Fredo,

I had posted some questions last month regarding a video that is available on ASHA's website, geared toward health care professionals and how they can best communicate with patients about HPV (http://www.ashastd.org/TalkAboutHPV/TalkAboutHPV.htm). In this video, it is stated that "Most sexually active couples share HPV until the immune system eliminates the virus" and that "When HPV infection goes away, the immune system remembers that HPV type and keeps a new infection of the same type from occurring again."

My first question dealt with the language that was used in the video when it states that the immune system "eliminates" the virus. As we've discussed, there are different opinions among researchers as to whether or not HPV really does go away completely. Considering that doctors usually err on the side of safety when there is room for doubt and give conservative answers to patients, it surprises me that ASHA would present a video that instructed doctors to use such a definitive sounding term like "eliminates," giving the impression that HPV will most often go away completely. Your thoughts?

Second, is it true that the immune system keeps people from contracting the same HPV type twice? I have never heard this before; in fact, my doctor has suggested that researchers are confused as to whether "persistent" HPV infections are in fact, RE-infections of the same type!

I understand your need as a moderator here to err on the cautious side as well, but do you get the impression that MOST researchers "off the record" feel that transmission chances are remote after a negative DNA test? Finally, have there been any studies where an HPV-positive patient tests negative at the 24-month mark, then tests positive again in the future for the SAME type of HPV and WITHOUT further sexual contact?

Thanks again for your time and for fielding such tough questions!

i know i am not fredo but i am willing to share what i gathered from my research in hopes it helps you

My first question dealt with the language that was used in the video when it states that the immune system "eliminates" the virus. As we've discussed, there are different opinions among researchers as to whether or not HPV really does go away completely. Considering that doctors usually err on the side of safety when there is room for doubt and give conservative answers to patients, it surprises me that ASHA would present a video that instructed doctors to use such a definitive sounding term like "eliminates," giving the impression that HPV will most often go away completely. Your thoughts?

when you are dealing with a virus your body can fight it off to a point where it is undetectable on most tests because the anitbody counts are soo low , you will test negative. we can never know for sure if it is "eliminated" like it would be when you have a sinus infection and the antibotics will "elimiate" the infection.

Second, is it true that the immune system keeps people from contracting the same HPV type twice? I have never heard this before; in fact, my doctor has suggested that researchers are confused as to whether "persistent" HPV infections are in fact, RE-infections of the same type!

if your body fights it off once it often recognizes it again and it makes it much easier to know what to do to fight it off; though it does not mean it will not recerface once again because if you immune system is shot by smoking, stress, lack of sleep; it can manfest itself because you body will not have the resources it fight off the causes of the infection.


I understand your need as a moderator here to err on the cautious side as well, but do you get the impression that MOST researchers "off the record" feel that transmission chances are remote after a negative DNA test? Finally, have there been any studies where an HPV-positive patient tests negative at the 24-month mark, then tests positive again in the future for the SAME type of HPV and WITHOUT further sexual contact?

from my research with a negative hpv dna tests; tranmission is highly unlikley as the virual load is so low.

i have not seen anything to help with your other two questions.

Hi jreyn,

I won't be able to provide answers that are as definitive "yes or no" as you might like, but let's see what we can do. Let me also say I've referred elements of your question to an expert in the natural history of HPV, and I'll pass along anything I may hear from her.

Ok, there are many areas of HPV that aren't fully understood. It's clear that most HPV infections don't last forever, due to the immune response effectively clearing them. It's been debated just what this means, is the virus "gone" or simply at undetectable levels? Some of the DNA tests used in medical research studies are really, really sensitive, probably able to find as little as one viral particle per cell! It may be that HPV still exists but the thinking is that if so, it's probably so tiny there isn't likely to be future issues with it. However, experts are quick to caution they can't really prove what exactly is happening, and it is possible for the infection to emerge again (usually if the immune system is badly taxed or stressed). Transmission studies are also lacking: I do think most in the field would say the chances of transmission to a new partner likely diminish greatly in someone who has "cleared" the virus, but this too is speculative and it's hard to put a number on it.

I don't think a couple who shares HPV should worry too much about being sexually active with each other. The immune system does do a pretty good job here and there's no evidence of which I'm aware that continuing with the same partner opens you up to real problems down the road. The key is having recommended follow-up exams.

I asked the aforementioned expert some technical questions about reinfection and the limitations of memory cells with HPV, and will indeed share any wisdom she imparts.

Best,
Fredo

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ASHA Moderator