HPV transmission

[hpvconcern]

Hi Doc,
Thanks for taking my question.
A couple weeks ago, my girlfriend of 6 years just told me she had her first abnormal pap of her life and the nurse told her it was from high risk HPV. By the way, we are both 32 years old.

We have both been faithful to eachother except I made a dumb mistake of receiving oral sex from a stripper about 8 months ago. After that mistake, we had not had sex for 5 months. 4 months after the mistake, I got tested for all common stds and all came up negative.

1) Which is more likely, she had a dormant hpv infection that finally showed up on a pap or I got hpv from receiving oral sex, it did'nt go away in 5 months and I infected her?  Either way, she is going to follow up on this, but I was just wondering how much more awful I should feel.
2) If I did receive hpv from oral, I believe that is not a normal occurence. Which makes me worry greatly about all the other stds that I have tested for. I assume 4 months testing was ok for all? Should I follow up on any specifically?
3) Are there any hpv symptoms in men? In the last 5 months, I have been diagnosed with an enlarged prostate and my right ventricle to my heart is enlarged. Other random things I have noticed is a recurrent bout of some kind of jock itch on my inner thighs as well as a yellow/white coating on my tongue. Are any of these relevant to hpv or stds?
4) Is there anything further you recommend?

[SkaterDave]

Hello Dr. Hook, sorry to bust in on this thread but I and some others have been active on the HPV forum for a good while and recently there's been a couple of doomsayer's concerning oral hpv.  Therefore it's been a more or less ongoing topic.  I was wondering what you thought of this guy's recent post concerning oral HPV:   torsten47  at the thread: http://www.medhelp.org/posts/Human-Papillomavirus-HPV/Oral-cancer-and-HPV--IM-SCARED/show/1526048

Hope this isn't uncool to jump in here.  Thanks

[Edward W Hook, MD]

Welcome to our Forum. I'll try to help.  Your sex partner has been told she has HPV and this concerns you.  It should not.  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.  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.   When persons become aware of HPV infection, either in themselves or a partner, one of the first questions to come up is where did this come from and how long have I had it.  Unfortunately there are rarely good answers.  HPV can be manifest, particularly as an abnormal PAP smear years after it was acquired.  As for manifestations of infection, 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 before they cause serious problems.  For men there is far less risk of any sort.  With this as background, let's address your questions:

1.  Your risk for HPV form receipt of oral sex is quite low. On the other hand, we know that about half of women, even those with single sex partners, have HPV within two years of becoming sexually active.  I would not feel awful about her problem but I would urge you to be as supportive as possible.

2.  there are no recommended tests for HPV in men.  On the other hand, most typical STD test are excellent. I would suggest you believe the results.  4 month testing should be quite reliable.  I would believe your test results.

3.  See above.  Other than warts, HPV causes few symptoms in men, as is the case with women.  None of the things you mention (jock itch, enlarged right ventricle, prostate enlargement are typical HPV-related problems.

4.  Nothing, other than as mentioned above.

There is additional excellent information available at the American Social Health Association web site.  You might take a look.  (Disclosure. Dr. Handsfield is and I was a  member of the American Social Health Association Board of Directors.)


I hope these comments are helpful.  EWH