[Question #13392] oral hpv
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1 days ago
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As I explained, I had an oral and genital encounter with someone with warts 9 years ago.
1. Before I got married I told my husband about it to get vaccinated, he was 26. I just noticed he only got 2 HPV9 doses 3 months apart. (his first dose hpv 6 was held at home refrigerator for weeks prior to injection, so I consider it ineffective ) Does he have any immunity? Should he start the vaccine all over?
2. Husband never gave oral to me. Through the years, we had unprotected sex and kissing and sharing drinks what is his risk of oral hpv?
3. How safe is getting oraldna spit test (OraRisk® HPV) for oral hpv, and can I rely on the results? I know it is not FDA-approved but is it safe? and after 9 years, is it reliable?
3. How safe is getting oraldna spit test (OraRisk® HPV) for oral hpv, and can I rely on the results? I know it is not FDA-approved but is it safe? and after 9 years, is it reliable?
4. How many more years should I wait to know if I get cancer or not?
Thank you.
Thank you.
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H. Hunter Handsfield, MD
1 days ago
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Welcome back, but I'm sorry you remain concerned about (even obsessed with?) possible oral HPV despite the reassuring discussions you had with both me and Dr. Hook nearly two years ago. Just having had oral sex with a person with genital warts did not put you at any higher risk than anyone else for having oral HPV. To your specific questions:
1. Although it was initially believed three doses of HPV vaccine are necessary for complete protection, it is now know that two doses is sufficient and is now the normal recommendation. Even one dose is now known to be almost 100% protective.
2. His risk of oral HPV would have been very low even if he had performed cunnilingus on you. I certinaly hope fear of HPV was not a reason you and he decided against oral sex on you.
3. No single spit test, or any other test, can prove oral HPV is absent. It only means not enough HPV DNA was detected at that moment to give a positive result. Given your sexual history, it is unlikely you have oral HPV at this time, and a negative test result probably would be reassuring. But you cannot rely on it as proof you don't have it.
4. The only oral cancer due to HPV is squamous cell carcinoma of the pharynx, and almost all cases are caused by a single type of the virus, HPV 16. When it happens, it's most common in people in their 40s-50s. It's a rare cancer -- far less common than breast, prostate, lung, lymphatic and other cancers. In any case, your risk for pharyngeal cancer is low. But if you're still worried (obsessed?) with the possibility, discuss it with your primary care provider. You certainly could ask for referral to an otolaryngologist -- they're the real experts in such health problems -- for an annual examination.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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1 days ago
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Thank you for replying to my questions. This forum always says oral risk is low, but there are thousands of people in the mayo clinic forum who are suffering from this cancer. I believe there are too many unknowns. My follow-ups are:
1. can the vaccine help with oral as well? If yes, does the research support it? And how can research support it if there are no tests for oral hpv?
2. if the oral test or genital hpv test is negative and it means in your word, " not enough HPV DNA was detected at that moment to give a positive result" does it mean it can not be transmitted?
1. can the vaccine help with oral as well? If yes, does the research support it? And how can research support it if there are no tests for oral hpv?
2. if the oral test or genital hpv test is negative and it means in your word, " not enough HPV DNA was detected at that moment to give a positive result" does it mean it can not be transmitted?
3. I see ENT regularly since I have a chronic sore throat. How often should I continue seeing ENTs? Can warts like high riskHPV be dormant and suddenly appear a decade later, both in oral and vaginal? Thanks
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H. Hunter Handsfield, MD
1 days ago
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You are overreacting to inflammatory and perhaps exaggerated information about pharyngeal cancer. Yes, there are many unknowns; but the risk is low and trust me on this: your sexual lifestyle, choices, and exposures do NOT place you at higher risk for this than anyone else.
1. The HPV vaccine is 100% effective prevents HPV infection with 9 HPV types -- including HPV 16 -- anywhere on the body, including oral infection.
2. Certainly transmission chance is lower with negative saliva testing, but nobody can say it reduces the chance to zero. Probably it does not.
3. We are not experts in detection or screening for pharyngeal cancer and I don't have an answer. This is a question for your ENT doctor. Can warts be dormant and reappear a decade later? Yes, but rarely. And in general high risk HPV doesn't cause warts.
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1 days ago
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Thank you. The reason I became obsessed is that they keep saying keep an eye out for a wart, it may happen at any time. There are many bumps and pimples in the body, and for someone without a medical background, it means endless dermatology, ENT, and obgyn appointments. As my final follow-ups:
1. How likely is someone with a visible wart, which is 6 or 11 have HPV 16 at the same time? Statistically speaking
2. Are there any new data on deep kissing transmission?
3. In the first question, you said "now know that two doses are sufficient and is now the normal recommendation." isn't this research done on younger people? I believe the participants were 15 and under? He was 26 at the time, and the recommendation still is 3
1. How likely is someone with a visible wart, which is 6 or 11 have HPV 16 at the same time? Statistically speaking
2. Are there any new data on deep kissing transmission?
3. In the first question, you said "now know that two doses are sufficient and is now the normal recommendation." isn't this research done on younger people? I believe the participants were 15 and under? He was 26 at the time, and the recommendation still is 3
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H. Hunter Handsfield, MD
1 hours ago
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I can't comment on what "they" keep saying, whoever they are. The vast majority of humans with various "bumps and pimples" do not seek "endless appointments" with derm, ENT, or OBG providers.
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1. Infection with multiple HPV types is common, but I can't say the frequency with which those with HPV 6/11 also have 16. But since the vast majority of even the highest risk HPV types (like 16 and 18) never get cancer.
2. I am unaware of recent or new data on HPV and kissing.
3. You might know more detail about those studies than I do. My understanding is that age makes no difference.
That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.