Human papillomavirus (HPV) is a very common virus that can infect anyone who is sexually active. There are over 100 types of HPV, with around 40 types that can infect the genital areas. Most people who contract HPV never know they have it, and 90% of infections are cleared by the body’s immune system within 2 years. However, sometimes HPV infections persist longer than expected. If you have received a positive HPV test result, you may be wondering how long it will last.
What is HPV?
HPV stands for human papillomavirus. It is a group of related viruses, rather than a single virus. There are over 100 identified types of HPV, each given a number to distinguish it from others in the group. HPV is considered the most common sexually transmitted infection (STI) worldwide.
The HPV virus infects epithelial tissues, such as the skin and mucous membranes. Different types of HPV infect different areas of the body:
- HPV types 1, 2, 4, and 7 cause common warts on hands and feet.
- HPV types 3, 10, 8 are associated with flat, irregular skin lesions.
- HPV types 6 and 11 cause 90% of all genital warts.
- HPV types 16 and 18 are high-risk and can lead to cancers in the genital areas as well as the head and neck.
Genital HPV is passed via skin-to-skin sexual contact and intercourse. It can infect the genital areas of both males and females, including the vulva, vagina, cervix, penis, anus, and scrotum. HPV can also spread between partners through oral sex.
HPV Testing
HPV tests look for the presence of high-risk HPV strains in cervical cells. The main high-risk types are HPV 16 and 18. These tests can be performed alone or along with a Pap smear, which screens for abnormal precancerous cells on the cervix that could lead to cervical cancer.
The HPV DNA test is used for women over 30. It involves swabbing the cervix and testing the cells for HPV genetic material. A positive test means that HPV was detected. A negative result means no HPV was found.
The most common HPV tests include:
- HPV-only testing: Detects HPV genetic material only
- HPV testing with Pap smear (co-testing): Performs both HPV test and Pap smear
- HPV genotyping: Identifies the exact HPV types present
An HPV test is usually only recommended for women aged 30 and above. Those under 30 are not screened for HPV since the infection is very common in young women and their immune systems are able to clear it. Instead, Pap tests every 3 years are recommended for women 21-29.
How Long Does a Positive HPV Test Last?
If you have received positive results from HPV testing, you may wonder how long the infection will last. Unfortunately, there is no definitive answer, as the duration of a HPV infection can vary widely between individuals. However, most people are able to clear HPV from their bodies within 1-2 years.
Here is a overview of how long HPV can persist:
In Most People: 6-12 Months
For the majority of healthy individuals with a strong immune system, a HPV infection will usually clear within 6-12 months. About 90% of infections are eliminated by the body within two years.
Younger people under 30 are especially likely to clear HPV quickly, as their immune systems are primed to combat viruses. Even high-risk HPV strains like 16 and 18 often resolve spontaneously in younger women.
Research shows that about 40% of HPV infections will clear within 6 months, and about 65% clear within 12 months.
In Some People: 12-24 Months
In a subset of individuals, HPV may linger longer than average. Around 30% of infections can last between 1-2 years before finally clearing.
People who are older or have weakened immune systems may have a harder time eliminating HPV. Other risk factors for longer-lasting infections include smoking, HIV/AIDS, poor diet, stress, and chronic conditions.
HPV types also play a role. Low-risk HPV strains clear more readily than high-risk varieties associated with cancers. HPV 16 in particular is more persistent compared to other high-risk types.
In Few People: More than 2 Years
For a small percentage of people, HPV can persist for many years. Around 10-20% of women still test positive for HPV 2 years after their initial positive test.
In rare cases, HPV may not clear at all and become a chronic, lifelong infection. The reasons for this are not entirely known. One theory is that the virus remains dormant at low levels undetectable to the immune system. Chronic HPV is more likely in those with weakened immunity.
The risk of precancer and cancer goes up significantly when HPV lingers for many years or indefinitely. Persistent infections with high-risk HPV types greatly raises the chance of developing cellular abnormalities that may become cervical, vaginal, penile, anal, or head/neck cancers.
Can HPV Go Away Then Come Back?
Having HPV once does not necessarily make you immune if you are exposed to the virus again. In some cases, HPV can go away or become undetectable, only to reappear months or years later under the right circumstances. This occurs for a few reasons:
- Recurrent infection: You become exposed to the same HPV type again through sexual activity.
- Reactivation: The virus remains dormant in cells at undetectable levels, then reactivates later.
- New infection: Exposure to a new type of HPV that is closely related to a previous infection.
Recurrences happen more often with high-risk HPV types like 16 and 18. Even if you cleared a previous infection, it’s possible to test positive again after being re-exposed to an old HPV infection. Using condoms reduces, but does not eliminate, the risk of picking up recurrent HPV.
It’s also possible for the virus to lay low at very low levels your body can’t eradicate completely. When your immune system becomes compromised, the virus may reactivate and replicate again.
Testing positive for a new but closely related HPV type can also occur, since immunity against one HPV variety does not confer protection against other types.
Can HPV Be Dormant for Years?
There is evidence that HPV can become dormant in the body for months or even years before flaring up again.
One reason HPV may go dormant is that it hides from the immune system in specialized cells and tissue compartments. These viral reservoirs act as hideouts where HPV can lurk when active infections have been cleared. The virus may reactivate when the environment is right, such as if you become immunocompromised.
