"Sounds like you did everything you could to protect yourself, but..."
August 14, 2013 6:39 PM Subscribe
Looking for information after receiving positive HPV screening result, several years after Gardasil vaccine.
I recently received the results from my annual exam and was told that while my pap smear was normal, I tested positive for HPV (either strain 16 or 18 -- "it wasn't clear, but we can test again, if you want"). The clinic's recommendation was to get another test in 12 months, which is fine with me, and please note that my access to health care is limited and that seeking out a second opinion is not really possible for me.
Now, in 2007, I received the Gardasil vaccine, after being tested for "high-risk" HPV and coming up negative. At first, I felt angry, because I spent all that money ($575 out of pocket!) getting those incredibly painful shots, apparently all for nothing. Then I read this, which mentioned that false positives are a point of contention with HPV screening recommendations, and that rate range from 5 to 15%. I have been in a long term relationship for a few years now with a (male) partner who, like me, has had no (known) history with STDs, up to this point.
YANMD etc, but I am wondering if this sounds at all weird to anyone else. I am aware that viruses can remain dormant for many years and that most of the time the immune system will take care of the virus within a few years and also that there isn't really a guarantee for long-term efficacy of the vaccine, but I am still wondering how it is possible that I tested positive for the exact strains of the virus that Gardasil is supposed to guard against. I am rather curious about rates of false positives, but have found it surprisingly difficult to find reliable information (that is, not marketing material, anti-vaccination craziness, or general overviews). Please note that although I am wondering about the possibility of having received a false positive result, my intention is of course to assume that it is NOT a false positive and to follow through on my health care providers' recommendations.
On a related note, I find it strange that they wouldn't tell me what exactly they will do if I test positive enough for strain 16 or 18 next year (they just said that they would 'take it from there'). What will they do if I am positive for the virus, but still without abnormal cells? Does it make any sense to to a colposcopy without abnormal cells? Is there any way this story ends without my soft parts getting jabbed with sticks?
I recently received the results from my annual exam and was told that while my pap smear was normal, I tested positive for HPV (either strain 16 or 18 -- "it wasn't clear, but we can test again, if you want"). The clinic's recommendation was to get another test in 12 months, which is fine with me, and please note that my access to health care is limited and that seeking out a second opinion is not really possible for me.
Now, in 2007, I received the Gardasil vaccine, after being tested for "high-risk" HPV and coming up negative. At first, I felt angry, because I spent all that money ($575 out of pocket!) getting those incredibly painful shots, apparently all for nothing. Then I read this, which mentioned that false positives are a point of contention with HPV screening recommendations, and that rate range from 5 to 15%. I have been in a long term relationship for a few years now with a (male) partner who, like me, has had no (known) history with STDs, up to this point.
YANMD etc, but I am wondering if this sounds at all weird to anyone else. I am aware that viruses can remain dormant for many years and that most of the time the immune system will take care of the virus within a few years and also that there isn't really a guarantee for long-term efficacy of the vaccine, but I am still wondering how it is possible that I tested positive for the exact strains of the virus that Gardasil is supposed to guard against. I am rather curious about rates of false positives, but have found it surprisingly difficult to find reliable information (that is, not marketing material, anti-vaccination craziness, or general overviews). Please note that although I am wondering about the possibility of having received a false positive result, my intention is of course to assume that it is NOT a false positive and to follow through on my health care providers' recommendations.
On a related note, I find it strange that they wouldn't tell me what exactly they will do if I test positive enough for strain 16 or 18 next year (they just said that they would 'take it from there'). What will they do if I am positive for the virus, but still without abnormal cells? Does it make any sense to to a colposcopy without abnormal cells? Is there any way this story ends without my soft parts getting jabbed with sticks?
To clarify, said colposcopy took place after a postive HPV test with good Pap, and situations like mine are why my gyn insisted on following up, and why yours might as well. That said, your positive HPV screen, like most people's, is probably no big deal and you'll likely just clear the infection with no issues beyond your current worry and frustration.
posted by My Top Secret Sock Puppet Account at 7:05 PM on August 14, 2013
posted by My Top Secret Sock Puppet Account at 7:05 PM on August 14, 2013
I tested positive for multiple strains of "high risk" HPV but without any abnormal cells for about 1.5 years (I had pap smears every 6 months after my first positive result) before my doctor brought me in for a colposcopy. At that point the colposcopy was just to make sure there weren't any abnormal cells that somehow weren't caught in the previous tests, not because the positive test meant anything bad in itself. For what it's worth, my colposcopy came back totally fine and I haven't had a positive result since.
