What can I do about the HPV infection?
What happens if I have persistent HPV?
You will be referred to see a gynaecologist if you have type 16 or type 18 HPV (“high-risk” types) even if your pap smear is normal. This is because these 2 types of virus account for the majority of cases of cervical cancer, and so women with these types need to be monitored more closely. It usually takes years to decades from acquiring HPV to the development of cancer, so some women will be in it for the long-haul!
If you have HPV Other (“intermediate-risk” types) you may have your test repeated in 12 months, or be referred to your gynaecologist, depending on the result of the pap smear part of your test.
Can I make the HPV clear any faster?
If you are a smoker, quitting smoking may help you clear the virus faster. But really, we all have to wait for our immune systems to do their jobs.
Women who are immunosuppressed, and women with HIV, Hepatitis B or Hepatitis C infections will clear HPV more slowly and have higher risks for HPV-related disease like pre-cancerous cervical changes, and cervical cancer.
When do you treat HPV?
We can’t treat the virus, but we can treat the effects of the virus. Genital warts can be “treated” by methods that increase the immune response around the area – these treatments should be considered cosmetic rather than curative, as it still takes months to years for your body to clear the actual virus.
With regards to cervical changes due to HPV, we treat if we have a biopsy showing high-grade pre-cancerous change in the tissue of the cervix. These changes are treated with a minor surgical procedure and will cure the virus in the vast majority of women. If you have cancer in your biopsy, you will be referred to a specialist gynaecology-oncologist for further treatment.
Can I be reinfected with HPV?
Once you have acquired one strain of HPV and have cleared it, you are unlikely to be infected again with the same strain. That strain, however, can become inactive, lie dormant, and then reactivate later – confusing! Remember as well, that there are 40 potential strains that can affect the genital area, and the new HPV test only tests for a subset of those – so, the bottom line is that we do need to keep having our cervical screening tests done!
I’ve had the “cervical cancer” vaccination – can I still get HPV?
Yes! The current vaccination, Gardasil 9, covers 9 strains of the virus, which accounts for about 90% of the cervical cancer-causing types. You still need to get cervical screening tests if you have been vaccinated.
I haven’t been vaccinated – should I be?
You should definitely consider it. Some of us were “too old” to receive the vaccination for free when it first came out; in any case, the initial vaccine didn’t cover as many strains of HPV as it does now. The vaccination works best if given before exposure to HPV, i.e. before you become sexually active – which is why it is given to school-aged children currently. But, studies have suggested that even in women who have had abnormal smears in the past, 2/3 of these women will receive some benefit from the vaccination – I now discuss the vaccination with all previously unvaccinated women whom I treat for high-grade pre-cancerous cervical changes.
The vaccination will not cure any current abnormalities in the cervix, or current HPV infections. All women <45 years old are eligible to have the vaccination. The cost is around $150 per injection and 3 injections are needed for the course to be complete.