorites]


Asymptomatic HPV is really, really common. If someone never had noticeable bumps, and never had an abnormal pap smear (no smear at all, or just no changes in cervical cells), I can easily imagine that they could carry HPV for 20 years and not know it.

On the tests - I don't know whether HPV testing is a new thing or not, but I do know that as a late 20 something who has been getting regular gyn exams for ten years, I wasn't tested for HPV until a year or so ago. Could be due to my change in provider, or to a change in protocol (I know thinking about HPV has changed a lot recently), maybe someone with more of a medical background can address that.

There's so much out there that suggests that many or even most adults carry HPV and most don't know it, and so many variables and inconsistencies with testing, that if you're looking to this as proof that your wife has recently been unfaithful, I don't think it's good evidence at all.
posted by crabintheocean at 11:31 AM on January 5, 2010 [1 favorite]


Also, it's possible that you've had asyptomatic HPV and passed it to her. Not to put this out as an issue of blame, but because it's really, really possible that either of you had this, undetected. I don't even know if they can test for asymptomatic HPV in men.

It's also completely possible to have a pap smear fail to detect HPV. There are also, if I remember correctly, relatively new DNA based hpv tests that could produce the "just started testing for" answer.
posted by mercredi at 11:40 AM on January 5, 2010 [1 favorite]


Incredibly likely and common. I'm wondering exactly what keywords you put into Google, because that's what you should have discovered. As many have mentioned, HPV can be asymptomatic, not be indicated by lab results, and yes, 80% of the population has it. Keep in mind, that there is no test for men, and yet, they are likely carriers. The presence of HPV is not a reliable indicator of infidelity, and if you are this suspicious about your wife, I think you need to have a serious conversation.
posted by katemcd at 11:47 AM on January 5, 2010


I was told that "they just started testing for it", which I'm pretty sure is not accurate.

Yes, there is a new test, and I was subjected to it, too. They told me that since I am over 30 and monogamous, if it was negative, they would only retest every 3 years or so. They also told me that the majority (!) of women under 30 have already been exposed. Don't know a citation for that but so I was told by the doc.
posted by Knowyournuts at 12:15 PM on January 5, 2010


The test for HPV is new enough that my insurance company (Aetna) considers it "experimental" and won't pay for it. (Which, of course, I found out about after I already got the test. Feh.)
posted by ocherdraco at 1:27 PM on January 5, 2010


Who told you that they just started testing for it? Your wife? Or her doctor?

The fact that you doubt her so completely that you came here to be convinced of this is a big red flag.

For the record I had it for EIGHT YEARS before it was detected, due to cervical dysplasia. You should be happy that it was caught and that your wife doesn't have dysplasia and have to go through excruciating, uncomfortable treatment (Google LEEP if you want to Google something) and spend the next two years hoping for a clean pap smear each time.

You should be concerned for your wife's health.
posted by micawber at 2:17 PM on January 5, 2010 [3 favorites]


I was told that "they just started testing for it", which I'm pretty sure is not accurate.

I'm pretty sure you're wrong.

There've been Pap smears, etc for decades, but a Pap smear is not a test for HPV. A Pap smear looks for irregularities in a tissue sample from the cervix. An active HPV infection may (or may not) show up. An inactive (dormant) HPV infection will not, pretty much by definition. There is a fairly new text specifically for HPV, and my OB ordered it for all of his under-45 patients the year it became available at the lab (it's a teaching hospital, and *every* female patient under 45 got an HPV screen with their next Pap smear just as a wide population sample.)
posted by jlkr at 2:27 PM on January 5, 2010 [7 favorites]


As everyone above me has said, the test that they've done for aeons is a pap smear, which tests for cervical cancer. Which can be caused by some strains of HPV, but isn't the same as HPV itself.
posted by Lady Li at 2:53 PM on January 5, 2010


There are over 100 different strains of HPV, but I assume we're talking about one of the 30 or so sexually transmitted ones.

Not every strain is linked to cervical cancer. Also, an HPV infection will many times will resolve itself (generally in younger women). Given that the test is new, and that a positive result doesn't necessarily mean an increased risk for cervical cancer, generally the test is not given unless a Pap comes back abnormal.

I'm taken aback by how your question is phrased, but since there's no HPV test for me, there is no way to know whether you gave it to her, or whether she had it before you.
posted by jennak at 2:59 PM on January 5, 2010


I have had gyn exams annually for the last 19 years and have never had an HPV test, since they only became available since 2003 and many insurance companies, mine included, does not cover that cost under the annual exam.
If she had the hysterectomy due to cancer than I'd bet 100% that the HPV caused the cancer.
posted by 8dot3 at 4:48 PM on January 5, 2010


In addition to all the great answers above, just remember - right now she may be thinking "How likely is it that I've had undetected HPV for 20 years? Or is it more likely that my husband cheated on me and then gave it to me?"
posted by witchstone at 4:48 PM on January 5, 2010 [1 favorite]


[This is a followup from the asker.]
Thanks all. Yes, there is an underlying question that I'd hoped to answer, but it's not "Did my wife have an affair"? It's actually "Did my wife contract an STD during the affair she had"?

A definitive answer might have helped me decide which path to take, but since it doesn't look like there can be one, I'll just continue trying to work things through.
posted by cortex at 4:53 PM on January 5, 2010


Oh, then scratch my answer above. So sorry you have to deal with this.
posted by witchstone at 5:01 PM on January 5, 2010


Thanks all. Yes, there is an underlying question that I'd hoped to answer, but it's not "Did my wife have an affair"? It's actually "Did my wife contract an STD during the affair she had"?

A definitive answer might have helped me decide which path to take


I don't understand why--HPV is transmissible even with condoms, so even if she had contracted it during the affair, that wouldn't be an indication that she engaged in unsafe sex as well as breaking your relationship agreements.
posted by Sidhedevil at 5:16 PM on January 5, 2010


Note: I think that "breaking relationship agreements" is bad enough, don't get me wrong. But it seems like you're trying to suss something out by deduction where that just isn't possible. If unsafe sex is a dealbreaker for you where illicit sex isn't a dealbreaker, I think you'll just have to ask her.
posted by Sidhedevil at 5:18 PM on January 5, 2010


There's really no way of knowing when she got HPV, unless maybe they tested her other partner and they were found to have the same strain, but AFAIK (this is my knowledge from a couple of years ago when I had to be up on this stuff for my job), HPV tests on men are practically nonexistent.

HPV is so common and while condoms are very effective at preventing the spread of HPV, they aren't 100%, so there's really no way to know for sure if she had it for a long time, or if she got it from her partner. And there's also no way to use this information to prove that she had unsafe sex. For all you know, she got it from you a long time ago. There's just no way to know for sure.

I used to answer questions about HPV/cervical cancer a lot and one of the most common situations would be someone trying to deduce whether their spouse had an affair. A lot of relationships were damaged by the woman being diagnosed with HPV and the man (probably wrongly) assuming that she had cheated on him. Of course, in this case you know what happened, but there's no way to be sure of anything other than that.
posted by ishotjr at 6:20 PM on January 5, 2010 [1 favorite]


They don't always check for HPV at regular gyno appointments. They might do it the first time you go, and not do it again.
posted by frecklefaerie at 9:07 AM on January 6, 2010


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