[Question #70] Hpv16

39 months ago
My husband been Dx with cancer of tonsils due to HPV16. I have had Pap smear and Hpv test which proved negative. We have been married 30 years! He was married before!  Perhaps the virus has been dormant to some years. Could the hpv16 be passed onto me with kissing or intercourse? Please advise thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome to Ask the Expert. I'm happy to help. I'm sorry to hear of your husband's diagnosis and I wish him well. As you may already know, throat cancer due to HPV-16 usually responds well to treatment. I hope that's how it goes for your husband.

You have little if anything to worry about in regard to your own health as it relates to your husband's HPV-16 infection. However, a few simple precautions would make sense -- discussed below. You are correct that your husband probably had a dormant HPV-16 infection for many years, apparently oral but perhaps genital as well. By now, you have been repeatedly exposed to it sexually and by kissing, and almost certainly infected yourself -- perhaps all your 30 years together. Indeed, there is a very good chance you were the source of his infection, assuming you had other sex partners before you and he became partners. This can never be known with certainty. However, by now it is almost certain your immune system has controlled the infection and it will never cause you any problem.

Since you have been married 30 years, I assume you are over 50 -- i.e. beyond the age when routine pap smears are recommended. Nevertheless, given this development, you should discuss the situation with your gynecolgist, who may want to examine you and perhaps do a pap smear. And to be extra safe about the possibility of an oral infection, ask him or her (or your primary care provider, or your dentist, to carefully examine your throat. None of these is urgent; any can be done at your next routine medical or dental appointment. The chance you have an active HPV-16 infection, either genital or oral, is extremely small, and the chance of cancer or pre-malignant abnormality smaller still. The vast majority of people with HPV-16, whether genital or oral, never develop cancer or any other abnormality.

There are a few special HPV-16 strains that appear to be especially likely to cause malignancy, and I am aware of a medical journal case report (about to be published) in which penile and vulvar cancer occurred simultaneously in an elderly married couple, due to one of these rare strains. But I stress how uncommon this is:  rare enough to warrant journal publication as a special case! In any case, you do not need testing for HPV-16 (or any HPV infection) itself -- only precautionary exams to be sure you have no genital or oral signs of active infection.

So don't lose sleep over your health. The important thing here is the care and support your husband will need as he deals with his throat cancer.

I hope this has helped. Best wishes--  HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Oops -- in my initial reply, I forgot you've already had a pap smear with HPV testing. Glad to hear it was negative, but not surprised. You can expect the same if and when you have a careful oral examination. Another option for that would be an otolaryngologist (ENT specialist); presumably one is involved in your husband's care and I'm sure he or she would be happy to examine you.---