Oral Transmission - HPV

[HPVcurious9797]

Dear Doctors,

I am writing in hopes you can give me clarification about whether I have contracted HPV. My main concern is that I may have contracted it orally. My timeline is this:

On my 5 or 6th date with a man,I performed unprotected oral sex on him. On our next date he informed me that he has suffered from mild genital warts over the years. Has had minimal symptoms for the past year and 1/2. We refrained from further sexual contact.

I consulted a doctor, she gave me my first Gardasil shot. Continued to date the man and getting to know him w minimal sexual contact since my doctor advised that exposure to the virus could defeat the purposed of the vaccine. Over the course of the next 6 months (while I was getting vaccinated) we had unprotected oral sex 5-6 times. My logic here was that I may already have been exposed to the HPV orally and my doctor told me oral transmission is extremely rare. Had protected intercourse 3-4 times.

After 6 months together, the man broke off the relationship. There were many factors for this; stress of very little sex while waiting for me to complete the vaccine was one of them.  I completed shot 3 of the vaccine 3 weeks after we broke up.. It has been almost a year since our first encounter. It has been 6-7 months since our last encounter. I have no symptoms of HPV and feel fairly confident that I did not contract it. Would you agree that my risk of having the virus is fairly low given that I was vaccinated and that if I was exposed, it was orally? I may see an ENT doctor to be sure, but what do you think?

I want to move forward w my dating life but need to feel that I am doing right by the men I meet in the future - If there is a major chance that I have HPV I will feel obligated to let future partners know -

Thank you for your input -

[H. Hunter Handsfield, M.D.]

Some experts believe that HPV never completely goes away.  Others aren't sure.  What is clear, however, is that almost all HPV infections clear to the point that they do not cause disease and cannot be transmitted to anyone else.  So for practical purposes, they are cured, even if HPV DNA persists in our bodies -- along with many other viruses as well.  Having silent HPV is no different than carrying staph and strep in our noses and on our skin, and having E coli in our intestines.  Sometimes those things cause disease, but mostly they just sit there.

Further, 90% of all of us get genital HPV, and most of us probably have several infections in the course of our sexually active lives.  Therefore, very few sexually active people can honestly reassure a partner they are not contagious.  If every person potentially infected with HPV were to inform their partners of that fact, then every human being would say it to every sex partner for his or her entire life.  Does that sound realistic?

So just mellow out about HPV.  If you have ever had genital sex, it is a good bet you already have been infected.  And you're going to get it again someday.  Getting HPV, both genital and non-genital strains, may not be desirable, but it is normal and expected.  It is wise to be vaccinated for protection against most of the disease-causing strains.  But aside from immunization, the wise sexually active person just gets on with life without worrying about HPV.  I suggest you try to do the same.

[H. Hunter Handsfield, M.D.]

HPV of the mouth is rare.  The types of HPV that cause most genital infections don't survive well in tissues away from the anal or genital area.  Even if you happened to acquire your partner's penile wart virus infection on or near your mouth, you can expect it to remain asymptomatic (i.e., to never cause warts or any other problem) and to go away by itself.

In other words, the odds are you were never infected; and if you were, it probably is gone by now.  There's no point in seeing an ENT doctor or anyone else.  There is no test to show accurately whether or not you have an oral infection.  And as I already suggested, it doesn't matter.

So let it go.  You're fine.  There's no health problem here.

Best wishes--  HHH, MD

[HPVcurious9797]

I really appreciate your answer and your help with this.I do, however,  worry about the concept of "clearing" a virus. Does "clearing" a virus mean that the immune system fights off the virus before it ever becomes active? How could I reassure a partner that I am not asymptomatic and contagious?