Human papillomavirus (HPV) is a very common virus that can infect anyone through sexual contact. Many strains of HPV cause no symptoms and resolve on their own, but some persist and can cause health problems like genital warts or cancer. A positive HPV test means you have been infected with HPV at some point in time, but not necessarily right now.
Why do HPV tests come back positive?
There are over 100 strains of HPV, and about 40 of them can infect the genital area. HPV is spread through intimate skin-to-skin contact and can infect areas not covered by condoms. Some strains cause warts while others cause abnormal cell changes that can progress to cancer over time if left untreated.
An HPV test looks for the presence of HPV’s DNA in cells from the cervix, vagina, penis, anus, throat, or mouth. A positive test means you have been infected with one or more high-risk strains of HPV that can potentially lead to cancer. However, most HPV infections resolve without intervention within 1-2 years as your immune system clears the virus.
How long does HPV stay in your system?
For most healthy people, an HPV infection will become undetectable within 6 months to 1 year as their immune system eliminates the virus. However, HPV can persist in a small percentage of individuals.
Factors that can contribute to HPV persisting include:
- Having a weakened immune system
- Being infected at an older age
- Having exposure to cancer-causing strains of HPV
- Smoking
In 10-20% of women, an HPV infection can linger for over 2 years. The chance of HPV remaining detectable declines after this point but in rare cases, HPV has been found to persist even longer than 5 years.
Can HPV come back positive years later?
Yes, it is possible for HPV test results to revert from negative back to positive after previous clearance. Reasons this can occur include:
- Recurrent infection: You become exposed and re-infected with the same high-risk HPV type after clearing a past infection.
- Reactivation: The same HPV infection emerges again after going dormant in your cells.
- Intermittent detection: HPV levels fluctuate near the limits of test detection.
In one study, HPV results reverted from negative back to positive in 11% of women over 3 years. The likelihood was higher in women with persistent infections and those infected with multiple high-risk HPV types.
Does a positive HPV test mean you still have HPV?
A positive HPV test means you have been infected with high-risk HPV at some point, but not necessarily right now. HPV can linger in an inactive or dormant state in your cells after an infection clears. The virus may no longer be transmittable or posing any health risks even if detected.
Factors that increase the likelihood that a positive test represents an active HPV infection include:
- Testing positive for the same HPV strain multiple times
- Having an HPV strain known to persist longer (e.g. HPV types 16, 18)
- Detection of HPV along with abnormal cervical cells
Your doctor may recommend additional follow-up testing like repeat Pap smears or HPV genotyping to determine if a positive test reflects active infection or just dormant viral remnants.
Does HPV ever go away completely?
For most people, HPV is cleared from the body by the immune system over time and becomes undetectable by testing. However, it remains unclear whether the virus is completely eradicated or just suppressed to levels undetectable by current tests.
Studies using highly sensitive PCR tests have detected tiny fragments of HPV DNA in cervical samples even after infections were considered eliminated. This has raised questions about whether HPV truly goes away or can persist at very low levels in the body indefinitely.
More research is needed, but for now, experts consider an HPV infection resolved when no HPV can be detected on the standard tests for a period of time, usually 1-2 years depending on risk factors.
Can you test negative for HPV after being positive?
Yes, it is common for the immune system to successfully clear an HPV infection so follow-up testing yields negative results. This occurs in the majority of people within 1-2 years.
Some key points about testing negative after a positive HPV test:
- Women under 30 often clear HPV rapidly within 6-12 months.
- Over 50% will become HPV negative within 1 year.
- Over 90% revert to negative within 2 years.
- Clearance rates may be lower for high-risk strains like HPV 16 and 18.
- Suppressed immunity can delay clearance.
- Negative results must be confirmed with multiple tests over time.
Becoming HPV negative again reduces, but does not eliminate, the risks of cervical cancer or genital warts. It is still recommended to get regular Pap tests as prescribed by your doctor.
Conclusion
Testing positive for HPV does not necessarily mean you still have an active infection. The virus can linger in the body at undetectable levels after the immune system clears an infection. However, there is a chance new exposure or reactivation from dormancy could make HPV test positive again later. Periodic testing helps monitor whether HPV remains suppressed or has become active again so any cell abnormalities can be identified and treated early.