Can HPV Come Back?

Medically reviewed on Nov 17, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• HPV And Its Symptoms
• HPV Recurrence
• How Is HPV Diagnosed?
• How Is HPV Treated?
• How Is HPV Prevented?
• Everlywell: At-Home HPV Tests For Women And People AFAB
• Related Content

Human papillomavirus (HPV) is a type of viral infection that’s most commonly transmitted through sexual skin-to-skin contact. However, that isn’t always the case. It’s possible to contract HPV by touching a wart or an infected surface where the virus lives.[1] There are over 200 viral strains of HPV, 12 of which can cause several types of cancer.[2]

Fortunately, the body can typically fight off the virus itself without medical intervention, and it’s likely to fully eradicate the infection in one to two years. But, can HPV come back? Yes, it is possible to become reinfected with the HPV virus, but it’s very uncommon.

HPV And Its Symptoms

HPV is considered the most commonly spread sexually transmitted infection (UTI) in the United States, with 14 million cases each year.[2]

HPV comprises many viral infections that can affect the body differently. When a virus enters your body through the skin or a mucous membrane, such as the mouth, nostrils, genitals, or anus, it hijacks the cells.[3]

Viruses are very small—with billions of them able to fit on the head of a pin—and they multiply at an extremely fast rate. They cannot multiply on their own, without the host’s genetic material that allows viruses to essentially hijack the host’s cells and use its reproductive mechanisms.[3]

When you become infected with a low-risk HPV strain through sexual activities or contact with an infected surface, you’ll likely experience no symptoms at all, which is why many people with the virus don’t know they have it.[1]

Other times, low-risk HPV strains can cause warts at the site of infection. They can appear on the [1]:

• Genitals
• Anus
• Rectum
• Hands
• Feet
• Mouth
• Face

Fortunately, low-risk HPV types are rarely dangerous. High-risk HPV types, however, do have the potential to cause the formation of precancerous cells, which can lead to several types of cancers including [2]:

• Anal cancer
• Cervical cancer
• Throat cancer
• Penile cancer
• Vaginal cancer
• Vulvar cancer

HPV Recurrence

When it comes to HPV, it can be difficult to know if the virus is completely eradicated or has simply become dormant. An HPV infection can remain dormant in the body for months or even long periods of time, however, the exact duration will vary from person to person.

It’s also possible for HPV viruses to be completely asymptomatic, meaning you may think the virus is gone when it still lives inside your body. When it remains in your body, it’s possible for warts to appear after infection, which may lead some to believe that the HPV virus has come back—when in reality, it hasn’t even left in the first place.[1]

A study conducted on older women aimed to identify how to differentiate between reactivation and a new infection. In 90% of cases, HPV clears in the first two years, meaning the virus is undetectable and cannot be detected through PCR tests and/or cervical and vaginal swabs. That said, it’s impossible to prove that HPV has been completely eradicated from the body.[4]

When HPV tests come through negative, it’s very possible that the virus is still living in the body, even if it’s at very low levels.[4]

But let’s get back to the study: Researchers enrolled 843 women, aged 35 to 60 years old, and separated them into two groups: those with fewer than five sexual partners and those with five or more sexual partners in their lifetime.[4]

They found that the group with more sexual partners was at greater risk of developing a potentially cancerous oncogenic HPV infection. This group is also at a higher risk for HPV reactivation. It was also found that the chance of reactivation can increase in people aged 50 and over, specifically when the immune system begins to weaken.[4]

All that said, recurrence comes down to immunity. It’s very possible that two monogamous partners have the same type of HPV. However, one sexual partner may be able to fight off the infection better than the other. In this case, reinfection can occur if one sexual partner’s natural immunity is lower than the other, meaning their immune system is less likely to remember the virus—and how to fight it.[5]

Even if you do have natural immunity to one strain of the HPV virus, it’s also possible to become infected with another strain of HPV that your body has yet to encounter.

Additionally, it’s very possible that genital warts, caused by low-risk HPV types, come back even after treatment. However, in this case, this occurs because the virus is still in the body.[6]

Why Might HPV Not Go Away?

In most cases, the HPV virus will go away in one to two years. However, there are several factors that can cause the virus to linger. These include [7]:

• Being immunosuppressed, such as those with AIDS or transplant patients
• Having a low-risk HPV type that causes recurring genital warts
• Having a high-risk HPV type that lies dormant before causing cancer

How Is HPV Diagnosed?

It’s fairly common for HPV to be asymptomatic. However, if you do observe warts forming, visit your healthcare provider. They’ll likely be able to identify HPV just by observing the warts, since all of these warts link back to the HPV virus.[1] They can also help answer: How long do genital warts last?