Please feel free to memail me if you want any gory details. The colposcopy itself was... not pleasant, but you do what you gotta do and it's over within a few minutes. Keep your ladyparts safe.
posted by joan_holloway at 7:07 PM on August 14, 2013 [1 favorite]
Please feel free to memail me if you want any gory details. The colposcopy itself was... not pleasant, but you do what you gotta do and it's over within a few minutes. Keep your ladyparts safe.
posted by joan_holloway at 7:07 PM on August 14, 2013 [1 favorite]
I went through the same thing with the full three rounds of the Gardasil vaccine, followed by positive HPV results down the road. I had the vaccine in 2007 and my annual tests were clear until 5 years later. I've had two colposcopies and have since cleared it. I was slightly stumped by the positive result after vaccine, but just grew to accept it after being unable to find a convincing argument.
Like Secret Sock Puppet said, it's very likely that you'll clear it, just be diligent with your check-ups.
posted by icaicaer at 7:22 PM on August 14, 2013
Like Secret Sock Puppet said, it's very likely that you'll clear it, just be diligent with your check-ups.
posted by icaicaer at 7:22 PM on August 14, 2013
For what it's worth, in trials I've come across about 2% of vaccinated women fail to develop a measurable immune response to Gardasil, though I wouldn't exclude the possibility of a false positive on HPV PCR.
posted by drpynchon at 8:07 PM on August 14, 2013
posted by drpynchon at 8:07 PM on August 14, 2013
anonymous posted">> I have been in a long term relationship for a few years now with a (male) partner who, like me, has had no (known) history with STDs, up to this point.
Men are not tested for HPV and have absolutely zero symptoms for the types which cause cervical cancer, so his STD history is basically irrelevant to your issue.
What will they do if I am positive for the virus, but still without abnormal cells? Does it make any sense to to a colposcopy without abnormal cells? Is there any way this story ends without my soft parts getting jabbed with sticks?"
They'll want you to get paps more frequently until you show clear results a couple of times in a row. No need for a colpo unless your pap actually shows abnormal cells. And even if you have abnormal cells, that doesn't mean you have cancer or are going to get cancer -- it means that you've got an elevated risk of cancer which is kindly* showing itself in a detectable way which can be monitored.
*Yes, kindly. There are not very many types of cancer which flash their pre-cancerous cellular ambitions so clearly, so early, with so much room for intervention at a pre-pre-cancerous stage.
I have had cervical cancer -- despite zero risk factors and a 10 year totally monogamous relationship with no abnormal paps or positive STD tests -- and my one millimeter-sized tumor was removed via minor local surgery two years ago. Feel free to MeMail me.
posted by desuetude at 12:12 AM on August 15, 2013
Men are not tested for HPV and have absolutely zero symptoms for the types which cause cervical cancer, so his STD history is basically irrelevant to your issue.
What will they do if I am positive for the virus, but still without abnormal cells? Does it make any sense to to a colposcopy without abnormal cells? Is there any way this story ends without my soft parts getting jabbed with sticks?"
They'll want you to get paps more frequently until you show clear results a couple of times in a row. No need for a colpo unless your pap actually shows abnormal cells. And even if you have abnormal cells, that doesn't mean you have cancer or are going to get cancer -- it means that you've got an elevated risk of cancer which is kindly* showing itself in a detectable way which can be monitored.
*Yes, kindly. There are not very many types of cancer which flash their pre-cancerous cellular ambitions so clearly, so early, with so much room for intervention at a pre-pre-cancerous stage.
I have had cervical cancer -- despite zero risk factors and a 10 year totally monogamous relationship with no abnormal paps or positive STD tests -- and my one millimeter-sized tumor was removed via minor local surgery two years ago. Feel free to MeMail me.
posted by desuetude at 12:12 AM on August 15, 2013
OP, I am not a doctor BUT- google Bethesda cervical cytology consensus guidelines (the graphical algorithms are particularly helpful, see p. 8 in the 2012 revised guidelines here) and you will see that there appears to be fairly widespread agreement that, if you are over 30 (and I assume you are, if they tested you for HPV) repeat positive HPV tests should indeed be followed up by colposcopy even if cytology is negative.
posted by My Top Secret Sock Puppet Account at 12:54 AM on August 15, 2013
posted by My Top Secret Sock Puppet Account at 12:54 AM on August 15, 2013
This thread is closed to new comments.
I can't help with the vaccine part of this question, but I can help with this part. My gyn told me that it was considered best practice to do a colposcopy with back-to-back positive HPV tests, regardless of PAP results. My cervical adenocarcinoma in situ was discovered through endocervical curettage during a colposcopy in which everything looked fine, in fact.
posted by My Top Secret Sock Puppet Account at 6:47 PM on August 14, 2013