Does HPV remain in the human body forever?
The idea that the virus remains in the human body forever, after an initial infection and despite treatment, is a popular hypothesis, often propagated as a fact, but never been scientifically proven.
The term “persistence” refers to persistent detection of infection rather than true viral persistence. A lack of consensus on what constitutes a persistent infection makes it difficult to compare results across studies. For example, some support that persistent infection should mean a positive HPV test on two consecutive visits 6 months or 1 year apart.1
Whether HPV DNA persists in a latent state in the epithelium, after successful treatment of immunocompetent individuals, also remains an unresolved issue. However, the fact that HPV DNA becomes undetectable in the majority of cervical infections, even by exquisitely sensitive PCR techniques, implies that complete viral clearance is possible.2 Although, it is indeed possible that the virus remains in the body, there is equal possibility for the virus (detected in the body again after treatment) to come from a new infection (reinfection). Still, a tendency has prevailed to conceal this possibility, perhaps for reasons of social discomfort.
Among women older than 40, detected for another time with an HPV infection, those who had reported recently having a new sexual partner showed an increased risk for HPV detection3, which supports the new infection hypothesis and has also been observed in other studies involving older women4, i.e. the same women who are supposed to remain carriers of an inactive virus from their past that later becomes reactivated.
Furthermore, another study involving women of a wide age range that did not have a new sexual partner, reports low viral reappearance levels5. In this study, the low levels of viral reappearance could still be attributed to reactivation of an inactive virus but perhaps they are attributed to new infections, sexually transmitted from their existing partners, which social rules would prefer to remain obscure.
Our clinical experience of many years confirms these studies. If thorough treatment is performed and re-examination follows for a sufficient amount of time in monogamous couples, reappearance is extremely rare for many years. In contrast, in cases of intercourse with new sexual partners, reappearance is usual.
Much could be written on this issue, but since there is no unequivocal evidence that the virus remains in the human body, this should not be presented as a fact.
- Holmes, King K., et al. “Genital Human Papillomavirus Infection.” Sexually Transmitted Diseases.4th ed. McGraw-Hill Education, 2007.495
- Goldsmith, Lowell A., et al. “Human Papilloma Virus Infections.” Fitzpatrick’s Dermatology in General Medicine.8th ed. McGraw-Hill Professional Publishing, 2012.2424
- Trottier, Helen, et al. “Human papillomavirus infection and reinfection in adult women: the role of sexual activity and natural immunity.” Cancer research 70.21 (2010): 8569-8577.
- Muñoz,Nubia, et al. “Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results.” Journal of Infectious Diseases 190.12 (2004): 2077-2087.
- Rodríguez, Ana Cecilia, et al. “Low risk of type‐specific carcinogenic HPV re‐appearance with subsequent cervical intraepithelialneoplasia grade 2/3.” International journal of cancer 131.8 (2012): 1874-1881.