STDs Expert Forum
HPV
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HPV

Dear Doctor,

My girlfriend has been diagnosed to have HPV type 16. She does not have any lesions or anything related to cervical cancer as her doctor told her. Last week i was also tested with microchip test (or microarray) and waiting for the results this week.
Her doctor told her to have gardasil(the name here is SILGRAD but i think its the same thing) injections for both of us and prescribe her some immune support pills.

1- Does the injection works for us if we already have hpv 16 (we are both 32 years old)? Does it work on men too at this age?  
2- How are my chances to have oral, neck, head or penile cancer out of these? (we had oral sex for both) Does it take years? What can i do to fallow the infection and protect my self in the future? For example should i go for routine cancer check ups from now on?
3- What are the chances for us that the infection clears itself ? If it persists, does it mean that we will have cancer for sure?
4- How can i know as a man that the hpv cleared itself? is this microarray test reliable?
5- Should i be tested for oral hpv? If positive, is there anything to do?

Thank you so much for the help.






300980_tn?1194933000
Welcome to our Forum. You are asking questions that we get quite often.  I'll be glad to answer them.  In addition, I would suggest you take a look at the excellent information about HPV and the vaccine available at the ASHA (American Sexual Health Association) web site (disclosure- both Dr. Handsfield and are or have been on the ASHA Board of Directors).

Your sex partner has been told she has HPV and this concerns you.  It should not.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  For men there is far less risk of any sort.  With this as background, let's address your questions

1- Does the injection works for us if we already have hpv 16 (we are both 32 years old)? Does it work on men too at this age?  
Yes, the vaccine works for older persons as well as younger ones.  The age recommendations for the  vaccine reflect the groups at highest risk for all STIs, including HPV.  I recommend it for all of my patients who can afford it (the total cost is about $400-$500) if they have any concerns about HPV.  While it has no proven benefit for existing infections it would prove to prevent future infections.

2- How are my chances to have oral, neck, head or penile cancer out of these? (we had oral sex for both) Does it take years? What can i do to fallow the infection and protect my self in the future? For example should i go for routine cancer check ups from now on?
The topic of oral infections is a topic of much research at present however most experts agree that the risk for both infection and, among those who are infected, the risk for cancer is very, very low.  When cancers do form, they take years to develop and dentists now routinely examine their patients for signs of oral cancer.  Other than for routine dental care, I would not worry.

I have also pasted in a link to earlier comments by Dr. Handsfield on this subject:
http://www.medhelp.org/posts/STDs/HPV-and-oral-sex/show/1515473

http://www.medhelp.org/posts/STDs/Oral-HPV-Cancer-Risk/show/1512873


3- What are the chances for us that the infection clears itself ? If it persists, does it mean that we will have cancer for sure?
As your partner is over 30, while the chances remain high that her infection will clear by itself, they are slightly lower than for younger women.  Her risk for cancer is very low unless her PAP smear is abnormal.  She should discuss management with her doctor.

4- How can i know as a man that the hpv cleared itself? is this microarray test reliable?
HPV testing for men is not recommended.  If your test were positive, and if there are no visible lesions, there would be no reason for treatment or even re-testing.  Please see the comments above.

5- Should i be tested for oral hpv? If positive, is there anything to do?
No, you should not be tested and if you were and no lesions were present, there would be nothing to do about it anyway.

I hope these comments are helpful.  Given the length of this response, my ability to answer follow-up questions, if any, will be quite limited.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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