STDs Expert Forum
HPV Clarification
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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 Clarification

Hi there,

I have a few clarification questions with regards to genital warts. Here goes: -

1. can someone who already has genital warts on their genital area also simultaneously have genital warts in the mouth?

2. the chances of of contracting genital warts from just brief (2-3mins) oral exposure (passive receiver)? Im a man who received oral from a sex worker.

3. if someone has genital warts on their genitals but not in their mouth, but they gave you oral sex, can you still
get it on your genitals even if there was no direct skin to skin contact with the other persons genitals, only their mouth?

4. I have read that genital warts can even spread with skin to skin contact. Can just general hand shaking and gentle rubbing with someone on a non-affected area of their skin like their hands or arms transfer the HPV or is that once you have it in your body that it will be all over your skin surface?

5. is there anyone out there who is actually working on a vaccine to totally cure the HPV virus? will there ever be one?

I think thats it.

Regards

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Welcome back to our Forum.  I see you are still working through your concerns related to the oral exposure you had about a month ago and note that you have been working through things STD by STD, first with me and now, more recently on the International Forum before returning here.  Let me give you a summary statement and then work through your questions one by one.  

The risk for getting HPV infection from receipt of a single episode of oral sex is very, very low.  We do know that HPV can infect the oral cavity and that in some people warts.  There is an association of oral HPV with oral and laryngeal cancer but this association describes an association for a very rare disease among the very, very many people who perform and receive oral sex and in which other factors such as smoking play a very strong contributing role.  The science behind our understanding of oral HPV is relatively new and still being worked out but as it impacts your situation is just not something to worry about.  

In general, 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.  There are over 100 different types of HPV and virtually everyone will be infected with some of them over the course of their lives.  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.  As I said above, while less is known about oral HPV it is a far less important problem that genital infections.  With this as background, let's address your questions:

1.  This is not known but is probably not common.  HPV infections can occur in more than one location.  Different types of HPV seem to preferentially infect different sites. Thus the type of HPV that causes genital infections do not cause infection of the hands or feet.  

2.  Very, very low.

3.  No, HPV is spread through DIRECT contact.  thus the sort of indirect contact you describe would not put you at risk.

4.  No.  Probably because of the tendency of different types of HPV to "prefer" different tissues, this does not happen. Otherwise most people would be covered by genital warts, wouldn't they.

5.  The current vaccines are highly effective for prevention of HPV but are not curative.  Vaccine research continues however so we can hope that something will be forthcoming.  

EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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