My 24 year old daughter just tested positive for HPV. We have an appt with her GYN on Monday, but I need to know what questions to ask. She tested negative in January 2009 and has only had one partner since then. Does this mean he could be the one who infected her? Also, do the labs automatically do the DNA testing to find out what strain of HPV she carries? Should this be something we ask for? The doctor told her she wants to go in and look around since the test was positive. I read where most of the time your body fights off the infection and it should be a "wait and see" situation. How do you know when to proceed with a colposcopy or a LEEP? I want to make sure her doctor is appropriately conservative. Please, please give us some guidance. I would also like to know if getting the HPV shots series after this diagnosis would still be beneficial to her. Thank you.

Hi and thanks for posting. HPV is very, very common in young women under age 30, so your daughter's positive HPV test isn't surprising. Women in this age group do tend to clear the infection very fast, so conservative management is often indicated. It isn't clear if you daughter has had an abnormal Pap test: HPV tests are usually done with women under age 30 when there is a borderline or unclear Pap test. With an abnormal Pap and a subsequent positive HPV test, professional guidelines would normally recommend a referral to colposcopy, with management from that point depending on the result.

In women 30 and older who have normal Paps but a positive HPV test...they usually repeat both tests in 12 months and send her to colposcopy if the HPV test is positive. With a woman under 30 in this scenario, though, I don't know what the protocol would be, so it's best referred back to the healthcare provider.

HPV testing most often doesn't try and identify exactly which specific genotype (sometimes referred to as "strain") of the virus a woman might have, usually focusing instead on whether or not a "high risk" type is present. There is a newer test approved for clinical use that can tell if a woman is positive for HPV 16 or HPV 18, respectively, the types most often associated with cervical cancer but here again, its best use is in women 30 and over.

Hard to say how long she may have had HPV, as tests don't measure that.

Please follow-up and let us know how your daughter is doing, and if you (or she) have additional questions.

Best,
Fredo

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ASHA Moderator

Thank you for your response. We went to the doctor today and had, what I think, was the colposcopy procedure. The doctor did the vinegar and staining, looked at the cervix with a special microscope and found a spot that reacted to the vinegar and staining. She sent a biopsy of that spot for testing. She did not say what that testing would tell her. Do you know what that might be? She was very casual through out the testing and stated there was nothing she saw that "excited her". She told my daughter to just treat this as a nuisance illness. She stated she didn't need to talk to her partner about this since if she had HPV so does he and that he probably had it before. Her casual attitude seemed to make my daughter more comfortable, but I came away confused. Is this something we need to be concerned about? Since she is my daughter's doctor, I did not feel it appropriate to express my concerns until I find out if there is something I should be concerned about. I am hoping her casual attitude is warranted.

Hello and thanks for following-up. I'll begin by saying we aren't in a position to offer any sort of medical advice or opinion, of course. What I can tell you is that few women, especially younger ones in your daughter's age range, are at serious risk for cervical cancer. Many cervical abnormalities that are in fact HPV-related will actually clear on their own, so treatment isn't always needed. When treatment is indicated, along with follow-up exams it's almost always successful in protecting a woman's health. So, it's not surprising to hear that her doctor has what you describe as a casual attitude; frankly, any issues that might arise can typically be handled well enough. The biopsy should give her doctor a pretty good idea of what's going on.

Keep in touch if you would and let us know what you find out and how she's doing.

Take care,
Fredo

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ASHA Moderator

Hi there. I'm in somewhat the same position as your daughter. I came to this board because there seems to be a lot of information - and scary misinformation - when you look around. You've come to a good place.

As Fredo said, HPV is incredibly common, and since your daughter, like myself, does regular PAP tests, it's incredibly rare that this will ever lead to cervical cancer.

I had an abnormal pap when I as 24, and it cleared on its own. I had another when I was 29 and had the colp and eventually had a LEEP procedure to remove a spot of high grade dysplasia. It sounds scary when talked about like this, but it shouldn't be. I had a cyst removed from my shoulder that was more worrysome with a more painful procedure.

I think more women deal with HPV than we realize. Once I opened up to a friend that I was dealing with this, she revealed that she was too. I also see a naturopath and she says this is one of the more common things she treats.

The issues I wrestled with was that this is my fault. My first doctor did not give me any information, nor talk about how common this type of thing is. I ended up switching doctors, and I started crying at my first appointment. She said "You did nothing wrong here. There's no reason to be upset. You'll be fine."

And since then, I've had a much better outlook on this.