Q: I tested positive for high-risk HPV on my recent Pap smear. I'm freaked! If I get the HPV vaccine will it help cure me?
A: First, the good news. It's most likely that your body will clear the virus by itself through your own immune reactions. But the bad news is that we don't know how to help that process along and the vaccine won't do it.
A recent article in the Journal of the American Medical Association (JAMA) detailed a study in which more than 2,000 women between the ages of 18 to 25 were followed for over a year. These women lived in Costa Rica and were found, on initial testing, to be positive for human papilloma virus (HPV). They were divided into two groups: Half the women got a vaccine that immunizes against HPV 16 and 18, the other half did not. There are over 30 types of HPV, but only some are high risk. Type 16 and 18 are found in (and felt to be the cause of) 70 percent of cervical cancers. (The vaccine currently available in the U.S. is called Gardasil. It's a quadrivalent vaccine because it protects against four types of HPV: 16, 18, 6 and 11. These last two types of HPV are not involved in cervical cancer development but do cause genital warts.)
The women were then followed and tested for viral shedding at 6 and 12 months. The study found that there was no significant difference in viral clearance (i.e., the virus disappeared) between those who received immunization after becoming infected with HPV and those who didn't. The clearance rate of HPV in the women who took the vaccine at six months was 33.4 percent vs. 31.6 percent in the control group. At 12 months, the rate of continued shedding of the virus was 48.8 percent in the vaccinated group and 49.8 percent in the control group.
The study didn't evaluate the long-term progression of HPV infections, the extent of future abnormalities in cervical cells, or the development of cervical cancer in these women. There's still a possibility that the vaccine may diminish the progression to cancer, but it seems unlikely since it didn't cause the virus to disappear.
We do know that within two years of HPV exposure (and infection), most women clear these viruses on their own. Thank goodness for our cervical “powers of viral destruction.” HPV prevalence is frighteningly ubiquitous — 50 to 70 percent of sexually active young adults test positive for one of the HPVs within two years of initiating sexual activity, especially if they are not consistent in using condoms. (And even then there can be “oops” occurrences). Because of its overwhelming prevalence, the current recommendation is not to test for HPV infection in young adults (under the age of 30).
Those who have persistent viral infections are a small minority of women who are then at risk for cervical cancer. Finding a persistent HPV infection in women after the age of 30 should be a signal for careful follow-up.
Despite this study's results, there are those who feel that it is worthwhile to give the quadrivalent vaccine (Gardasil) to young women aged 11 to 26 who have tested positive for one of the high-risk HPVs. This is because, in theory, the vaccine may provide immunity against HPV types that these young women were not exposed to and/or infected with. Whether it is cost-effective to do this, especially in a large population, is still under discussion.
Dr. Reichman’s Bottom Line: If you are infected with HPV, getting the HPV vaccine will not help you clear the virus; the vaccine should not be used to treat current infections.
Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, “Slow Your Clock Down: The Complete Guide to a Healthy, Younger You,” which is now available in paperback. It is published by William Morrow, a division of .
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.