STDs Expert Forum
HPV 16
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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 16

Dear Dr.,

my girlfriend had a positive test for a high risk HPV strain. We are together for more than 4 years. With that information I went to a doctor and requested HPV-testing for me. My result is high risk, HPV 16 (swab from penis). The doctor at the lab told me that me and my girlfriend should be checking our privates regularly for abnormalities and that I shall come back in 6 months to retest. He said that the virus is often eliminated by the immune system. Actually I am still shocked by this news. After some reading I am aware that hpv 16 causes cancer. Somehow I feel that I would prefer now to not know about being positive for HPV. But as I have the information I want to do EVERYTHING POSSIBLE to prevent serious future outcome for me and my girl. So I was thinking about to consult another doctor now to get advice on what I can do NOW. So I am asking you for advice on the following questions:

1) Does it make sense to go to another doctor now or is it really safe to go back in 6 months (I feel there must be something I can do in between)?
2) Shall we carefully inspect our privates (as suggested by the doctor) or is it enough to have the controls in 6 months (girlfriend was also told to come back after 6 months)?
3) I have read that tea tree oil can be used against hpv. Any comments on that?
4) I am aware of the very rare cases of penile cancer in men. Our sex play involves frequent anal finger play as well. Shall me and my girlfriend have anal smears/examinations?
5) I am really worrying a lot about this now. With going to the control in 6 months can i just rest assured that there will be no adverse effects of the infection?

Your answer will be highly appreciated.

Best,
Pat
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Directly to the bottom line:  You have no serious health concerns here.  For all practical purposes, the risk is for your partner, since HPV-16 is one of the main causes of cervical cancer.  However, even untreated the vast majority of cervical HPV-16 infections don't progress to cancer; and with proper management (i.e., following her doctor's advice about follow-up visits), there is zero risk of invasive cancer.  And the proporation of infections in men that progress to anything serious is even smaller than in women.  Penile cancer remains an extremely rare condition, even in men with penile HPV-16.  So all is going to be well.  You really shouldn't lose any sleep over this.

Now some more detailed replies.  I'm surprised you find a doctor with access to type-specific HPV testing. No such tests are FDA approved for use in men; the available ones are used primarily for research only.  Your result probably is reliable, but no guarantee.

Sex partners don't "ping pong" HPV back and forth. Your gf undoubtedly already was already infected with HPV-16 and is immune to catching it again. You two are sharing the same virus.  And as your doctor told you, you can expect your infection (and your partner's) go go away. Your immune systems will clear it up.  Typically that takes several months, sometimes up to a couple of years.  Sometimes it takes longer, and if neither you nor your gf had had other sex partners in the past 4 years, then undoubtedly you both have been infected that long.  Still, it eventually will go away.

Now to the specific questions you asked:

1) It sounds like you have a doctor who is very knowledgeable about HPV, based both on what you say he told you and the very fact that he has sought a source for experimental type-specific HPV testing.  I would stick with him and see no reason for a second opinion.  If you notice any wart-like growths or other skin abnormalities of your penis, get it checked out; otherwise 6 months sounds fine to me.

2) Don't be compulsive about checking your genitals.  If something important develops, it will be obvious on casual inspection.

3) Definitely stay away from tea tree oil or anything else.  The only useful treatments are against genital warts, which you don't have (and which HPV type 16 rarely causes anyway) -- and TTO is not among the effective treatments anyway.  Here again, rely on your doctor's advice.

4) Your partner and you don't need to either alter your sex practices or have anal exams for cancer.  Of course if you or she get any sort of growth or sore near the anus, get it checked out. Otherwise don't worry about it.  

5) You can indeed rest easy.  There are many millions of people in the US with new genital HPV-16 infections every year; very few of them have any serious health outcomes.

Bottom line: You and your gf need to follow you doctors' advice, but otherwise don't worry about this. Don't let an impersonal virus, which likely will never harm you, run your life or make you crazy.  All will be well.

Good luck--  HHH, MD
4 Comments
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I forgot to mention: inspite of the positive HPV, my girlfriends papsmear has been normal.
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Even more reason not to be worried.  It probably was a mistake for you to even be tested for HPV.  CDC and other experts specfically recommend against HPV diagnostic tests in the partners of infected persons, precisely because in the absence of symptoms there is nothing to be done about a positive result, exactly as you have learned in your own case.  All things considered, probably you would have been better off not knowing about your HPV-16 infection.  
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Dear Dr. Handsfield, thank you very much for your prompt, detailed, informative and helpful answers. Indeed I feel now that I would prefer to not know about the infection. Your answers help me a lot though to now live my life as if i did not know (I think with that I got your message). Thank you again, your information was a great help and relief for me. Keep up this important work. The forum is a great resource.

Best,
Pat
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H. Hunter Handsfield, M.D.Blank
University of Washington
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