I had two abnormal pap smears a couple of years ago, and my gynecologist said I probably had HPV. A colposcopy turned out negative for cancerous cells and negative for HPV. Another gynecologist said it was possible that I had HPV and it went away. Is it possible for HPV to disappear or is it just undetectable? How likely is it that I had HPV, or could there be another cause for my abnormal paps? All the gynecologists I consult seem to have different answers.

--Mary

HPV, the human papilloma virus, is a common cause of abnormal Pap smears. HPV is a sexually transmitted virus that may cause external genital warts or may infect the cells of the cervix, leading to an abnormal Pap smear. There are about 60 different subtypes of HPV, and some of them are associated with an increased risk of cervical cancer.

HPV-related changes on the cervix may come and go spontaneously; like herpes, another sexually transmitted virus, HPV itself may remain dormant in your system, but undetectable, for many years. Studies have shown that mild dysplasia, a cervical abnormality which may be caused by HPV, will revert to normal in almost 60 percent of women without any treatment whatsoever. Because we cannot predict in which women these abnormalities will regress spontaneously, all women with dysplasia or HPV must be followed closely with Pap smears. It is not unusual that you may have had an abnormal Pap or two, and then a normal colposcopy.

Without seeing your actual Pap smear and colposcopy reports, I cannot comment on whether you really have HPV, but it certainly is a possibility. Still, while HPV is a common cause of abnormal Pap smears, it is not the only reason for a problematic Pap. Regardless of the cause, abnormal Paps must be followed closely. You should have a Pap every four to six months until you have had at least two completely normal Paps in a row, at which point you could go to annual screening.