Positive high risk HPV

[mark670]

Hi Doctor,

I went for a checkup few days ago after noticing small wart inside the tip of my pines. After screening the results came back positive for HPV 16 and 6. I have been in serious relationship in the past few months but was with multiple partners in the past. My fiance is around 11 weeks pregnant. I have not seen her for about 10 weeks as I'm working abroad. I understand that she is probably HPV positive as well, according to the Doctor, I was probably infected with the HPV for more than 6 months. He gave me cream treatment for a month, 3x a week. also shot of vaccine and scheduled one for in a month and another on the 4th month.

Doctor told me that I will probably remain HPV positive for about 2 years.

How should I live my live for the next 24 months with my fiance. I won't see here until late Dec in about 7 weeks.
does that mean that I shouldn't have any sex intercourse until 24 months after negative test?

Also, she is now pregnant and trying not to worry her too much but not sure what to tell as I don't want to put her and the baby at risk.

I'm currently working in Asia

any advice please. thanks    

[H. Hunter Handsfield, M.D.]

Sorry, I forgot you had already started on the vaccine.  Since you have started, I recommend you continue and have the second and third doses.

[mark670]

Thanks Dr.

This will be my last question:

So, it's not necessary for me  to get the two remaining vaccine scheduled on the 30th day and 4th month? and the infection should probably go away within the next 24 months?

[H. Hunter Handsfield, M.D.]

HPV never causes sore throat.  Oral HPV is not nearly as risky as all the media attention would imply.  You are at minimal risk of any serious health problem, even if you have an oral infection.  Don't worry about it.

The HPV vaccine prevents future infection, with types covered by the vaccine -- if you haven't already been infected.  It has no effect on infection already present, and will not protect your fiance in any way.

You already have two of the 4 types covered by the vaccine, and given your sexual exposures, it is likely you have had the other two as well.  I suggest you save your money (about $500).

[mark670]

Hi Dr. one more question please

I have had minor to mild sore throat for the past 2 weeks, could that be a risk of throat HPV as well? I'm currently working in a small town far from the doctor I have seen and won't be able to see him in about 3 weeks. Should I go for some kind of urgent Throat screening if it could be related to HPV?

Also, will the vaccine shots help clear up the infection in the future and reduce the risk of exposure to my fiance?

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

Given your sexual lifestyle (based on my brief scan of some of your past MedHelp threads), it is expected that you would have genital HPV -- you probably have had several infections over the years, and at present you are infected with two of the most common types:  HPV-16 is almost the most common type overall, and HPV-6 is one of the two usual causes of genital warts.  Even though HPV-16 is designated "high risk", the large majority of HPV-16 infections do not lead to cancer either in infected men or women.  In fact, your HPV test results make absolutely no difference in the treatment you need, or what your fiance requires now or in the future.

It sounds like your doctor is very knowledgeable about HIV; his recommendations and advice are pretty much exactly what we say routinely on this forum.  (Your infection may clear up sooner than 2 years, however.)

You need not make any change in your sex life or sexual practices with your fiance.  As you already understand, she has been repeatedly exposed to your HPV infections; at this time there is no point in avoiding sex or starting to use condoms.  Probably nothing will show up at all.

However, since she is pregnant, and pregnancy suppresses the immune system, there may an increased risk that she will develop warts or even a pap smear abnormality.  And if she has warts at the time she goes into labor, there may be risk of transmitting them to the baby's mouth and throat during delivery (called laryngeal papillomatosis).  This isn't common, but if it happens, it can be serious.  Therefore, her obstetrician needs to be informed of your warts so s/he can be on the lookout during the rest of the pregnancy.  

Having said that, don't be overly worried.  Usually these things turn out well, without any big problem.  But better safe than sorry.

I hope this has been helpful.  Best wishes--  HHH, MD