[Question #1511] Likelihood of HPV papilloma?

54 months ago
I have a question I'm hoping you can help me with.  On 10/19, I performed unprotected oral sex on someone.   On 11/8, I noticed a growth on my uvula.  I don't know how long it had been there, but I'm guessing it appeared a few days before.   It looks like a little sack that is attached to the uvula via a stalk or small piece of tissue, as I can move it around.   What are the chances this is HPV related?   I had previously also been sick with a virus, so this is complicating the diagnosis for me.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
54 months ago
Welcome to the forum. Thanks for your question.

It is very unlikely the thing you see on your uvula is a wart. First, oral warts are rare, even in people who regularly perform oral sex on partners with genital warts. Second, it appeared too soon:  warts typically show up 6 weeks to a year after exposure; 3 weeks probably is too early for this to be related to the Oct 19 exposure. Finally, an upper respiratory viral infection is a more likely explanation for some sort of enlargement or apparent growth on your uvula.

That said, the only way to know for sure is for you to be professionally examined. See your doctor, or perhaps your dentist, and take it from there. Even if it turns out to be a wart -- which I continue to doubt -- it should be easily removed and won't be an important health problem.

I hope this has helped. Let me know if anything isn't clear.

HHH, MD

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54 months ago
Thank you for your reply, Dr. Handsfield.  Neither my primary care physician or dentist are sure what it is - when I mentioned papilloma to them, they both said it was possible but didn't seem convinced (I didn't tell them the timeline I mentioned earlier).  I am going to an ENT on January 4 to have it removed.   In the meantime, should I worry about sharing drinks with others, deep kissing, etc?  I just want to make sure I don't endanger anyone.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
54 months ago
I think this is the right approach. Even though your doctor and dentist "weren't sure", their judgment or guess about the cause would be better than mine; they have seen it and I haven't. If they think a wart is likely, then until you see the ENT doc, I would suggest avoiding open-mouth kissing or oral sex on partners. (These would be low risk, just being extra safe.) But no risk from social kissing, sharing eating or drinking utensils etc. (Of course there are other reasons to avoid those things when practical -- it's cold season, after all!)

I'll be interested in hearing the outcome after your ENT visit and will keep this thread open. But I won't have any additional comments or advice until then.

Best wishes for an enjoyable holiday season. This thing really shouldn't have any important impact on that.

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53 months ago
So, I went to the ENT today.  He believes it is an oral wart caused by HPV and removed it, but is sending it off for a biopsy.  Dr. Handsfield, what precautions do I need to take?  I am pretty crushed by this news.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
This really shouldn't be a cause for great worry, even if the biopsy confirms a wart. It is very unlikely you will ever have a serious complication of oral HPV or that you will be a risk to future sex partners. If a wart is confirmed, to be maximally safe for others I would advise continuing to avoid sexual (open mouth) kissing or performing oral sex for the next 3-4 months. If no new warts have appeared at that time, I think you can resume those practices. With these precautions, there is no need to mention this to future sex partners.

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53 months ago
Thanks Dr. Handsfield.  Does having oral HPV mean you have it genitally as well?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
At any point in time, 20-50% of sexually active young adults (age 15-25) have genital HPV, of whom roughly 10-15% also have oral HPV (usually without oral warts or other symptoms). So in that sense, your situation is quite common. Probably most people with oral HPV also have genital HPV, but I'm sure there are many exceptions. Unless you have visible genital warts, there is no way to know with certainty. In the absence of visible evidence of infection, in my view you need not say anything to current or future sex partners. However, some might disagree and recommend informing partners. But not indefinitely -- only a few months, after which you can assume your immune system will have cleared the virus.

You might do some further reading about HPV. Excellent information is provided by CDC (www.cdc.gov/std) and by the American Sexual Health Association, the sponsor of this forum
http://www.ashasexualhealth.org/stdsstis/hpv/

Also consider getting immunized against HPV, if you're under the usual age cut-off (26). The vaccine prevents infection with the 9 HPV types that cause 90% of HPV-caused cancers and 90% of genital warts. It won't have any effect on infection(s) you've already had, but will provide 100% protection against the other types covered by the vaccine.

We're beyond the two follow-up comments and replies included with each thread, so that concludes this discussion. Don't make more of this than it is:  this whole business is a temporary inconvenience, not a serious health threat to you or your current or future partners. I hope the discussion has been helfpul.

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