[Question #6260] HPV conflicting info
69 months ago
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69 months ago
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69 months ago
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H. Hunter Handsfield, MD
69 months ago
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Welcome to the forum. Thanks for your confidence in our services and your insightful question -- and for reviewing similar ones before posting your own. You posted this question 3 days ago; I was writing my reply when the ASHA server went down. Your question and my reply were lost. You'll hear from the forum administrator in the next day or two, with an offer to refund the extra posting fee. Apologies for the inconvenience.
The differences between your two experts aren't as different as it may seem. Both are correct, depending on perspective. As you probably saw in other threads, in my 4 decades in the STD business, I have never had (or heard of) any patient with genital warts or other evidence of HPV in a patient whose only possible exposure was hand-genital contact, fingering, etc. So if it occurs, it is exceedingly rare, apparently Expert 1's experience and advice. Expert 2 probably is thinking of reports the past several years that HPV DNA can be present under the fingernails or elsewhere on the hands, primarily in people who also have genital HPV infections. This suggests there is at least a theoretical risk of transmssion by hand contact. However, DNA does not necessarily mean living, transmissible virus is present; or if present, it could be in extremely low amounts, perhaps not enough for transmission. (DNA testing is so sensitive it can be misleading, probably detecting amounts that have no possibility of catching hold when passed to another person.) This may explain Expert 2's comment that "it's no big deal", and I doubt s/he has actually observed patients believed to have been infected in this manner. (Or maybe s/he just means that getting genital HPV is no big deal, since it happens to everyone and most cases cause no disease -- which also is true.) My guess is that your two expert contacts would agree with each other and with my comments above.
Thanks for posting the link; I was unaware of the study published in Lancet earlier this year. I have not read the paper in detail (which I will do), but the online summary is exactly concordant with my comments above (which I wrote before following your link and didn't alter afterward!): detection of HPV DNA on hands does not correlate with transmission to partners' genitals, but genital HPV does predict transmission.
To the extent there may be some slight risk from hand-genital contact, it probably would be more likely when genital fluids are used for lubrication, not because of transmissible HPV on hands or fingers. That said, further research may provide more information about all this. But for now, you can consider your recent massage adventure as a no risk event in regard to HPV. Anyway, assuming you're not a virgin, and especially if you have had at least a few genuine sex partners in your life (i.e. not just hand-genital events like this), you can safely assume you have had genital HPV, perhaps several times. And assuming you don't plan life as a celibate hermit, you'll have more HPV exposures and infections -- no matter how carefully you select your sex partners or who they are. Your recent massage event for sure does not materially elevate that risk.
Which leads to the standard, common sense advice about HPV: Get immunized. The standard HPV vaccines are 100% protective against the HPV types covered (9 types in the standard vaccine used in the US, 4 types in some countries). Those types cause the large majority of genital warts, cancer, and pre-cancerous lesions of the cervix, penis, anus, and throat. (I would not necessarily recommend the one vaccine that covers only two common cancer causing types, without wart prevention, still in use in a few contries.)
I hope these comments are helpful. Let me know if anything isn't clear.
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69 months ago
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![]() |
H. Hunter Handsfield, MD
69 months ago
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69 months ago
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69 months ago
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69 months ago
|
69 months ago
|
69 months ago
|
69 months ago
|
![]() |
H. Hunter Handsfield, MD
69 months ago
|