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Does HPV come back once cleared?

Human papillomavirus (HPV) is a very common virus that can be spread through intimate skin-to-skin contact. Most sexually active people will get HPV at some point in their lives. In most cases, HPV goes away on its own and does not cause any health problems. However, in some cases, HPV can persist and lead to health issues like genital warts or cancer.

Can HPV come back after it goes away?

Once you have cleared an HPV infection, meaning your immune system has suppressed the virus to undetectable levels, it is possible for that same HPV type to come back. This occurs for a few reasons:

  • The virus may still be present in your body at very low levels that evade detection. When your immune system is weakened in the future, the virus can reactivate.
  • You may be exposed to the same HPV type again through sexual contact and get re-infected.
  • You may have cleared the infection from some areas of the body but not others, allowing the virus to spread again.

In most people, the immune system will suppress HPV once again after reactivation or reinfection. But in some cases, the virus can persist and increase the risk of HPV-related health problems. People with weakened immune systems, such as those with HIV/AIDS, are at greater risk for HPV becoming persistent.

How common is HPV recurrence?

Recurrence of HPV after clearance is common. Studies show that after testing negative for HPV, redetection rates can be:

  • 13-50% within 12 months
  • 39% within 24 months
  • 54% within 36 months

The recurrence risk varies between individuals and also depends on the HPV type. HPV 16 and 18, high-risk types that can lead to cancer, are more likely to recur than low-risk types that cause warts.

Who is at risk for HPV returning?

Individuals at higher risk for an HPV recurrence after clearing the infection include:

  • Those with weakened immune systems
  • People co-infected with other sexually transmitted infections (STIs)
  • Individuals with persistent infections lasting over 1-2 years
  • People who smoke or have other lifestyle factors that impair immune function
  • Those with new or multiple sexual partners, increasing HPV exposure

Can HPV recurrence be prevented?

There are a few ways you may be able to lower the likelihood of HPV returning after clearing the infection:

  • Get the HPV vaccine – If not already vaccinated, getting the full HPV vaccine series can protect against the strains most likely to recur or persist.
  • Use condoms – Using condoms during sex can lower the risk of getting re-exposed and infected again with HPV.
  • Don’t smoke – Smoking impairs immune function. Not smoking helps your body better clear and fight off HPV.
  • Boost immunity – Keep your immune system strong through diet, exercise, sleep, and stress management. A strong immune system better controls HPV.
  • Treat co-infections – Having other STIs like herpes, chlamydia, or HIV can increase the likelihood of HPV persistence. Treating co-infections reduces recurrence risk.

What are the symptoms of recurrent HPV?

In most cases, there are no symptoms when HPV reactivates or you get re-exposed. Symptoms more commonly occur with high-risk HPV types that can lead to cell changes.

Signs of potential HPV recurrence can include:

  • Genital warts returning after previous clearance
  • Abnormal cells on Pap test after previous normal Pap
  • Precancerous cervical, vaginal, or vulvar lesions
  • Genital warts turning into precancerous lesions

These symptoms warrant further testing and evaluation by your doctor.

How is recurrent HPV diagnosed?

HPV is often asymptomatic, so testing is needed to detect a recurrence. Your doctor can diagnose recurrent HPV infection through:

  • HPV testing – Samples from the cervix, anus, mouth, or other areas can be directly tested for the presence of HPV DNA.
  • Pap smear – Abnormal Pap smear results can indicate cell changes from persistent HPV.
  • Biopsy – For genital warts or precancerous lesions, a small sample may be taken and analyzed for HPV.
  • Colposcopy – This magnified visual exam of the cervix looks for abnormal tissue growth.
  • HPV genotyping – Lab tests can determine the exact HPV strain present.

Based on test results and clinical evaluation, your doctor can determine if HPV has recurred compared to previous cleared infection.

Is recurrent HPV dangerous?

The risks associated with recurrent HPV depend on the strain:

  • Low-risk HPV – Types that cause genital warts usually do not lead to cancer and are considered low risk on recurrence.
  • High-risk HPV – Cancer-causing strains like HPV 16 and 18 have higher risks with recurrence. They can trigger precancerous lesions that may progress to cervical, vaginal, penile, anal, or throat cancers over time if left untreated.

Around 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year. While many HPV cases resolve spontaneously, an estimated 33,700 HPV-attributable cancers occur annually in the U.S. Proper screening and follow-up care are important, especially for high-risk individuals, to detect and treat any lesions or early cancers associated with recurrent HPV.

Can recurrent HPV be cured or treated?

Unfortunately, there is no cure for HPV. But there are treatments available for the health conditions caused by HPV:

  • Genital warts – Treated through destruction (freezing, burning, surgical removal), topical medications, or immune-modulating injections.
  • Precancerous lesions – Removed through procedures like cryotherapy, LEEP excision, or conization.
  • Cancers – Treated through surgery, chemotherapy, radiation, immunotherapy, targeted therapy.

Even after treatment, HPV can still recur and require further intervention. Treating co-infections, avoiding re-exposure, and routine screening/monitoring are important to address recurrent HPV before it advances.

What is the outlook for recurrent HPV infections?

The prognosis after HPV recurrence varies based on the strain and individual risk factors:

  • Low-risk HPV has an excellent prognosis with treatment of genital warts and does not affect overall health.
  • For high-risk HPV, precancerous cell changes are usually treatable. But in some cases, lesions can advance to cancer, which has a less favorable outlook especially at later stages.
  • A healthy immune system will often suppress HPV again after recurrence. But in those with weakened immunity, HPV is more likely to persist and progress.

Close monitoring and managing of risk factors are important in recurrent HPV, as is appropriate follow-up care. For individuals at high-risk of progression to cancer, more intensive surveillance and treatment are warranted.

Takeaway points

  • HPV can come back after previous clearance since low viral levels may persist or you can get re-exposed through sex.
  • Recurrence is common and more likely in those with weakened immunity or multiple sexual partners.
  • Preventive measures include vaccination, condom use, and lifestyle changes to optimize immune function.
  • Symptoms like genital warts or abnormal Pap smears may indicate recurrent HPV.
  • Testing and procedures like biopsy, colposcopy, and HPV genotyping can diagnose a recurrence.
  • Low and high-risk HPV strains carry different risks with recurrence. Cancer-causing types warrant closer monitoring.
  • Treatments address precancers/cancers caused by HPV but cannot cure the virus itself.
  • Prognosis depends on individual factors like immune status. Routine screening is key for at-risk groups.

In summary, HPV recurrence is common, but precautions and proper medical care can reduce the likelihood of persistent HPV and progression to cancer. Maintaining immune health, preventing re-exposure, recognizing symptoms early, and responding to abnormal test results help optimize outcomes.