That being said, it’s important to note that high-risk HPV viruses never show symptoms. And, if not eradicated within a few years, they can create cancerous cells. To stay vigilant, make an appointment for regular visits with your healthcare provider, who can administer screenings like [1]:

• Pap smear – During a Pap smear, your healthcare provider will collect samples to screen for cervical cancer in women and people AFAB. Men and people AMAB can also undergo an anal Pap smear to identify the presence of precancerous cells.
• HPV tests – Currently, there is only HPV testing formulated for women and people AFAB. Using a vaginal swab, they identify cervical cancer-causing HPV strains, including types 16 and 18. That said, there are not yet HPV tests approved by the U.S. Food and Drug Administration (FDA) for HPV infections on the vulva, vagina, penis, scrotum, rectum, or anus.

To further assess the development of precancerous cells, there are procedures like a colposcopy. These are typically ordered when Pap smear results come back abnormal. Your healthcare provider will use a colposcope which can magnify the cervix, providing a visual of potentially infected cells. Typically, these cells will be removed to be analyzed in a lab to draw further conclusions.[1]

Healthcare providers may also use visual inspection with acetic acid (VIA), a vinegar-based solution, that turns abnormal cervical cells white.[1]

How Is HPV Treated?

Can HPV be cured with antibiotics? No – there are not yet medical treatments for HPV. However, those with low-risk HPV types that form warts can treat the skin conditions topically, with a prescribed cream or medication, like imiquimod (Aldara®), podofilox (Condylox®), and trichloroacetic acid (TCA).[1]

If the warts are causing extreme discomfort, it’s also possible to have them removed by freezing them off with liquid nitrogen, zapping them with an electrical current, or killing infected cells with a laser treatment.[1]

For people with cervical abnormalities due to HPV, they may undergo the following to remove cervical tissue that contains precancerous cells [1]:

• Loop electrosurgical excision procedure (LEEP)
• Cold knife cone biopsy (conization)

How Is HPV Prevented?

The first-generation HPV vaccination was developed in 2006. It protected patients from four HPV strains, including 6, 11, 16, and 18. In 2014, the second generation was born. GARDASIL®9 protects against 9 HPV types: 6, 11, 16, 18, 31, 33, 45, 52, 58.[8]

Types 6 and 11 are primarily responsible for genital warts, while types 16 and 18 cause about 70% of cervical and HPV-related cancers. The other five are high-risk HPV strains that account for 10 to 20% of cervical cancers.[8]

The newest vaccine is approved for ages 9 to 45, although it’s typically administered between the ages of 9 and 12. While it doesn’t fully protect patients against cancer, it significantly reduces the risk.[8]

To prevent the development of HPV-related cancers, make regular appointments with your healthcare provider for Pap smear screenings and HPV tests. Early detection of abnormal cells that cause cancer can help prevent the progression of cancer.[1]

Additionally, when engaging in sexual activity, always practice safe sex, such as using a condom and discussing sexual health and history with all your sexual partners. Keep in mind that a condom won’t completely decrease your risk of contracting HPV, particularly if the virus is present in warts on other parts of the body, such as the hands, feet, and face.[1]

Everlywell: At-Home HPV Tests For Women And People AFAB

It is possible for people to become reinfected with HPV, particularly when their immune system weakens or they’re exposed to a new strain of the virus. Fortunately, in most cases, the body can fight against the infection, before it evolves into skin warts or cancer.

If you’re experiencing symptoms or looking to stay up to date on your cervical health, Everlywell provides an at-home HPV Test that screens for 14 types of HPV strains, including 16 and 18. You can have the test shipped discreetly to your door for private, at-home testing. If you test positive, we’ll connect you with an expert physician to guide you through your treatment options. For more information on your health, visit our online women’s health services.

Related Content

Can HPV Be Cured With Antibiotics?

HPV vs. HIV: Comparing Sexually Transmitted Infections (STIs)

How Likely Is It To Get Throat Cancer From HPV?

References

1. HPV. Cleveland Clinic. Published August 4, 2022. URL. Accessed October 22, 2023.
2. HPV and Cancer. NCI. Published October 18, 2023. URL. Accessed October 22, 2023.
3. What You Need to Know About Infectious Disease. NIH. Published 2010. URL. Accessed October 22, 2023.
4. Brown D, Weaver B. Human Papillomavirus in Older Women: New Infection or Reactivation? J Infect Dis. Published January 15, 2013. URL. Accessed October 22, 2023.
5. HPV FAQs. Cervical Cancer Trust. URL. Accessed October 22, 2023.
6. HPV and Men – Fact Sheet. CDC. Published April 18, 2022. URL. Accessed October 22, 2023.
7. Does HPV Go Away on Its Own? Cleveland Clinic. Published December 14, 2021. URL. Accessed October 22, 2023.
8. History of HPV Vaccination. St. Jude’s Children’s Research Hospital. URL. Accessed October 22, 2023.