HPV-positive but 16- and 18-negative: What does it mean?

An HPV-positive but 16- and 18-negative test result means that a test has detected HPV but not type 16 or 18.

HPV has many types, which fall into low risk and high risk groups. Types 16 and 18 are high risk and cause most cases of HPV-related cancer.

HPV 16 and 18 account for around 70% of cervical cancer cases. Several other types of HPV are also high risk, including types 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59.

If a person tests positive for HPV but not type 16 or 18, they may need further testing or a follow-up test in 1 year.

• HPV-negative: The test did not detect any high risk types of HPV in the cervix. A person may need their next test in 5 years.
• HPV-positive: The test detected a high risk type of HPV. A person may need another test in 1 to 3 years, further testing, or treatment.
• Normal Pap smear: The test did not find any abnormal cell changes in the cervix.
• Abnormal Pap smear: The test found some abnormal cells. A person may need monitoring, further testing, or treatment.
• Unsatisfactory Pap smear: The sample was unsuitable for testing. A person will need to retest in 2 to 4 months.

HPV infections usually clear up quickly, with roughly 67% of infections clearing within 1 year. In 9 out of 10 cases, HPV resolves within 2 years.

However, this can vary depending on the type of HPV and a person’s age.

According to the Centers for Disease Control and Prevention (CDC), around 85% of people will contract an HPV infection in their lifetime. Vaccinating everyone who is 11 or 12 years old can protect them before exposure.

People can continue dating with HPV. Planned Parenthood recommends that people tell any potential partners that they have HPV before any sexual contact so that a partner can make an informed decision.

People 21 to 29 years of age should have a Pap smear every 3 years. This involves taking a swab from the cervix. A healthcare professional examines the cells in a lab for signs of HPV.

People 30 to 65 years old should undergo one of the following types of testing:

• a Pap smear every 3 years
• hrHPV (high risk HPV) testing every 5 years
• co-testing (both of the above) every 5 years

People who are more than 65 years old or have had a hysterectomy do not need screening if they have no history of HPV or cervical cancer.

If a person tests positive for HPV but negative for types 16 and 18 and has a negative Pap smear result, they may need to have a follow-up test in 1 year.

If someone has a possible low grade squamous intraepithelial lesion (pLSIL) or a higher grade lesion, they will need a colposcopy, regardless of which HPV types are present.

During a colposcopy, a doctor examines the cervix with a device called a colposcope, which has a bright light and magnifying lens, to check for any abnormalities.

They may also perform a biopsy, which involves taking a sample of tissue or cells. They will send the sample to a laboratory, where a healthcare professional will examine the cells under a microscope to check for any abnormalities.

If a person has a pLSIL, it means there are changes in squamous cells in the cervix that may suggest an abnormality.

A low grade squamous intraepithelial lesion (LSIL) usually resolves without treatment but can become cancerous in some cases.

If people test positive for HPV types other than 16 and 18, they may not need any treatment, but will need a retest in 1 year to check for any changes.

If further testing is necessary and a biopsy shows abnormal cell changes in the cervix, treatment depends on the level of abnormality.

If there are moderate changes, people may need monitoring every 6 months or treatment to remove the abnormal cells.

If there are high grade changes, people will need immediate treatment to remove the affected tissue.

The most common treatment method for high grade changes is conization. During this procedure, a doctor uses a scalpel or wire loop with an electrical current to remove the area of abnormal tissue from the cervix.

Other possible treatments to remove the abnormal tissue include laser therapy and cryotherapy. A hysterectomy is an option if the person develops cervical cancer.

People who test positive for HPV but negative for 16/18 may retest in 1 year, as the virus may clear within this time frame.

If people test negative for any high risk HPV types, they can retest in 5 years, as the risk for cervical cancer is very low within this time frame.

If a test shows other high risk HPV types, people may need further testing to check for abnormal changes.

If there are any significant changes, people may need monitoring or treatment to remove any abnormal tissue and prevent it from becoming cancerous.

Having a normal Pap smear result but testing HPV-positive means there are no abnormal cell changes in the cervix, but an HPV infection is present.

If people have a normal Pap smear result and a positive HPV test but the results are negative for HPV 16/18, people will generally need to retest in 1 year.

People may suddenly test positive for HPV because the virus can stay latent in the body and reactivate many years after the first exposure to the virus. It is usually difficult to know where the HPV infection came from.

It may take 15 to 20 years for abnormal cells to become cancerous. If a person has a weakened immune system, it may take 5 to 10 years.

HPV types 16 and 18 are high risk types of the virus. They are also the types that most commonly cause cervical cancer.

If people test positive for HPV but negative for 16/18, it means that an HPV infection is present but that it does not include type 16 or 18.

Depending on individual factors and test results, people may need to retest in 1 year, have further testing, or undergo treatment for abnormal cell changes.