Having the virus integrate into your DNA is another way HPV can remain dormant for long periods. When HPV inserts its DNA into human genes, the virus can lay low and only produce proteins when activated later. Since the viral DNA is integrated with your own genes, it becomes very difficult for your immune system to target.
Low-level HPV infections existing below detectable thresholds could also explain how the virus stays dormant. The amount of HPV may fluctuate under the radar until an event like illness causes viral loads to rise again.
Dormancy makes it challenging to know if you have completely cleared HPV, even after testing negative. However, the virus remaining dormant has less chance of developing into cancer compared to an active infection.
Does HPV Go Away Permanently?
Some people are able to permanently eradicate HPV from their bodies after initially testing positive. However, there is no guarantee that the virus is 100% gone. HPV can linger at undetectable levels or reappear years later.
Most experts agree that HPV generally does not reappear if:
- You test negative for the same HPV strain 3 times over 2 years.
- You test negative for the same oncogenic (cancer-causing) HPV type after 5 years.
These benchmarks give your immune system enough time to fully suppress or eliminate HPV. If the virus does not show up again within the expected timeframes, the chances are low that it is still hiding somewhere in the body.
However, some doctors advise their patients to be routinely checked for HPV even after testing negative multiple times. They recommend this precaution because it is difficult to say with complete certainty that HPV is gone forever.
Some key points about whether HPV goes away permanently:
- Your immune system can successfully eliminate the virus, but HPV can linger dormantly.
- You can test negative after clearing infection, but be reinfected by the same HPV type.
- Detecting the same HPV strain years later does not mean it never went away.
- The longer you test negative after initial infection, the lower the risk of recurrence.
Does HPV Affect Pregnancy?
Having HPV does not directly interfere with getting pregnant or carrying a pregnancy to term. However, an untreated HPV infection can sometimes lead to complications:
- Cervical cell changes. Precancerous cell abnormalities caused by HPV may require procedures that can impact fertility or increase risk of miscarriage/premature birth.
- Genital warts. Some types of HPV cause warts to grow in the genital region, which can obstruct the birth canal during delivery.
- Rare vertical transmission. HPV can very rarely pass from mother to newborn during birth, causing warts in the baby’s airways.
To protect against HPV-related pregnancy complications:
- Get routine Pap smears to find and treat abnormal cervical cell changes early.
- Have genital warts removed prior to getting pregnant.
- Discuss options to minimize vertical transmission risk with your OB-GYN.
In most cases, having HPV does not negatively impact your chances of getting pregnant. Continue getting prenatal care as normal if you are pregnant and have HPV.
Can mothers pass HPV to babies during childbirth?
HPV transmission from mother to newborn during vaginal delivery is very rare, occurring in less than 1% of births. When it happens, the most common outcome is the baby developing laryngeal papillomatosis (warts in the airways).
Ways HPV might be transmitted during childbirth:
- Contact with genital warts during vaginal delivery
- Swallowing infected fluids during delivery
- HPV can cross the placenta and infect the fetus
To lower transmission risk, doctors might recommend C-section delivery for women with genital warts or abnormal Pap smears.
Should I be screened for HPV during pregnancy?
Medical organizations advise against HPV testing in pregnant women. Since HPV is very common in younger women, testing provides little useful information for managing a woman’s care during pregnancy.
HPV testing is only recommended for these cases:
- If you need follow-up for an abnormal Pap result.
- If you develop symptoms like genital warts.
Routine HPV testing is not beneficial for pregnant women and can cause unnecessary stress or procedures. Pap smears and HPV tests may be falsely positive due to pregnancy-related changes.
Instead, current guidelines say pregnant women should follow the same Pap and HPV screening recommendations as non-pregnant women based on age. Talk to your OB-GYN about what cervical cancer screening schedule is right for you.
Can Men Clear HPV?
Just like women, most men who contract HPV are able to clear the infection through their immune response. However, HPV tends to persist longer in men. About 70% of men are able to suppress HPV within 1-2 years.
The extended infection timeline for men is thought to be because the virus survives better in the epithelium tissue covering the penis, scrotum and anus compared to the vagina, vulva and cervix.
Factors associated with men not clearing HPV infections include:
- Older age
- Weak immune system
- High-risk HPV strains
- Lack of circumcision
While many men eliminate HPV completely, it is also possible for the virus to go dormant then reactivate later, just as in women.
Unfortunately there is currently no approved test to screen men for HPV. But men can help prevent transmission by using condoms, Discuss HPV vaccines with your doctor.
How men can lower the risk of transmitting HPV to partners:
- Use condoms during sex
- Limit the number of sexual partners
- Keep the immune system strong
- Stop smoking
- Consider circumcision
- Get the HPV vaccine if eligible
Conclusion
To summarize key points about how long HPV lasts:
- Most HPV infections that cause abnormal Pap results will clear within 1-2 years as the body suppresses the virus.
- HPV may persist longer than 2 years in a minority of people, for reasons not always clear.
- HPV can become dormant and reactivate later, causing recurrent positive test results.
- Continuing to test negative for HPV 3-5 years after initial infection means the virus is likely cleared permanently.
- While treatment cannot eliminate HPV completely, regular Pap smears allow early detection and treatment of precancerous cell changes before they become cervical cancer.
Discuss your concerns about positive HPV test results openly with your doctor. Even if the infection lasts longer than expected, regular follow-up appointments ensure any cellular abnormalities are caught in time. Prompt treatment provides the best protection against HPV causing serious health conditions down the road.