[Question #7128] Oral HPV

8 months ago
Hi doctors, so I’m back again and feeling more anxious again. So like I’ve previously said, I had intercourse in July of 2019, from which in April of 2020 I has ASCUS cells in my cervix and an HPV + diagnosis. I don’t have any warts but I forgot to mention one thing, I also had oral sex with that same person which I should mention did not last long, not that I think that makes the situation any better but I’m feeling really scared because what if I have it in my mouth ?? In my throat?? I’m always checking my mouth to see if I have anything wrong & I notices a few bumps at the back of my tongue but I’m pretty sure those are only taste buds. Can yall please provide me with some information. I’m feeling so scared.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Welcome back, but I'm sorry you round it necessary.

You could well have an oral HPV infection. It's quite common -- and, like genital HPV, pretty much unavoidable. Even people who never perform oral sex often acquire oral HPV. Fortunately, just as for genital infection, most cases cause no symptoms, are cleared by the immune system, never cause disease, and are rarely transmitted to partners. In any case, there's no point in "always checking my mouth":  because almost all infections cause no visible abnormality, you're just wasting your time and increasing your own anxiety about it.

You may have read about oral HPV infection leading to throat cancer. However, this is rare, and it's only caused by one HPV type (HPV16) -- which you probably don't have, because it causes more serious pap smear problems than ASCUS.

Please go back and carefully re-read our discussion a month ago (#7038). I spent a lot of effort providing information you should find reassuring. Here is one paragraph from my replies there:

Getting and having genital HPV is normal, expected, and mostly unavoidable, unless someone is willing to go without sex for a lifetime. At least 90% of all persons get it and, as noted above, up to half have active infections at any point in time. The main prevention approach is not to attempt to avoid infection entirely, which is impossible, but to avoid infection with those types most likely to cause disease. That's where vaccination comes in. Have you been vaccinated? If so, you are immune to the 9 HPV types that cause 90% of cancers and 90% of genital warts -- meaning that your current infection is not with one of those types. If you have not been vaccinated, speak with your doctor about it. Vaccination won't have any effect on your current infection, but will markedly lower your chance of getting warts or HPV related cancer in the future.

All of that applies to oral HPV as well as genital infection. Have you looked into HPV immunization?

I hope these comments have helped. Let me know if anything isn't clear.

HHH, MD
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8 months ago
Thank you for your reply. A month ago I was really anxious and your responses really calmed me down but I’m going down the same spiral of anxiety again especially because now I have a boyfriend and I haven’t told him about it yet. Of course we haven’t done anything sexual but I’m just really scared that in the case that I preform oral sex on my partner that I could potentially infect him, with warts or simply with HPV. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
In general, people with HPV should not significantly alter their romantic intentions, sexual lifestyle, sexual practices on account of HPV. It would be reasonable for you to discuss your situation with your partner so he can participate knowledgeably in decisions about the relationship and sexual practices. However, he is at no more risk of HPV from sex with you than any other partner he has had in the past or might have in the future. Note my comments about how frequent HPV is. Probably he has or has had HPV, and will get it again in the future. Sex wtih you, including oral sex, will make no difference in his health risks. Take common sense precautions, but don't let this run (or ruin) your life.

I keep suggesting HPV vaccination and you have said nothing about it. I hope you're looking into it. Your partner could do so as well.
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