Hpv Questions

Dear doctor

My girlfriend was diagnosed with a abnormal pap in Nov 05 and was later tested for HPV and was found to have the high risk type so i assume i have it to neither of us have any visible signs of warts.
She had a coloscopy done and was told to come back in six months
She recently went back and once again her pap came back abnormal and she is due to have another coloscopy done.
I have a couple of questions is it normal to have this go on this long and is there anything else we could do to help her? or will it just take care of itself, i read on the net about using condoms again may help this but that didnt make much sense to me.

My second question is regarding oral sex and the worry we both have of contracting oral HPV or warts, we have had unprotected oral sex before the we found out about the hpv.  Seeing we have the high risk type is there a risk of developing warts or more of developing cancer later on the information on the net  is all over the place on this

Thankyou again for all the advice and help you give to all of us

[H. Hunter Handsfield, M.D.]

Thanks for the thanks about the forum.

It is perfectly normal for this to continue this long.  The average time to spontaneous cure of cervical HPV is 6-18 months, depending on the specific HPV type (longer with types 16 and 18, for example).  However, this doesn't mean that your (presumed) infection is still there.  In general, I do not recommnend condoms in couples like you.  Most likely you already have been infected, and may have already resolved your infection (and if so, resistant to catching the same strain again).  In any case, condoms won't make any difference at this point, either in your health or your partner's.

The information on the net is "all over the place" because there are no conclusive data--so there is no data-based brake on personal judgments and even wild guesses (and scare stories).  (Also, that's just the nature of internet-based health information, even when good data are available).  The best summary of the available information is that oral HPV infection can occur, but overt warts are uncommon, even in couples in which one or both persons has genital warts.  However, it is uncertain whether absence of warts is because genital HPV types often don't infect the mouth at all, or whether infection is common but warts usually don't develop.

Even less is known about the non-wart-causing HPV types.  Most likely some infections are transmitted, however.  Not to frighten you, but the frequency of oral and throat cancers has been rising in the past couple of decades, and most of those tumors are due to the GENITAL HPV types, like HPV 16, 18, and others.  This suggests a possible link with oral sex.  However, the rates still are very low, only 15-20,000 cases per year in the entire country.  Given the frequency of oral sex and genital HPV, this is good evidence that the risk is tiny for any single person.  And anyway, a link with oral sex has not been proved (or even studied).

In any case, since you and your partner had already had oral (and genital) sex before her HPV infection was diagnosed (just like most couples with HPV), there is no point in stopping now, just as there is no point in using condoms.

But keep your antennas up for more information in future years--while also treating most web-based information with healthy skeptcicism.

Good luck-- HHH, MD