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HPV and Compromised Immune System
I'm a 70-year old man, 50 pounds overweight, with emphysema (quit smoking 15 years ago) and Graves Disease. A few months ago I began dating a 68-year old woman, and recently we have begun talking about becoming sexually intimate (neither of us has been active for 17-18 years). However, she informed me that she has high-risk HPV (both HPV 16 and 18), recently had laser surgery, and in fact, has had that procedure about every two years for the last 15 years. She has serious concerns about our becoming intimate, for fear of giving me these strains of HPV, particularly with my compromised immune system. Since I had TURP surgery back in January, my guess is that most of our intimacy will be mutual masturbation and oral sex, my side of it aided by Cialis or Viagra, though we would like penetrative sex on occasion. I do understand that I will likely get these strains of HPV with any form of intimacy we share, and that's a risk I'm willing to take. The question is, will these strains of HPV be particularly harmful to me, given my compromised immune system (whether I get it orally or via the genitals)? Any general words of advice you can offer, and are there web sites we can browse to find additional information on this? Many thanks for any information you can give us.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
Congratulations on your budding relationship. My advice is to not give your lady's past (and maybe current) HPV infections a second thought, for a whole bunch of reasons. First, there is a good chance she is no longer infectious. Second, you could well have been exposed to and infected with these HPV types in past years, since all sexually active people get genital HPV and types 16 and 18 are among the most common of all types. Third, if you were to become infected, you probably would never know it; most infections, even with the high risk types, never cause symptoms and probably under 1 in 1,000 infections actually lead to cancer. Fourth, if you were doubly unlucky and acquired an HPV infection that caused penile, anal, or throat cancer, it would probably be 5-30 years before it would show up. (Not to dwell on your mortality, but at your age, the chance is you'll die of natural causes long before any HPV-related cancer would show up.) Fifth, penile cancers are easily treated and cured long before the cancer invades or becomes serious. And finally, the sort of modest immune system disorder reflected in Graves disease is not known to increase the risk of HPV related diseases, and your past prostate disease and TURP also wouldn't have any effect.
As for additional information, I can strongly recommend the information about HPV provided by the American Sexual Health Association (www.ashasexualhealth.org) (I'm on ASHA's Board of Directors and you can also find some video information there by me); and CDC (www.cdc.gov/std).
I hope this information is helpful. Best wishes for a romantic, mutually rewarding relationship. Definitely do not let your partner's HPV interfere with it!
HHH, MD
Congratulations on your budding relationship. My advice is to not give your lady's past (and maybe current) HPV infections a second thought, for a whole bunch of reasons. First, there is a good chance she is no longer infectious. Second, you could well have been exposed to and infected with these HPV types in past years, since all sexually active people get genital HPV and types 16 and 18 are among the most common of all types. Third, if you were to become infected, you probably would never know it; most infections, even with the high risk types, never cause symptoms and probably under 1 in 1,000 infections actually lead to cancer. Fourth, if you were doubly unlucky and acquired an HPV infection that caused penile, anal, or throat cancer, it would probably be 5-30 years before it would show up. (Not to dwell on your mortality, but at your age, the chance is you'll die of natural causes long before any HPV-related cancer would show up.) Fifth, penile cancers are easily treated and cured long before the cancer invades or becomes serious. And finally, the sort of modest immune system disorder reflected in Graves disease is not known to increase the risk of HPV related diseases, and your past prostate disease and TURP also wouldn't have any effect.
As for additional information, I can strongly recommend the information about HPV provided by the American Sexual Health Association (www.ashasexualhealth.org) (I'm on ASHA's Board of Directors and you can also find some video information there by me); and CDC (www.cdc.gov/std).
I hope this information is helpful. Best wishes for a romantic, mutually rewarding relationship. Definitely do not let your partner's HPV interfere with it!
HHH, MD
MEDICAL PROFESSIONAL
That's good news. Thanks for the thanks; I'm glad to have helped.
Again, many thanks. My girlfriend and I greatly appreciate the time you've taken to answer our questions, and thanks to your efforts, our concerns are no longer in the way of our moving forward in our relationship.
