The term “pure HPV positive” means that the cervical cytology or liquid-based cytology and the pathological diagnosis after cervical biopsy are negative (i.e. “normal” or “chronic inflammation” category), but only HPV test is positive, or one or several subtypes are positive. The first thing that should be noted is the method of testing for HPV. There are many different methods of HPV detection, including immunohistochemistry with cell smears or biopsies, in situ hybridization, or PCR-based DNA or mRNA testing with vaginal secretions. The first 2 are mainly used in pathology departments, and the 3rd method is generally used clinically. The 3rd method, which is commonly used clinically, is to take vaginal secretions and detect them by PCR or some kind of signal amplification technique. This method is very sensitive, especially the PCR technique, which can theoretically detect 1 copy (copy) of viral DNA, and a large global survey found that if HPV is detected by PCR technique, it can be about 20-40% positive in the normal population. To address this problem, the current clinical approach to HPV detection usually requires setting a threshold (below). The rationale for threshold setting is to include as many pathogenic individuals as possible, not just those for whom the technology can detect viral DNA. the threshold set varies for each different test, but is set by large-scale clinicopathologic controls, usually after a global survey of hundreds of thousands or millions of points. The HPV tests approved for marketing by the US FDA that can be applied are HC2, Cervista, Cobas and Aptima, 4 in total. Among them, the first two cannot be typed, and the latter two can detect 14 high-risk HPV subtypes, and can separately classify HPV subtypes 16 and 18. At present, there are at least 30 domestic clinical methods for HPV testing, and we were not able to find out how these methods set thresholds through the literature. If the threshold is set unreasonably or too low, as shown in the yellow line below, technically, HPV DNA is indeed detected, but a large number of “normal carriers” are included. So, when you get a HPV test report, first you need to determine what method you are using for your test. Distinguishing them is actually quite simple. In the internationally accepted test method, HC2 is tested as a value, Cervista is grouped, cobas and aptima can only be divided into subtypes 16 and 18, and the other 12 subtypes are not. If this is not the result, it is not tested by the international common method. Second, even if it is true that HPV is positive, the sky is not falling. Because, HPV infection is self-limiting. That is, like other viral infections, such as the flu, it can recover on its own, so HPV infection often appears as a “transient” infection. In the graph below, the black bars indicate the prevalence of HPV infection, with the highest rates in the 15-19 and 30-34 age groups, which correspond to the peak age of sexual activity. However, at least 1/3 of each age group can be cleared on their own, as indicated by the gray bars, with clearance rates above 50% for most age groups. This means that there is a 30-50% or more chance that HPV infection is self-clearing. This is largely dependent on the local immune function of the body, and there are no effective therapeutic drugs that target the virus. HPV clearance takes time. About 50% of people may turn negative within six months, 70-80% may turn negative within one year, and the remaining 20-30% may take 2-3 years to become normal. Therefore, there is no need to go for repeated HPV tests in a short period of time as it will not disappear in a short period of time. Finally, it is important to note that HPV may become persistent in some people for a variety of different reasons. persistent infection with HPV is the most dangerous factor leading to lesions. Under normal circumstances, the body can clear the virus through the local immune system. Therefore, when the local immune function of the organism is impaired, such as combined with other inflammatory conditions, especially other viral infections such as herpes virus and cytomegalovirus, it is easy to make the infection persistent. When the whole organism is in an immunosuppressed state, such as the combination of lupus erythematosus, kidney transplantation and other use of immunosuppressive drugs, and the use of anti-tumor drugs, it is also certainly prone to become persistent infection. Co-infection with HIV (AIDS) will definitely predispose to the development of cervical cancer. Therefore, it is very important to be able to clear the virus from the body, to maintain a healthy lifestyle, to keep the immune function of the body in a normal state, to keep the local cleanliness and hygiene to prevent other infections, etc. It is much more effective than various so-called antiviral drugs. In general, when the virus remains positive for 2 years, it is necessary to be examined. The important thing to note here is that it is the same type of HPV, such as HPV 16. Whereas if it is other types of HPV now, and 2 years later it is HPV type 16 that is detected, this is an indication of a new infection and not a persistent infection. Current HPV testing methods usually detect the high-risk types of HPV (the types of HPV that can cause cervical cancer), while the general low-risk types are of little significance. If the test appears to be positive for both HPV 16 and 18, it is necessary to conduct further tests. Simply put, when the cervical cytology is negative and the cervical biopsy for pathology is also negative, a positive HPV test alone does not indicate the presence of lesions, but is often only a carrier state for the virus. This may be substantially increased by the coexistence of multiple testing methods in different hospitals in China. The HPV typing is meaningful, if it is only a low risk virus (HPV6/11) infection, there is no need to treat it and wait for natural recovery, but if it is HPV16 and 18 infection at the same time, it is necessary to go to the hospital for further examination.