How can I determine if I have cleared Human Papillomavirus (HPV) 16?

Determining HPV 16 Clearance

HPV DNA testing is the only reliable way to determine if you have cleared HPV 16 infection, but these tests are not recommended for routine STD screening and should only be performed in specific clinical contexts.

HPV Testing for Clearance

• HPV DNA tests can detect the presence of high-risk HPV types, including HPV 16, but these tests are only FDA-cleared for use with cervical specimens collected during clinical examinations, not for self-testing or routine STD screening 1
• Currently available FDA-approved tests include those that detect multiple high-risk HPV types (including HPV 16) and specific tests that can identify HPV 16/18 individually 1
• HPV testing should NOT be performed for deciding whether to vaccinate against HPV, testing persons with genital warts, routine STD screening, or testing oral or anal specimens 1, 2

Clinical Context for HPV Testing

• HPV DNA tests are recommended only in specific clinical scenarios:

  • For triage of women aged ≥21 years with abnormal Pap test results (ASC-US) 1
  • As adjunctive testing with cervical cytology for screening women aged ≥30 years 1
  • For follow-up after treatment of cervical precancers 2

• HPV clearance is determined when a previously positive HPV test becomes negative on follow-up testing 3, 4

Natural History of HPV 16 Infection

• HPV 16 has a lower clearance rate compared to other HPV types, making it more likely to persist 4, 5
• Research shows that approximately 49% of women with normal cytology clear HPV 16 within 18 months 4
• By 48 months after initial detection, about 82% of HPV 16 infections clear in women without cytologic high-grade squamous intraepithelial lesions 3
• Persistent HPV 16 infection carries a higher risk of progression to cervical intraepithelial neoplasia (CIN) grades 2 or 3 or worse 3, 4

Follow-Up Protocols

• If you've had a positive HPV 16 test:
  • With normal cytology: The CDC recommends colposcopy due to the high association with cancer 2
  • After colposcopy with no CIN 2 or higher found: Follow-up HPV testing is typically performed at specific intervals 2
  • After treatment for high-grade precancer: Surveillance should continue for at least 25 years with initial post-treatment testing at 6,18, and 30 months 2

Important Considerations

• Most HPV infections, even with high-risk types like HPV 16, are transient and will clear on their own within 1-2 years 1
• HPV clearance rates decrease with increasing age 3, 5
• Women who have used oral contraceptives may experience faster clearance rates, while parous women may have slower clearance 5
• Even after apparent clearance, HPV can remain latent and potentially reactivate later, so a negative test doesn't guarantee permanent clearance 3

Common Pitfalls to Avoid

• Do not seek HPV testing outside recommended clinical guidelines, as results may lead to unnecessary anxiety and procedures 2
• A single negative HPV test after a positive one doesn't guarantee permanent clearance, as the virus may be present below detection levels 4
• Self-collection for HPV testing is not FDA-cleared or recommended by U.S. medical organizations 1
• Remember that HPV testing is not recommended for routine STD screening, only in specific cervical cancer screening contexts 1