[Question #514] HPV16 questions
103 months ago
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Edward W. Hook M.D.
103 months ago
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Welcome to the Forum. we get more questions about HPV and its significance than we do about any other STI, by far. I can understand that, the idea of a widespread STI which causes cancer is scary, particularly when you start to worry about your partner. I hope that my replies, reinforcing what your doctor has already told you will help.
HPV is not only the strain of HPV that causes most gynecological cancer but it is also the most common HPV. Women with a single sex partner acquire the virus at a rate of 10-15% per year after starting to have sex. Most of these infections clear with time and only a small fraction of 1% go on to cause cancer. Clearance occurs more slowly in older groups of women (sorry, at least in the HPV world, you fall into this group) s.o I am not overly worried that your infection will not clear. Further, you have a doctor who is doing just what needs to be done, watching closely for signs of progression which, in the unlikely circumstance that they occur, can be reliably treated.
You are good to be concerned about your husband but this is not the time to let this infection interfere with your sex life. He has, without doubt been exposed and is at far lower risk for development of cancer or pre-cancerous problems than you are and as I said about, your risk in tiny. As for oral sex, here is something my colleague Dr. Handsfield wrote recently which I think is right on target- "... oral HPV. On average, at any point in time, it's about a quarter as common as genital HPV. That's a good news/bad news scenario: not as common as genital, but frequent enough that a very high proportion of sexually active people (probably over half) get oral HPV at one time or another. Second, oral HPV is probably not acquired only by oral sex. In the largest US national study of oral HPV, its presence was correlated with no. of lifetime sex partners, but not with frequency of oral sex. So it is likely that oral HPV often (usually?) is acquired by less direct exposure, such as auto-transfer from one's own genital infection, and perhaps because sexual fluids get spread around quite a bit and can easly get into the oral cavity without oral sex. (Sex is inherently sloppy, right?) Third, a higher proportion of oral HPV infections, compared with genital, cause no symptoms and no disease; and almost all infections are cleared by the immune system. Fourth, transmission of HPV from oral infection to partners appears to be uncommon. While oral sex may account for a few genital infections it partners, it is far less likely than genital to genital transmission." I agree and see no reason for you to worry about sex, oral or otherwise with your husband.
Finally. many HPV infections are what is called "multicentric" and cells from your cervix regularly contact other parts of the body. Those areas however need not be tested for HPV- just keep doing what you are doing.
I hope these comments are helpful. EWH
103 months ago
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Edward W. Hook M.D.
103 months ago
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Yes, I did mean to say that HPV 16 is the most common strain of HPV. Most people acquire several types of HPV during their lives. Among them, HPV 16 is more likely than others to persist as well. Certainly infections which persist are more likely to evolve into cancers but even then, the percentage which go on to cancer is quite low.
Regarding contact with HPV infected cells, this could occur even in the absence of sex. EWH
103 months ago
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Edward W. Hook M.D.
103 months ago
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Your takeaway is on target, good job.
Regarding HPV 16 and dysplasia, most persons with HPV 16 do NOT have dysplasia and, even when dysplasia is present, this most often resolves with time. It does not trouble me that your PAP smears have been negative. While any single PAP might miss dysplasia if present, you have had multiple PAPs AND atwo colposcopies- if there were dysplasia present, it would have been detected.
I'm pleased you found my comments helpful. The internet is a wonderful source of general information but it also can all too often be misleading and a bit overly dramatic. Stick with your doctor and try to keep off the internet. EWH