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HPV Questions

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RobbyR:
I have a question about HPV. I had a rectal pap by my ID doc back in December, and never heard back from them so I had to call to find out the results. They said it came back "abnormal" showing a low grade "squamous lesion". What the hell does that mean? Does it mean I have HPV or cancer? I haven't had anal sex for three years. I had some rectal bleeding which caused me to have a colonoscopy, which found an inflammatory polyp, which was causing rectal bleeding, which was removed. I think they biopsied the polyp and said it was inflammatory, but  it said nothing about any cancer or malignancy. The doc did say he thought I possibly had an anal abscess under where the polyp was but he is seeing me back.

So is it possible the pap test from December only reflected the inflammatory polyp, which caused the abnormal result? I am really confused and freaked out. It seems like when I overcome one health obstacle another arises. I am not sure if the pap said I have HPV or not, but I am going to have to ask my primary doc when I see her this week. Is there a vaccine for HPV I can get? Or any preventative treatment I can take? I have heard some people on here say they had to be treated for anal warts, but to the best of my knowledge, no evidence of warts was found in my colonoscopy, just the small polyp and possible abscess area. Rest of the colon was totally clear, except the small area they removed.

buginme2:
You don't have cancer.

I've been dealing with HPV for quite awhile and have learned quite a bit about it.

There are several different strains of HPV.  Some strains cause genital (anal) warts.  These strains usually don't progress to cancer however, if you have warts it's very possible that your infected with additional strains that may progress.

Other strains do not cause warts.  Some will lead to changes in the cellular level that can lead to dysplasia.  Dysplasia and warts are not the same thing.  You can have dysplasia and never had warts.  So just because you have never had warts you should still be regularly screened with an anal pap and high resolution Anoscopy.  Dysplasia can lead to cancer over time (usually a long period of time).

HIV positive people especially MSM have a higher incidence of HPV and dysplasia.

Dysplasia is categorized as either low grade or high grade.  Low grade is usually not treated.  Often times they will monitor you over time to make sure it doesn't progress.  Lo grade dysplasia can resolve on its own, stay the same, or progress to high grade dysplasia.

High grade dysplasia should be treated so it does not progress to anal cancer.  High grade dysplasia can also resolve on its own, stay the same, or progress to cancer.  Treatments include creams, acids, and Infrared coagulation (they burn the area infected). 

The medical center I go to screens all HIV positive people with an anal pap and high resolution Anoscopy yearly, or more if you have dysplasia.  They will also take a biopsy to look at the area under a microscope to get a certain diagnosis.

For me, the treatment has lasted quite a long time.  It's a slow process. 

The University of California has a great website about anal dysplasia. Just google
UCSF Anal Dysplasia and it should come up.

RobbyR:
Thanks for such a helpful informative response, buginme. I guess the name of the game of the game is being proactive. I haven't had anal sex for three years, and have been on HAART for about the same period of time. I still don't know if in fact I have HPV or not, I'm hoping to get some clarity on the pap results tomorrow when I see my doc..I know the small polyp the colorectal doc removed came back as inflammatory and said nothing about it being cancerous, so not sure if the pap test just reflected the polyp being there or what.

I haven't ever had warts to my knowledge, but I know some HPV strains don't cause any warts. I am a bit reassured that other than the small poly they removed, nothing else was found in my colonoscopy. However, I'm not sure if they did a high-res anoscopy or not. Now that I know about it, I'll DEFINATELY ask that they do one on me, and another pap also.

I mainly want to know if in fact I have HPV or not, and if so, have regular paps and high-res anoscopies to make sure I stay on top of it..I defintately don't think I will have anal sex again anytime soon, because I don't want to risk anything.

I think my pap results said I had a low-grade squamous lesion, (but wondering if that just was showing the polyp I had at the time).

They biopsied the polyp which was removed, and if it is benign, wouldn't a future anal pap be benign as well? Thanks again for such a reassuring, helpful response.

buginme2:
if your pap said you have a low grade squamous lesion (you will also see it referred to as anal intraepthelial neoplasia) then you do in fact have hpv.

low grade lesions usually do not require treatment. 

RobbyR:
If I do have HPV, can I do anything to treat it? Or better keep it under control, manage it, etc? Or am I just at its mercy? This sucks, as if HIV wasn't enough to deal with. I assume HPV is highly contagious, so what about like oral sex and stuff?

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