What to do about HPV-51 infection?

March 16, 2008 8:37 AM

My ex has been diagnosed with HPV-51. She probably passed it to me. Cervarix and Gardasil do not protect against this strain. What should I do about my current relationship?

My ex was tested positive for HPV using the Digene Hybrid Capture II HPV DNA test. She took this test after we broke up, and, according to her, before she engaged in sexual intercourse with any one else. She subsequently went for a HPV PCR test, and the results showed that she has HPV-51.

Because the ex-relationship I had with my ex was sexually active over a period of more than five years, and assuming she did not contract her current HPV infection from sleeping with anyone after we broke up and before she got the Digene test, I think it is almost certain that I contracted HPV-51 from her.

It has been a few months less than two years since I had any sexual contact with the ex in question. I am now in a relationship with someone else. This is a serious relationship, not a fling, and I treat relationships as things you enter into with a view to seeing if the two of you would be suitable for marriage. My current girlfriend has tested negative for HPV under the Digene HPV DNA test. Cervarix and Gardasil, the only two HPV vaccines commercially available (to my knowledge), do not protect against HPV-51.

Obviously I am hoping that my system either has or will soon clear the HPV-51 infection. But given the lack of any commercially available male HPV tests, it would be difficult to verify this. This is an avenue that I still hope to explore, however.

Assuming that I cannot find a way to tell whether I still have HPV-51 or not, what should I do? Should I end the relationship even though I love my girlfriend very much because I don't want to expose her to the risk of contracting HPV? Does this mean that I can't ever marry anyone else, unless they happen to have the same strain of HPV that I do?

As far as my girlfriend is concerned: she isn't sure what I should do either. Any advice would be much appreciated. If you have additional questions or wish to contact me directly, use [e-mail]. Thanks in advance.

posted by anonymous to health & fitness (23 comments total)

What? No. Chill. Disclose and chill.
posted by Phred182 at 8:55 AM on March 16, 2008

Should I end the relationship even though I love my girlfriend very much because I don't want to expose her to the risk of contracting HPV? Does this mean that I can't ever marry anyone else, unless they happen to have the same strain of HPV that I do?

I would think that you could use a condom. I would tell your girlfriend to make an appointment with her OB-GYN and go together, explain the situation, and talk about your concerns.
posted by red_lotus at 9:04 AM on March 16, 2008

Given the prevalence--or near-ubiquity--of the various HPV strains, which I am sure you have researched, ending the relationship over this would be like turning in your driver's license because you have toxoplasma gondii.

Once you have each satisfied your disclosure requirements, remain monogamous and monitor regularly: pap smears for her, the possibly useless "vinegar test" for you (if you're male).
posted by Phred182 at 9:05 AM on March 16, 2008 [1 favorite]

People really seem to be freaking out about HPV these days. Here in Canada, we don't even bother doing HPV DNA tests regularly - and we never do it as a screening test. There really is no point as about 75% of people contract HPV at some point in their lifetime (30% prevalence at any point in time). Usually the immune system just clears it. If not, it can cause cervical dysplasia or genital warts. The important thing (for women) is just to get regular pap tests which I assume your girlfriend is doing already. Pap tests do not test for HPV. They do, however, test for cervical dysplasia or cancer which is the only really serious consequence from HPV. The strains most likely to cause cervical cancer are HPV-16 and 18.
posted by madokachan at 9:31 AM on March 16, 2008

End the relationship? Wow. Even Magic Johnson has unprotected (pro-creative) sex with his wife, and by all accounts she's unaffected.
"Cookie and I will probably have another one ourselves. The medical community is making great progress with HIV. It's unbelievable. I'm still healthy and strong. God has really blessed us. [source]"
Not to make light of your situation, and you've done the right thing by disclosing it to your partner.
But I don't think this damns you to a life of celibacy.
posted by dawson at 9:40 AM on March 16, 2008

