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HPV: HIGH RISK HUMAN PAPILLOMA VIRUS ON PAP SMEAR

“Help! What is HPV and why is it on my Pap smear?” Have you recently had that scary phone call from the doctor’s office after a Pap smear? Here is some information about HPV and what to do about it.

The Human Papilloma Virus (HPV) is a common cause of abnormal Pap smears. This virus was first identified several decades ago. Over 80 different types have been identified and different strains may lead to different symptoms ranging from genital warts, to abnormal Pap smears, to no symptoms at all.

The virus is very common and recent studies suggest that 80% of sexually active men and women may carry the virus. Only a few percent of affected women will ever develop genital warts or an abnormal Pap smear. In most cases the viral infection is totally asymptomatic and the majority of men and women never have a problem.

The virus is highly sexually infectious. There is a significant chance that HPV will be contracted from exposure to an infected partner. Although condoms do reduce transmission rates of HPV and many other conditions, condoms do not totally prevent transmission. There is currently no concern for household members or other casual contacts; good personal hygiene is adequate.

Why is this virus important? A growing body of evidence suggests that some types of HPV can be a cause or a contributing factor in the development of premalignant or malignant changes in the genital tract, especially on the cervix. These are called High Risk types of HPV. The cervical changes can show as Atypical Cells on a Pap smear. Therefore if a Pap smear shows Atypical Cells, the Pap specimen is then usually tested for High Risk HPV. If the Pap smear does show High Risk HPV, colposcopy is usually recommended. In addition, if a Pap smear shows evidence of premalignant changes (dysplasia), then a colposcopy is recommended to determine the extent of the problem. Colposcopy is an office procedure in which a microscope-like device is used to examine the cervix. Very small biopsies are also usually taken during the colposcopy.

There are other strains of HPV which can cause genital warts. These appear on the external genitals of both men and women and can cause pain and itching. They can be removed with a variety of treatments. These will be discussed in another post.

Like other viruses, there is no cure for HPV. It is important to remember that many cervical HPV infections will go away or become latent without any treatment. Therapy should be aimed at realistic goals such as removal of visible warts and removal of dysplasia or premalignant changes.

Although HPV can be spread sexually, there is no evidence that treating asymptomatic male partners is helpful in the management of HPV. If your partner does have symptoms or visible warts, he should be evaluated by his physician. There is no reason for monogamous couples to change their sexual practices because HPV is diagnosed.

HPV vaccination is a proven way to reduce protect against viral infection. The Gardasil® vaccine protects against 4 types of HPV: two that cause cervical cancer and 2 that cause genital warts. The vaccine can be given to girls and young women between ages 9 and 26 years old. The vaccine is ideally given prior to any sexual activity, but can still be effective even if activity has already occurred. We have offered the vaccine since its release and believe strongly in using it for disease prevention.

If you have had abnormal Pap smears, we would be happy to review these results and perform an examination of your cervix in order to determine your risks. We have all the necessary equipment in our office for colposcopy and for treatment of abnormal cells in order to prevent cancer.

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