[Question #6697] HPV positive for hpv-81, 82 68 - surprise

14 months ago
Hi - I am a male 55 years old. My wife and I have been married 29 years.
Before we met, 30+ years ago, wife had HPV genital warts, and they were removed, and she has not had a re-occurance.
Early in our marriage, her PAP smears showed some abnormalities, but for the longest time, perhaps like 20 years or so, 
her tests have been normal, and we have assumed she cleared the virus.

I have never had any symptoms at all.
For the past several years, we have opened up our marriage to other partners. 
Wife has had 2 sexual partners, one of whom she is still seeing. They are "fluid bonded", no condoms, etc. 
I have only had 1 encounter with someone - very brief oral contact (me on her), and mutual use of hands on genitals, and some kissing. 
No other sexual contact.
I decided to do full HPV type testing with a company that has you self collect samples. The use DNA NAAT testing.

To my surprise, I came back postive for the following:
penile HPV-68 (high risk)  AND  HPV-81 (low risk)
anal hpv-82 (high risk)
oral hpv-82 (high risk)

A follow up with a urologist told me that those types are not tested for and there is no way to really confirm if i have them.  Interested in your comments. Are these self collect reliable? Should I be concerned about spreading these to my wife if she doesn't have the types? Is it assumed that all men have HPV and I shouldn't be concerned?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
14 months ago
Welcome to the forum. Thanks for your confidence in our services.

Your story is an excellent lesson in some of the reasons that HPV testing is not recommended for anyone, except a) in connection with pap smear results and b) (much less commonly) when someone has a cancer or precancerous lesion. And especially why testing is not recommended for men without symptoms, according to authoritative guidelines (e.g. CDC, American Cancer Association, state or local health departments, and most of their counterparts in other countries. Negative results DO NOT prove HPV is absent; positive results may be false (no HPV tests are approved for use in males by the US Food and Drug Administration); and neither positive nor negative results indicate either increased or reduced risk of cancer, warts, or other important health outcomes.  

In other words, I agree exactly with your urologist. There is nothing you can do now that will reduce your risk of getting cancer or warts -- but probably neither of these is going to happen. As for your wife, if your results are valid -- i.e. if you really have detectable DNA for those HPV types -- your wife undoubtedly has been repeatedly exposed over the years, and stopping sex now will make no difference. She could even be the source of your infiections.

Not everybody has these particular HPV types, but it is true that almost all men (and women) have had genital area HPV, and once present, past infections can reactivate to a point at which DNA is detectable. It means nothing in terms of health. If you ever develop any sort of skin growth of your penis or anal area, or unhealing sores, of course you should see a doctor -- but that advice goes for everyone, regardless of known HPV infection, past or present.

I hope these comments are helpful. Let me know if anything isn't clear.

14 months ago
Thank you so much for your response Dr. Handsfield!  I regret having the test.     In terms of other future  partners -  it seems odd to tell a  future partner "oh, i have never had a symptom, but i did have a non-approved test that showed some rare HPV types".   My feeling is that it is better to tell all, and discuss, but on the other hand, men are not tested routinely, and it just may cause unnecessary misunderstanding. 
Also - despite my regret - I am thinking of waiting a year and doing this self collect again to see if my body has cleared it, or at least it has gone dormant. 
 Very interested in your thoughts about these items.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
14 months ago
Thanks fot the thanks. I'm glad to have helped so far.

Disclosure of HPV is a dilemma. On one hand, your results may be false; if positive, do not necessarily indicate transmissibility; and if transmitted, the chance a partner will have an important health outcome is low. And anyone sexually active outside a monogamous reltionship -- including the open relationship you have with likely additional partners -- should know that HPV infection is likely; that any one person informs a partner of a current or past infection is stacked up against all the other partners who have HIV but don't know or disclose it. All things considered, why disclose?

That said, many partners would hope and expect to be informed -- either because they don't understand the truths just stated, or because they know but still would have an emotional reaction to the information and might choose tnot to proceed with sex. In other words, personal expecations and desires don't necessarily accord with the science.

What to do? Individual choice. Some persons in your situation would diclose, others would not. I don't see either decisio as wrong. In other words, it's up to you!

I see no need for you to be retested yet again. The odds are you'd be psoitive again, perhaps with other HPV types not detected this time. Certainly I would not do it if somehow I were in your shoes.