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HPV-positive But 16- And 18-negative: What Does It Mean?
Testing HPV-positive but 16- and 18-negative means an HPV infection is present, but it does not include HPV-16 or HPV-18, two types that pose a higher risk of cancer.
HPV-16 and HPV-18 are high risk types of HPV that have an increased chance of causing cancer.
This article examines what an HPV-positive but 16/18-negative test result means and what the next steps are.
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An HPV-positive but 16- and 18-negative test result means that a test has detected HPV but not type 16 or 18.
HPV has many types, which fall into low risk and high risk groups. Types 16 and 18 are high risk and cause most cases of HPV-related cancer.
HPV 16 and 18 account for around 70% of cervical cancer cases. Several other types of HPV are also high risk, including types 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59.
If a person tests positive for HPV but not type 16 or 18, they may need further testing or a follow-up test in 1 year.
HPV infections usually clear up quickly, with roughly 67% of infections clearing within 1 year. In 9 out of 10 cases, HPV resolves within 2 years.
However, this can vary depending on the type of HPV and a person's age.
According to the Centers for Disease Control and Prevention (CDC), around 85% of people will contract an HPV infection in their lifetime. Vaccinating everyone who is 11 or 12 years old can protect them before exposure.
People can continue dating with HPV. Planned Parenthood recommends that people tell any potential partners that they have HPV before any sexual contact so that a partner can make an informed decision.
People 21 to 29 years of age should have a Pap smear every 3 years. This involves taking a swab from the cervix. A healthcare professional examines the cells in a lab for signs of HPV.
People 30 to 65 years old should undergo one of the following types of testing:
People who are more than 65 years old or have had a hysterectomy do not need screening if they have no history of HPV or cervical cancer.
If a person tests positive for HPV but negative for types 16 and 18 and has a negative Pap smear result, they may need to have a follow-up test in 1 year.
If someone has a possible low grade squamous intraepithelial lesion (pLSIL) or a higher grade lesion, they will need a colposcopy, regardless of which HPV types are present.
During a colposcopy, a doctor examines the cervix with a device called a colposcope, which has a bright light and magnifying lens, to check for any abnormalities.
They may also perform a biopsy, which involves taking a sample of tissue or cells. They will send the sample to a laboratory, where a healthcare professional will examine the cells under a microscope to check for any abnormalities.
If a person has a pLSIL, it means there are changes in squamous cells in the cervix that may suggest an abnormality.
A low grade squamous intraepithelial lesion (LSIL) usually resolves without treatment but can become cancerous in some cases.
If people test positive for HPV types other than 16 and 18, they may not need any treatment, but will need a retest in 1 year to check for any changes.
If further testing is necessary and a biopsy shows abnormal cell changes in the cervix, treatment depends on the level of abnormality.
If there are moderate changes, people may need monitoring every 6 months or treatment to remove the abnormal cells.
If there are high grade changes, people will need immediate treatment to remove the affected tissue.
The most common treatment method for high grade changes is conization. During this procedure, a doctor uses a scalpel or wire loop with an electrical current to remove the area of abnormal tissue from the cervix.
Other possible treatments to remove the abnormal tissue include laser therapy and cryotherapy. A hysterectomy is an option if the person develops cervical cancer.
People who test positive for HPV but negative for 16/18 may retest in 1 year, as the virus may clear within this time frame.
If people test negative for any high risk HPV types, they can retest in 5 years, as the risk for cervical cancer is very low within this time frame.
If a test shows other high risk HPV types, people may need further testing to check for abnormal changes.
If there are any significant changes, people may need monitoring or treatment to remove any abnormal tissue and prevent it from becoming cancerous.
What does it mean if your Pap is normal but HPV is positive?
Having a normal Pap smear result but testing HPV-positive means there are no abnormal cell changes in the cervix, but an HPV infection is present.
If people have a normal Pap smear result and a positive HPV test but the results are negative for HPV 16/18, people will generally need to retest in 1 year.
Why am I suddenly HPV-positive?
People may suddenly test positive for HPV because the virus can stay latent in the body and reactivate many years after the first exposure to the virus. It is usually difficult to know where the HPV infection came from.
How long does HPV 16 and 18 take to turn into cancer?
It may take 15 to 20 years for abnormal cells to become cancerous. If a person has a weakened immune system, it may take 5 to 10 years.
HPV types 16 and 18 are high risk types of the virus. They are also the types that most commonly cause cervical cancer.
If people test positive for HPV but negative for 16/18, it means that an HPV infection is present but that it does not include type 16 or 18.
Depending on individual factors and test results, people may need to retest in 1 year, have further testing, or undergo treatment for abnormal cell changes.
4 Best At-Home HPV Tests
This budget-friendly HPV test can be purchased for one-time use or as a subscription that's delivered once every 3 months.
After taking a vaginal swab sample, you'll use the prepaid packing to send it to a Clinical Laboratory Improvement Amendments (CLIA) certified lab, where it will be tested for 14 high risk HPV strains, including HPV 16, 18, and 45. These three strains are the ones most likely to cause cervical cancer.
Results are analyzed by an independent, board certified doctor who's licensed to practice within your state of residence.
In about 5 business days, you'll be notified that your results are ready to view in the secure online portal. Your easy-to-read report shows a breakdown of each HPV marker tested for.
If your test is positive, someone from Everlywell's physician network will contact you to discuss your results.
Though the brand doesn't accept insurance, you can use your health savings account (HSA) or flexible spending account (FSA) funds.
Teal Posts Data On Newly Approved At-home Cancer Screening Device
Dive Brief:The Teal Wand device allows people to self-collect samples for cervical cancer screening at home, rather than undergoing collection by a clinician at a healthcare facility. Screening rates in the U.S. Have fallen this century, culminating in almost one-quarter of women aged 21 to 65 years not being up-to-date with testing in 2023. A project in Sweden suggests self-collection could increase uptake of screening.
Teal won FDA approval for a self-collection device after running a study at 16 sites in the U.S. Writing in the JAMA paper, researchers said the study was sized to obtain the number of HPV-16-positive samples requested by the FDA.
HPV-16 is strongly associated with cancer. The trial found self-collection identified 95.8% of samples that tested positive for HPV-16 and HPV-18, another cancer-causing virus, in the clinician-collected process. Absolute clinical sensitivity for the detection of high-grade cervical dysplasia, a condition in which abnormal cells are in the cervix, was equivalent for self-collected and clinician-collected samples.
The self-collection device was linked to two adverse events. One patient had a minor cervical abrasion without associated bleeding or pain. Another patient reported spotting after collection. No spotting was noted on the clinician examination.
More than 92% of patients said the instructions were easy or very easy to understand. Assuming the test results are comparable, 93% of patients said they would choose self-collection over traditional clinician-collection.
Teal plans to start shipping the device to customers in California next month before expanding across the U.S. The company raised $10 million in January and is partnered with Labcorp. Samples collected with the Teal Wand are analyzed using Roche's Cobas HPV test.
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