HPV high risk

[Carl747]

Dear Dr. HHH, I have questions concerning high risk HPV. My wife was tested positive for HPV high risk 7 months ago. Her PAP however was normal. Her gyn suggested a checkup for me, so they also tested me positive for HPV high risk. We informed us about HPV very thoroughly and came to the conclusion that following the advice of our doctors the risk for cancer will be virtually zero for both of us. So we did rest easy. Now we had the recommended checkups after 6 months and the result is the same: HPV high risk for both of us, her PAP normal. We both had a long talk to our doctors who reassured us that everything will be fine, we just need to come to the next checkups in 6 months. I feel kind of helpless in the face of being told just to sit and wait. So my questions:  
1) Is there nothing we can/should do in the meantime?
2) Is this 6 months interval for checkups a virtual guarantee that no cancer will develop in the meantime?
3) If something bad would develop in me would it be obvious?
At the moment my thoughts are fixated on this subject. So I would be pleased to hear that I can let it go for the next months without being scared or alternatively to know what would be an appropriate strategy to manage it. I feel that this "sit and wait strategy" drives me crazy.
Thanks for your help,
Carl

[Edward W Hook, MD]

No risk of transmission by your fingers.  No reason for worry or anal testing.  EWH

[Carl747]

Dear Dr. Hook, one last question. Our sexual practices involve anal finger play. I wonder if there is a risk of transmitting the genital infection to the anus. Shall we have anal smears/examinations/HPV-tests? If so, is it fine to include that in the next checkup in 6 months or shall we have it done earlier?

Thank you,
Carl

[Edward W Hook, MD]

Thank you.  Glad you came to this conclusion as well.  Take care.  EWH

[Carl747]

I made some more homework on HPV and its risk by rereading medhelps archives and the information provided by ASHA. With considering the STATISTICAL risk of HPV infections I could really calm our worries completely. So for the many others who are scared of HPV this might be educational: 1) A maximum of 1% of all HPV-infections progresses to cancer in women (men far less). 2) Regular checkups and perhaps treatment lowers that figure to virtually zero. Now please compare: Every second smoker will die from his addiction. So really put things in perspective (it really helped us). Recommendations: 1) If you smoke, definitely give it up. 2) DO ABSOLUTELY NOT WORRY about HPV, but 3) Strictly stick to your doctors and follow their advice.

...and everything will be well!

Happy easter to everyone,
Carl

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I understand your concern and wish I could give you a better of more definitive answer.  I must also say that I totally agree with your doctors' "wait and see" approach.  It is important to remember that nearly everyone gets high risk HPV at some time in their lives and that in nearly all of them, the infection goes away by itself, causing no complications or problems who are infected.   In general neither Dr. Handsfield nor I suggest testing of males at all.  The fact that infection is present or not is not known to impact management of men in relationships with infected partners.  On the other hand, among women, know that one is infected provides a woman with the opportunity to be followed to make sure that the things we are trying to avoid (cancers and pre-cancerous lesions) can be looked for.  In a recent study (published this week) follow-up of women found to have high risk HPV protected better than PAP smears alone.

Having said this, let me comment on your specific questions:

1. No.  Try not to worry, there really is no reason to.
2. Cancers in women develop over a period of years or more.  Evaluation at six month intervals is about the right interval.  Remember, high risk HPV does not go straight to cancer but progresses (slowly) through a predictive series of pre-cancerous lesions.
3. Your chances of having "something bad" (a cancer or precancerous lesion) are miniscule.  You need not be concerned unless you notice a skin abnormality which persist.  Should you note something, it is not an emergency but something that can be evaluated and taken care of over several weeks or even months.


For further information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA)..

Hope this helps.  EWH