MEDICAL PROFESSIONAL
I was just guessing that your partner may no longer have an active HPV infection -- but that's purely a guess since I don't know enough about her specific situation, most recent treatment, etc. The normal practice would not usually include repeated DNA testing for HPV itself, but to manage women with abnormal paps only on the basis of cellular abnormalities of the cervix.
Once infected with a particular HPV type that then clears up, people appear to be immune, or at least highly resistant, to new infections with the same type.
The time from acquiring HPV to throat cancer is, if anything, longer than for genital cancers, not shorter. The average age of acquiring oral HPV 16 (the only type associated with throat cancer) is 20-30, but the average age at onset of throat cancer is 50-60. By contrast, most cervical cancer probably occurs within 10 years acquiring HPV. You can do the math.
The issue of throat cancer with HPV isn't all that new; it's been an active area of research for a decade or so. Here are a couple threads about it:
http://www.medhelp.org/posts/STDs/Oral-HPV-Cancer-Risk/show/1512873
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
Once infected with a particular HPV type that then clears up, people appear to be immune, or at least highly resistant, to new infections with the same type.
The time from acquiring HPV to throat cancer is, if anything, longer than for genital cancers, not shorter. The average age of acquiring oral HPV 16 (the only type associated with throat cancer) is 20-30, but the average age at onset of throat cancer is 50-60. By contrast, most cervical cancer probably occurs within 10 years acquiring HPV. You can do the math.
The issue of throat cancer with HPV isn't all that new; it's been an active area of research for a decade or so. Here are a couple threads about it:
http://www.medhelp.org/posts/STDs/Oral-HPV-Cancer-Risk/show/1512873
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
Not quite sure what the protocol is here, but my girlfriend (a retired nurse) has asked me a couple of follow-up questions, based on her personal experiences.
First, regarding your statement that she may no longer be infectious. Our understanding is that HPV infections in general clear the body in 8 -24 months in most cases. Are you saying that she may no longer have the HPV strains that originally caused her abnormal PAP tests, but that the damage done by those strains is possibly the cause of her ongoing abnormal PAP tests, followed by the laser surgery treatments roughly every two years? (Wouldn't the normal practice be to continue testing, year after year (via DNA testing), for those HPV strains once a patient presented initially with complications from those strains?) Too, do strains of HPV remain over periods of time longer than the times normally given for clearing?
Next, regarding your statement that I may have been infected with those strains in the past. Possible, perhaps probable, in fact. But are you then saying that once infected with HPV strain 16 (for example), and it is then cleared by my system, I cannot be infected by that particular strain again (though I could be infected by any of the other strains out there)?
She also expressed concern about potential different growth rates between genital HPV-caused cancers and oral HPV-caused cancers due to the different environments each matures in (the mouth being a more moist environment). Are you aware of any research in the area of oral HPV-caused cancers? This does seem to be a relatively new area of concern.
Again, Thank You.
First, regarding your statement that she may no longer be infectious. Our understanding is that HPV infections in general clear the body in 8 -24 months in most cases. Are you saying that she may no longer have the HPV strains that originally caused her abnormal PAP tests, but that the damage done by those strains is possibly the cause of her ongoing abnormal PAP tests, followed by the laser surgery treatments roughly every two years? (Wouldn't the normal practice be to continue testing, year after year (via DNA testing), for those HPV strains once a patient presented initially with complications from those strains?) Too, do strains of HPV remain over periods of time longer than the times normally given for clearing?
Next, regarding your statement that I may have been infected with those strains in the past. Possible, perhaps probable, in fact. But are you then saying that once infected with HPV strain 16 (for example), and it is then cleared by my system, I cannot be infected by that particular strain again (though I could be infected by any of the other strains out there)?
She also expressed concern about potential different growth rates between genital HPV-caused cancers and oral HPV-caused cancers due to the different environments each matures in (the mouth being a more moist environment). Are you aware of any research in the area of oral HPV-caused cancers? This does seem to be a relatively new area of concern.
Again, Thank You.
Many thanks for your quick response, Doctor.
You are reading content posted in the STDs Forum
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