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Author Topic: HPV Questions  (Read 1398 times)

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Offline RobbyR

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  • Posts: 333
HPV Questions
« on: March 05, 2013, 05:53:14 PM »
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.

Started Atripla August, 2010.

Offline buginme2

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Re: HPV Questions
« Reply #1 on: March 06, 2013, 01:02:29 AM »
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.

Offline RobbyR

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  • Posts: 333
Re: HPV Questions
« Reply #2 on: March 06, 2013, 05:43:13 PM »
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.
Started Atripla August, 2010.

Offline buginme2

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  • Posts: 3,120
Re: HPV Questions
« Reply #3 on: March 06, 2013, 06:39:22 PM »
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. 

Offline RobbyR

  • Member
  • Posts: 333
Re: HPV Questions
« Reply #4 on: March 06, 2013, 08:05:53 PM »
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?
Started Atripla August, 2010.

Offline RobbyR

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  • Posts: 333
Re: HPV Questions
« Reply #5 on: March 06, 2013, 08:27:56 PM »
And is there a vaccine I can get for this damn HPV if I do have a strain of it? I know anyone can get hpv, hiv or not, but it seems like it would be standard for ID docs to offer the vaccine to hiv patients? Just seems bizarre that I could have had this damn thing forever and not known about it.
Started Atripla August, 2010.

Offline buginme2

  • Member
  • Posts: 3,120
Re: HPV Questions
« Reply #6 on: March 06, 2013, 10:35:20 PM »
There is an HPV vaccine however, it is only approved for people less than 26 years of age (I think).   You can receive the vaccine off label, my doctor prescribed it for me.  However, I must tell you it did not get rid of my existing HPV issue so whether or not its worth it is your choice.  Insurance usually won't pay for it if its off label.  I don't remember the exact amount but it was about $300per shot (its a series of three shots).

I posted this in your other thread, you seem to have the same theme going on in a few different threads so I just cut and pasted this.  It's relevant here also.

Robby,

You seem to be having a lot of anxiety regarding your HPV and anal issues.  It's possible that some of the aloofness you are receiving is because many colorectal specialist are not trained in anal dysplasia.  It's possible you are asking questions outside their expertise.

HRA's (High resolution Anoscopy's) which you have inquired about are only performed at a few medical centers in the country.  Many places don't do them yet. 

Here is a link to every (most all) providers in the United States that perform HRA's.  I don't know where you live but it's possible there is one close to you.  Find the closest one and make an appointment, hopefully there is one in your area.
a lot of the time finding the right specialist is half the battle.

http://id.medicine.ucsf.edu/analcancerinfo/all_providers.html

Offline RobbyR

  • Member
  • Posts: 333
Re: HPV Questions
« Reply #7 on: March 07, 2013, 05:11:02 PM »
Got my formal results of the pap test today and it came back saying I have a low-grade squamous intraepitheal lesion, lsil. It said glandular & metaplastic cells identified, acs-uc and lsil have significant risk of getting hsil and recommends I have a hi-res anoscopy.

Doc told me I do not have cancer, which is reassuring, and that most low-grade cases go away on their own or don't turn into something worse. Just have to stay on top of it. I am going to get a hi-res anoscopy soon. And another pap in 3-6 months. I did manage to get the HPV vaccine today, although I am over age 26, they still gave it to me. I have to go back in 3 months for a second shot, then 3 months later for the last shot. It is given in three different shots apparently.

Just relieved I don't have any tumor or cancer right now, and she also reassured me that many many men have LSIL and don't even know it.
Started Atripla August, 2010.

Offline aaware72

  • Member
  • Posts: 226
Re: HPV Questions
« Reply #8 on: March 14, 2013, 10:53:05 AM »
Well I going through the same thing as you.  I have to say that we are being told VERY different things about HPV.

This is my understanding a pap only tell if you have abnormal cells.  The purpose of a hi-res endoscopy is to check and look at these abnormal cells and if they don't look good take a biopsy to determine if they will cause more problems. 

There are many strains of HPV.  I talked about getting the vaccine also, however it does cure your current strain of HPV.  The idea of the vaccine in women is to prevent these other stains, however my doctor tells me they study for men is ongoing right now.  He thinks it may be wise to try the vaccine, however there is no support research for men that it will work the same as women.  I am guessing this may be way insurance will not cover this vaccine for men over a certain age.

As for the cancer concerns it is also my understanding that it the purpose of the biopsy to determine what we are dealing with.  He show me the pictures of my exam and said that I have just two abnormal cell one on the posterior of the anus and one just inside.  AKA as gentail warts.  These will not just "go away" they would be remove.

Anyway just some information from my experience thus far.  I had my hi-res endoscopy yesterday and my doctors tells me that I will have results of the biopsy in one week.
« Last Edit: March 14, 2013, 10:56:49 AM by aaware72 »
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline Miss Philicia

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  • Posts: 24,209
  • celebrity poster, faker & poser
Re: HPV Questions
« Reply #9 on: March 14, 2013, 02:39:04 PM »
aaware72, basically what you related is also what my colo-rectal specialist says (I've been having anoscopies done for almost a decade). I don't understand the point of doing repeated anal PAP smears if you're having routine anoscopies, but maybe my doctor has done them and I didn't realize it. I don't think so though.
"Iíve slept with enough men to know that Iím not gay"

 


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