[Question #3583] hpv

36 months ago

took home anal, oral, penal, hpv dna test from selfcollect.com. I was NEG for all oral, penal, HPV,  but for anal I was only NEG for 16,18, but did get positive for "OTHER high risk" HPV (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 & 68) . No specific # was given. How is this possible when i'm not gay.  I’m 40, drink wine often, not really smoker and work out and eat very well. I do frequent massage parlors often but only go for the tug, but realize sometimes they often touch the anus area? About 20 years about i did get my anus licked by a dude that looked like a girl. That’s about it for anal contact. Perplexed here.... Worried about persistant HPV cause i don't see a reoccurring source.  What you think about cause and what do suggest i do with this result if anything?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome back to the forum.

This is a good example of the problems that can arise when anxious persons seek unnecessary STD testing. The HPV tests are not recommended by any responsible health authority (health departments, CDC, STD/HPV experts)  for testing in this manner, especially by men -- even though many labs offer and market them. The first caution is that the performance of the tests isn't completely understood, and not all positive results are truly positive; you may not have an anal HPV infection at all. Also, the negative genital area testing does not rule out the possibility that you in fact have genital HPV. The available tests do not detect all infections. Indeed, HPV researchers disagree on the best way to collect genital specimens in men to maximize test sensitivity -- and whatever method your lab uses probably doesn't detect all infections.

But if you do have anal HPV, it probably will never mean anything important. Strictly heterosexual men get anal HPV all the time -- not as frequently as women or as men with rectal sexual exposure (mostly men who have sex with men), but still quite common. The exact origins aren't known, and it's almost always unknowable in any particular case. Self-inoculation from genital infection probably accounts for most cases, and you could have had a past genital infection that was the source of the anal one, with the genital infection having cleared. This undoubtedly is more likely than the oral exposure 20 years ago or from a massage. That you are generally healthy is great, but such things have absolutely no effect on susceptibility to HPV or in how well (or how rapidly) the immune system clears HPV infections.

So it was a mistake for you to be tested -- nohting can be done about asymptomatic HPV infections, and nothing is known to further reduce the already very low risk that such an infection will ever cause an important health problem. And as noted above, HPV testing undoubtedly misses many infections, so a negative result isn't necessarily reassuring. Therefore, why test?

However, now that you have done it and have the positive result, it would make sense for you to see a doctor experienced in anal and rectal HPV infections, such as a proctologist or colorectal surgeon. (Your PCP probably can refer you to someone.) Such a provider would probably examine you closely, including anoscopy or proctoscopy (to look inside). If nothing abnormal is found, which is what you should expect, perhaps another examination or two over the next couple of years.

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

HHH, MD
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35 months ago
If it's unnecessary, then why is Merck proposing to inoculate every child in the world, boy or girl? Being consistent, i hope you are calling all women who get paps anxious and paranoid too. Mainstream media is selling the fear hard on HPV 16,18, so I guess I'm a sucker for biting.    When u hear such fact that a large percentage od throat and anal tumors are HPV 16,18, and others, related, one does wonder. Yes, stikl statistically low, but i don't sit and say when it's my time it's my time., I'll schedule a colorectal visit, with a history of crohns in the family it'll be a dual purpose visit. I am 40 now.

Knowing I haven't done anything risky in the last 2 years I should have cleared it. So either on persistent or reoccurring. So how it got into my butt still perplexes me, any more 411 on that?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
We're talking about HPV testing, and I certainly did not imply that HPV immunization ("inoculation") isn't necessary. It's a high priority, and not only by the manufacturer (Merck), but for all public health agencies (like CDC) and some national governments (e.g., Australia). HPV vaccination is one of the most important STD prevention strategies ever developed, and preventing anal cancer is one of the reasons.

That you "should have" cleared it doesn't imply anything unusual or abnormal about your immune system and does not imply any elevated risk of a bad outcome. And if you read and understood my original comments, you also understand you may not have anal HPV at all. And I have also given reasons why "how it got into my butt" shouldn't be perplexing.
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