[Question #11059] Hpv oral incubation period
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17 months ago
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I’m mid-30s F, monogamous 7 yrs, vax at 19 with gard-4. Didn’t have genital sex until after, but prob had 5 oral sex partners b4, 1 prob had active warts or were resolved. After vax, had excessive oral partners, most recent 7 years ago prob had warts (nothing visible) bc he gave them to a virgin. I noticed this week what looked like papillae on the side of my tongue (horrible health anxiety so I look frequently). 1 mm, white, just like those on the top of the tongue. pinched it off w/ease & a few days later, one near it. They’re gone- all looks normal. sent pic to a dentist friend; said it’s nothing serious, could be local trauma or common wart (prob since I’ve been monogamous for so long), but nbd, do nothing unless worsens. 1) oral hpv incubation: the best estimates I can find max out at 20 months. What are the chances that a 1st wart appears 7-20 years after exposure? 2) chance it’s cancer if it was a wart?
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Edward W. Hook M.D.
17 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment.
It's tough to say whether the lesion you noted on your tongue was a wart or not- if it were a wart it would be rather unusual to pinch it off as easily as you seemed to. I agree with your dentist friend however- if it were a wart, on over 90% of infected persons, the body eliminates the infection without any specific therapy over a period of 1-2 years.
HPV does sometimes infect the oral cavity. When it does some (about half) is caused by the types of HPV that infect the genital tract while the other half is causes by the types of HV that cause "common" warts of the hands, etc. Most infections with genital strained are due to HPV 16, one of the types in the vaccine and most commonly these infections are asymptomatic and not even visible. Most of what we know about the appearance of visible warts is that it takes on average, 2-3 months following infection/contact for warts to appear. It's conceivable that a wart acquired from performance of oral sex might appear now, 7 years out but this would be unusual.
The chance that this lesion is HPV is low, if it is HPV, there is a more than 98% chance it will NOT progress to cancer. I agree with your dentist that there is NBD. If you are worried, and if the lesions reappear, I suggest that before you pinch them off you have your dentist take a look. Personally, I doubt this was a wart and would not be worried. EWH
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17 months ago
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Interesting. I was under the impression that no warts progress to cancer because of their nature and it is only high risk strains that do not cause warts?
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17 months ago
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I hit send on accident. Also was wondering how unusual it is in your estimation that this would appear first 7 years later
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17 months ago
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And, this can be my last question, if you could estimate what the odds are that this lesion is hpv based on your clinical experience I would be grateful
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Edward W. Hook M.D.
17 months ago
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It is decidedly unusual for visible, genital warts to progressed to cancer. I would have no concerns about that, particularly since you’ve been vaccinated. in addition, as I’ve already indicated, it would be most unusual for an infection to appear after a period of more than seven years. I remain skeptical that the lesions you noted were warts.
FYI, you have one additional follow up remaining. EWH.
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