[Question #10728] HPV Transmission and Clearance Questions - Thank you
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20 months ago
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Greetings Dr HHH and Dr Hook, I hope this finds you well, been a follower since your medhelp days and can't tell you how much your expertises have helped, many many thanks for your services.
I am a Male, no HPV vaccination and have had numerous sexual contacts (condom always used for vaginal sex, sometimes for receptive oral sex but not always). No symptoms of HPV infection, no warts etc.
Girlfriend was vaccinated with Gardasil 9 valet at 18, which was prior to her starting to have any sexual contact with anyone, and I was her first sexual partner and have been the only one for her ever since.
After being together with her, I have had some sexual contact with other ppl (again condom always used for vaginal sex, sometimes for receptive oral sex but not always) and I am negative for all common infections as per the latest test. My GF and I have always used condoms for vaginal sex with no exceptions, which I am certain about, however no protection for both cunnilingus and fellatio.
I understand that I most likely have been infected with HPV at this point and likely have also infected her. I understand that our body usually clears HPV infections on its own, now my questions is how can we ensure clearance of HPV for the both of us should we remain monogamous from now on?
Let's say I have the type 59 and some other types and have passed it on to her, and I clear it before her and have no new infections, could I receive it again from her? Or vice-versa?
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Edward W. Hook M.D.
20 months ago
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Welcome to our Forum. Thanks for your thoughtful questions. Congratulations on your approach to condom protected sex- it will do much for you and your partner's sexual health. As you point out, while condoms reduce risk for HPV from any single encounter, even with consistent condom use, most unvaccinated persons will get HPV. Thus, as you suggest, it is quite possible, even likely that you have HPV. Over time, those infections will subside and be unlikely to be transmissible to partners. On the other hand, your partner's vaccination will do much to protect her from any active infection you might have. In addition, while the data are preliminary, research does suggest that vaccination offers some degree of resistance to infection even against non-vaccine types.
The scenario you describe when infections are passed back and forth between partners is sometimes referred to as "ping-pong" infections. There are no good data on the frequency or likelihood of this happening with HPV. The best advice I can give you is that, short of getting the vaccine which might still offer some degree of added protection to you, is to not worry about passing any HPV infection you may have to her. What is done is done and her vaccine is a great step towards protecting her.
Sorry there are not more data on the situation you describe. EWH
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20 months ago
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Hi Dr Hook, Thank you so much for your reply.
Just following up, I read that long-term, persistent infection of some high risk hpv types is the cause for precancerous lesions and could progress to cancer. So does what I described in my original question the likely cause of this persistent infection? Since there is no tests for men, is there no way of knowing for sure that both of us have cleared it?
Some info seems to suggest that what we understood as clearance isn't that the virus no longer exists in our body, but our immune system has suppressed it to make it undetectable thus non-transmisible. However both men and women would carry this for life and hpv tests could become positive in the future despite no new infections. What's you opinion on this?
Thanks again for your prompt reply and your diligent and caring service.
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Edward W. Hook M.D.
20 months ago
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Less than 1% of HPV infections in men persist. You are correct, there are no tests for HPV in men. Should you note abnormal lesions on your penis, then you should seek evaluation by a medical professional. This however is unlikely to happen. I would urge you not to worry.
As long as there are no lesions, the likelihood of recurrence is very low. I really would not worry about it. EWH
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20 months ago
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Understood, one last follow up.
Do you mind expanding on your answer to the question "Some info seems to suggest that what we understood as clearance isn't that the virus no longer exists in our body, but our immune system has suppressed it to make it undetectable thus non-transmisible. However both men and women would carry this for life and hpv tests could become positive in the future despite no new infections. What's you opinion on this?"
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Edward W. Hook M.D.
20 months ago
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There's not much more to be said. Using sophisticated research tools not available to the public, is a variable proportion of persons in whom HPV becomes non-detectable using most methods, HPV DNA can be detected. This indicates that the virus is still present and has a SMALL possibility of re=activating in the future. This reactivation is a rare event.
Once again, i URGE you to put your concerns aside and move forward. There is nothing here worth worrying about and as long as you and your partner follow routine sexual health recommendations (periodic screening for women, seeking evaluation if abnormal lesions are present and persist more than a week or two for men).
This completes this thread. Please move forward without concern. there should be no need for follow-ups. EWH
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