This is really a troublesome disease to you. In general, the chance of a recurrence after treatment is about 10%. Recurrences could be due to reinfection or reactivation of the HPV. We believe that your immunity has something to do with the disease. If you are smoking, stop smoking. Be remember to go for check up with cervical smears every 6 months until normal for 3 times before spacing out to yearly check up. There were some evidences coming up showing that HPV vaccination can help reducing the chance of recurrences but solid evidence is being awaited. I do not know much about Chinese medicine and am not sure if this stengthen your immune system to combat the disease.
What you have said was true and I am sure you have spent a lot of time studying about your diseases. Genital warts is a disease caused by low risk HPVs mainly 6, 11, 42, 43 and 44. Once you have this disease, despite treatment, it comes and goes from time to time. When you have warts, you might have abnormal smears but the low risk HPVs would not cause you high grade CIN or cervical cancer. Some women have the warts growing rapidly during pregnancy, this may be related to the immunity, but this is not always the case.
You said you had abnormal smear showing CIN1. In fact, CIN1 is not a smear diagnosis. Sometimes, HPV effects can cause you an abnormal smear. You need a colposcopy examination +/- a biopsy to confirm the diagnosis. HPV81, as you said was previously regarded as low risk and was recently typed as high risk. But, only a tiny proportion of the significant cervical disease was caused by this virus. If you have CIN2 or 3, you would need a treatment, if you have only CIN1, do not go for treatment because, overall, about 70% of all the CIN1 regress spontaneous. Unless, 3 or more quadrants of your cervix is involved by the CIN1 or if the disease persisted for 2 years, then, you should consider treatment using the LEEP.
You have had HPV81 detected for twice in the past, a few years apart. I am not sure if this is a persistent infection and just another infection. A lot of women having HPVs can be cleared by their immunity. If this is the case, another episode of infection would probably not causing you problems.
Up till now, there is no commercially available HPV tests for men. Using condom to prevent HPV is not effective. Some quoted the efficacy of around 30-40%. Interestingly, a lot of women who were treated for CIN2/3, majority (~85%) do not have the disease come back afterwards (of course, their partners were not treated). Therefore, it is really difficult to predict the behavious of this virus. A lot of things about this virus is still unknown.
Nowadays, a lot of people are carrying HPVs (80% of sexually active individual have had contact with HPV). Only a minor proportion would develop high grade CIN that requires treatment. Therefore, there may not be a point checking the HPV status regularly. Having regular smear tests seems more reasonable and useful because it is more specific. For somebody carrying HPV, there is no good recommendation on how it should be followed. Usually, they are asked to have smears more frequently. Repeating the HPV test can only give you more stress.
Your gynaecologist is correct. If you are able to clear a type of virus, it is unlikely that future contact with the same virus would cause you problems.
If you are infected with HPV, there is nothing you can do to helping clearing it. If you are smoking, stop smoking. Up till now, there is no medication to treat this infection.
Even though your partner is still carrying the virus (just a presumption), if you can clear the virus that he is carrying, it does not matter.
If you have ASC-US and positive for high risk HPV, you need a colposcopy examination because you have about 20-30% chance of having CIN2/3. There is nothing special about multiple infection with more than one HPV type. Multiple infections is not common in the past just because the tests used to detect multiple infections is just available in the recent years. Family Planning Association does have the colposcopy service that you need. Since you are indicated to have a colposcopy examination, do not go for another smear or HPV tests. Cervical smears should not be repeated within 3 months because it takes time for the cells on the cervix to regenerate. A negative result on repeated smear within 3 months can just be a false negative and it is not reliable. During your follow up in future, if you do not need treatment for CIN2 or 3, follow up with smear is good enough. Including HPV test would not alter the management but you will spend more money on this.
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