[Question #10615] HPV type 31

21 months ago

I am a male. I have been having recurrent gentital warts confirmed by dermatologists for about 4 years now. These warts recur every six-eight months after surogical removal.

About two years ago I met a new female partner and informed her shortly that I am HPV infected and been having warts. Till this day we always use condoms for sex. I Informed her back than, that to my knowlegde most people get HPV infection anyway and generally GWs are caused by low-oncogenic types of HPV– as I was told by the dermatologist. So she would get infected anyway, but nothing really to worry about.

2 weeks age my girlfriend went to have a pap smear and HPV DNA ,after few years not visiting ginecologists.

It turned out to find LSIL result, a suspicion of Cervical Intraepithelial Neoplasia caused by ongoing and persistant HPV infection caused by the oncogenic type 31. Colposcopy is needed.

1.I always believed that genital warts can only by caused by low-oncogenic types of HPV like 6 or 11. Can my genital warts be caused by oncogenic HPV type 31?

2.Can I be infected with more HPV strains then just one and pass one of them to my girlfriend?

H. Hunter Handsfield, MD

21 months ago

Welcome back to the forum. Directly to your questions:

1) The classification of warts as high risk (cancer causing) and low risk (not cancer causing) is not rigid; these are tendencies only. Some low risk types occasionally result in pre-cancerous Pap smear changes and some high risk types can cause warts from time to time. That your partner's abnormal pap tested positive for HPV 31 does not mean it necessarily is the cause of your warts; you'll probably never know. And assuming she has a past sex life before you became a couple, her abnormal pap could be the result of a distant past infection that reactivated. (That's the most common cause of abnormal paps in women after age 30.) It could be from your warts, but not necessarily. It usually is not possible to know with certain when and where any particular HPV infection was acquired.

2) Yes you could have more than one HPV type. So could your partner. The available tests do not detect all infections; the chance is high that either or both of you has more than a single type of HPV.

FYI, LSIL is generally harmless: it rarely progresses to later stages. Your partner will need to follow her doctor's advice about follow-up, but her chance of progression to cervical cancer is very low.

Condoms are not very helpful in preventing HPV infection, by the way. They reduce the transmission chance, but not completely -- and therefore after multiple sexual exposure, the chance of HPV is nearly as high as without condoms. At this point I see no need for you to continue routine condom use in your sexual relations together.

Finally, have your warts been treated? If not, why not?\

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

---

21 months ago

Thank you for your responde Dr,

My warts have been removed a few times over this time, but they do recur.

My girlfriend is aware of my previous sexual lifestyle and blames me for the aformentioned sitution with infecting her and for her results.

1. Should I feel guilty on this matter? Considering her Pap smear - LSIL results .

2. Is it safe for us to resume sex? Can I infect her with an another type of HPV and somehow worsen her situation?

3. Is it a way for me to test which type of HPV I am infected with, as a male?

4. Does every woman, infected with active HPV have bad Pap smear results?

21 months ago

Follow up questions:

5.Is it worth for us to get vaccinated for HPV at this stage ?

6. Can HPV 31 happen to be in my & girlfriend’s throats ?

H. Hunter Handsfield, MD

21 months ago

1. No, you should not "feel guilty". As I said above, your partner's LSIL is equally likely due to some past HPV infection she acquired elsewhere as from exposure to your warts. Women at zero current HPV risk get abnormal paps all the time!

2. Stopping sex now would be like closing the barn door long after the horse has escaped. She has already been repeatedly exposed and probably infected with your HPV, whether or not is it is the cause of her abnormal pap smear. Stopping sex now will make absolutely no difference in her health or risks.

3. Various labs offer HPV tests. They are not approved for clinical use by the FDA and should not be trusted. Whether or not your warts might test positive for particular types of HPV will make absolutely no difference in your health or your partner's.

4. Most HPV infections, including in women, cause no warts, abnormal Pap smears, or any other abnormalities.

5. The value of HPV vaccination depends on the likelihood of current or past HPV infection and exposure. Since actual exposures are almost impossible to know, the main criteria are age (usually not advised beyond age 26 and never beyond 45); and potential new exposures, i.e. more than one sex partner. If the two of you are and remain monogamous, vaccination is a low priority. In any case, it has no benefit for people with known HPV infection or their regular sex partners. You could discuss this further with your wife's gynecologist and your personal physician.

6. Yes, oral infection is possible and even likely, especially if oral sex is among your sexual pleasures. But throat HPV is generally harmless. Only one type, HPV16, causes almost all HPV related throat cancers, and even with that virus such outcomes are rare. Just as with intercourse, if you've been having oral sex all along, there is no point in stopping now.

---
---