[Question #3400] Oral HPV Diagnosis

89 months ago

Good Afternoon Drs

I am a repeat user and want to thank you for your previous answers and guidance. I've expressed my OCD and overworry issues paired with having HPV and you've been helpful both medically and mentally..

Unfortunatley at a recent dentist visit, I asked to have an Orarisk HPV test done at the suggestion of my dentist. The results came back yesterday as Positive for HPV 42.

I am aware that this is a low risk for oral cancer, but also aware that this strain is typically a genital strain. I have taken this sam etest in the past (roughly a year ago) with negative results, but have had no sexual partners other than my wife between testing.

My questions are this:

1.Why would I have been negative a year ago and positive now? Testing discrepancy, dormant then and active now, recurring infection?

2. Since this is a low risk type, is there even reason to worry? Just go on with my life, continue to have regular dental visits and act like nothing ever happened?

3. Can I pass this to my children through sharing drinks or utensils? (Casual transmission)

4. How common is having oral HPV and if there are no lesions, is it a big deal or is it like a woman getting an abmnormal pap?

I know this is a lot, just have many questions and my dentist was not very knowledgeable about the subject. It's bad enough I had a previous genital infection, but to now have this on top of it... I am trying to keep my spirits up and am hopeful this is not a big deal as it's a low risk strain.

Thank You in advance for your advice.

H. Hunter Handsfield, MD

89 months ago

Welcome back yet again, but once again I'm sorry you found it necessary.

As you probably expect me to say, it was a mistake for you to have an oral HPV test. Such testing is not recommended or approved by any public health agency, even if some manufacturers have developed commercial tests of the sort you had. There is nothing to be done now, and you are at little or no risk for any adverse health outcome and probably for infecting partners. And even if you transmitted HPV42 to a partner, s/he probably would never know it and would not be at any health risk.

1) HPV can come and go. Also, I don't know the reliability of this particular test. You might have been infected a year ago and the test missed it; or maybe the result is false now and you don't have it; or perhaps you were somehow infected during the past year. I know of know way to distinguish between these possibilities.

2,4) Yes, you should not worry and go ahead with your life without worry about this. At any point in time, 30-50% of people have genital area HPV, and 5-10% have oral HPV. So it's fairly common, but not as frequent as genital infection. It's definitely "no big deal", especially with a low risk type like 42.

3) We discussed this in one or both of your previous threads. Re-read those discussions. Your kids are not at risk.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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89 months ago

Thank you dr handsfield.

Again, your advice is reassuring and helpful.

I did expect your response, and a large part of me wishes I had just left well enough alone... but it’s done now..

I know you answered my question about kids previously, I just didn’t know if an oral infection acted differently. Since sharing a drink or straw or whatever, transfers saliva, I wasn’t sure if oral hpv was different or if it also required direct contact with a lesion as well.

The test I took looks for hpv dna, so I know there’s no way to distinguish between dna and an active infection, but if there’s no lesion, how do I test positive?

So it still begs the question for me of can I pass this to my kids by sharing drinks, etc.

Thanks for your help. I apologize if I continue to ask the same question in a different way, I’m just still unclear when it comes to the oral transmission method.

H. Hunter Handsfield, MD

89 months ago

If you think it through, you'll understand that oral infection makes no important difference in the chance of nonsexual household transmission of HPV. If 30-50% of adults have genital HPV, and 5 -10% have oral infections, there must be millions of families in the US (and billions worldwide) in which at least one person has oral infection. And still no recognized transmission to kids or other household members.

A "lesion" does not need to be present to test positive for HPV DNA, which can be present in entirely normal skin or mucous membrane cells.

Your kids could get non-sexually (non-genital) HPV at any time; the strains that cause common hand and foot warts are easily transmitted among playmates, schoolmates, etc. And they are all going to catch genital types of HPV someday. But not until they become sexually active, and not from you. Do your best to stop worrying about it -- and please no more forum questions about it!

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