STDs Expert Forum
HPV Genotype 31
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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 Genotype 31

Dear Doctor,

I am 33 yrs old.  I have been diagnosed with HPV Genotype 31 (Oncogenic – High risk) last month.  I’ve researched the web, talked to my doctor, and talked to the help line at the CDC however still require further clarification regarding this infection.

I have the following questions:

General

1. Now that I have been infected with HPV 31, am I infected for life, or will my immune system be able to clear the infection on its own.  If my immune system can clear the infection, how long would approximately take?
2. What are the risks of me developing penile cancer?  Is there anything that I can do to reduce the risk of cancer developing in the future?

Transmission

3. Can transmission occur by genitals rubbing (external contact)?
4. Can genital strain HPV be transmitted through oral sex resulting in an oral HPV infection?  I understand that HPV 16 infects both genitals and the mouth; is it the same case for HPV 31?
5. If in the future I decide to have children, my partner will be infected with HPV.  Once infected how often will she need to go for PAP smears?  Can any complications arise during pregnancy?  Can the virus be transmitted to the infant during birth should there lesions in the birth canal?
6. Is it possible for my partner’s immune system to clear the virus over time, or will she undoubtedly develop precancerous lesions and/or cervical cancer in the future.

Vaccination (Gardasil)

7. I have read that vaccination for men and boys was approved by the U.S. Food and Drug Administration in October 2009.  Though I am already infected with HPV 31 would it be prudent for me (and future partner) to be vaccinated against HPV 16, 18, 6, & 11 at this point?
8. I have read that the ideal vaccination program is implemented for males and females during adolescence; how effective would the vaccine be for me (and partner) as I am already 33 yrs old?

Regards and thank you in advance for your assistance.
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Welcome to the forum.  I'll try to help.

Interesting that you were tested for HPV, including determination of virus type.  Can you say more about it?  Why were you tested?  What sort of lab did you use?  Routine HPV testing is not recommended, especially in men.

There are no available data that distinguish transmission issues, resolution, cure, etc for individual virus types.  Somewhat stronger data are available for HPV 16, 18, 6, and 11.  There are no reasons to believe things would be materially different for HPV-31 versus other high risk types, but it isn't really known.

Questions essentially identical to yours have been asked many times.  Here is a thread that goes into detail about HPV clearance, cure, long term risks, etc.  In it, my response also refers to still other threads that may be helpful:  http://www.medhelp.org/posts/STDs/HPV-AND-CLEARANCE/show/1137032

Main concepts you need to understand:  Getting genital HPV, including one or more high risk types, is a normal, unavoidable aspect of human sex.  The vast majority of infections clear up, at least to a point they cannot be detected, and they rarely recur later.  There probably is no significant risk to your health, or to that of any current or future sex partners, from your HPV-31 infection.  This is why routine testing isn't recommended:  it makes no difference in how people should behave or what their medical risks are, and nothing can be done about it anyway.  To your specific questions:

1) HPV may or may not persist for life, but falmost all cases are cleared by the immune system and can be considered cured.  See the thread linked above.  

2) Very low risk of penile cancer.  And although the concept of penile cancer is alarming, most cases start very small and are easily detected and cured, without dramatic treatments.  For example, penile amputation is almost never necessary.

3) Transmission usually requires insertive sex.  There is theoretical but rarely any practical risk for genital rubbing, hand-genital contact, etc.

4) HPV doesn't take well in the oral cavity, and the virus usually connot be found in the sex partners of people with genital HPV, even if they frequently enjoy oral sex.  However, HPV oral infections are not rare. As for all HPV anywhere on the body, most oral infections are harmless, remain asymptomatic, and are cleared by the immune system.

5) Your future partner(s) will not necessarily be infected with your HPV strain; probably not, since your infection will clear up.  They might well have HPV, however, acquired from past partners, since over 80% of sexually active people are infected at one time or another.  If overt warts are present during vaginal therapy, HPV can infect the baby's throat, apotentially serious problem but rare.  Otherwise, HPV is rarely an important health issue for either pregnant women or their babies.

6) The vast majority of infections in women are cleared without ever causing cancer or precancerous lesions; that includes infection with the high-risk HPV types.

7,8) At your age, the vaccine is not known to provide benefit.  The main reason is that by age 26, most people have already been infected with some if not all the types covered by the vaccines.  However, it would not be harmful in anyway -- except to your pocketbook.  Because it isn't approved at your age, your medical insurance probably won't cover it.

Bottom line:  Probably you shouldn't have been tested.  The positive result should have no important impact on your health in the future or that of your sex partner(s).

Regards--  HHH, MD
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