IANAD, but I used to work at a family planning/gyno clinic. That being said, HPV can be transmitted through condoms (the virus is just that small), which is why upwards of 75% of women are infected. Upon a cursory google search, it doesn't look like 51 is a high-risk strain. I think disclosure is a good practice, but really I think this is a non-issue, as long as the women you are sleeping with are getting regular pap smears (once a year). As stated above, this is the best screening device for the development of abnormal cells on the cervix. With regular pap smears, the abnormal cells will be caught early & can be treated and there's almost a 0% chance of cervical cancer developing (that is, if she were to have a high-risk strain). And, by the way, cervical cancer has one of the best recovery/survival rates of all the cancers.
posted by crunchtopmuffin at 10:20 AM on March 16, 2008 [1 favorite]

Yeah, uh, freaking out and planning to break up because you have HPV is like deciding to become a hermit because you caught a cold one year. Seriously; tell your girlfriend, but keep in mind that 75% of sexually active people will likely acquire a strain of HPV during their lifetime. Do you think 75% of people should go celibate?

You're really, really overreacting, dude.
posted by Justinian at 10:33 AM on March 16, 2008

uh, if you're really concerned why not suggest your SO get the vaccine? Assuming she hasn't already contracted HPV - which she probably has.
posted by Justinian at 10:34 AM on March 16, 2008

I would think that you could use a condom.

HPV is transmitted through the skin, so this won't work. But, look, HPV is a very common infection that a lot of people carry and usually it causes no harm. You're not going to be able to never again have a relationship with someone because of this, so just tell your current girlfriend, have her talk to her doctor about the risks, and make sure that future partners are vigilant about pap smears. This is not a relationship-ender.
posted by Dasein at 10:35 AM on March 16, 2008

Um. Wow. Everybody has HPV these days. Seriously. Certainly just about every girl I know has it or had it at one point, and we're only in our early 20s. When I had it (I don't know what strain it was), it cleared up within a couple of months. It almost never affects guys in any way at all, and girls just have to make sure to be tested regularly and get a colposcopy when need be.

You should also know that in a monogamous relationship where both partners have the same strain of HPV, they will very likely both become immune to that strain eventually. Personally I see no reason to end your relationship. If she doesn't get HPV from you, she'll get it from somebody else. In fact, she could already have it and not know. Assuming she is relatively young and relatively healthy, her body will almost certainly rid itself of it in time.

Relax!
posted by timory at 10:38 AM on March 16, 2008 [1 favorite]

There are so many strains of HPV that it is possible that you have one or more. It is also possible (probable) that your current girlfriend has one or more. A study released not long ago stated that one in four teenage girls has an STD. To some this seems far-fetched, but when you factor in the 100 kinds of HPV, it seems a little more likely. Most people can carry some form of HPV without symptoms, it is mainly dangerous to women because it is incurable and some forms can cause cervical cancer among other problems.

HPV doesn't "clear up" is it a virus that may stay dormant for long periods of time, but always resurfaces at some point. It isn't necessarily something to panic about, but it can be life-threatening to women if they don't get frequent pap smears to monitor any changes occuring in their cervical tissue.

That said, you should be honest with your current girlfriend, if I found out down the road that my partner (whom I loved and trusted was dishonest about something that could (no matter how small the chance) negatively affect my health, that would be a dealbreaker.
posted by nikksioux at 11:58 AM on March 16, 2008

It's wonderful that you're treating HPV as a "real" STD and trying to do the right thing. But nthing others that you are way overreacting. Make sure that your girlfriend knows. She (or both of you) should chat with her gyn. That's it.

It's also worth noting that if you had any sexual partners before your ex, you could've given it to her. HPV is often completely asymptomatic in men, and it can be spread despite condoms through skin contact.
posted by desuetude at 12:05 PM on March 16, 2008

I avoided getting into any romantic/sexual relationships for 7 years because I thought I was in the same situation as you. In that time, I learned, when it comes down to it, that the vast majority of people put their hearts first and accept the potential risk as long as there is honest discourse and appropriate precautions taken. You're not a disgusting and diseased monster (as I thought I was, but didn't think my ex was), and there's certainly no reason to break up with your SO.
posted by Cat Pie Hurts at 12:10 PM on March 16, 2008 [1 favorite]

uh, if you're really concerned why not suggest your SO get the vaccine?

The current available vaccines don't cover genotype 51.

HPV doesn't "clear up" is it a virus that may stay dormant for long periods of time, but always resurfaces at some point.

This is not true. 90% of most strains are cleared within 2 years of contraction. Also, anon, you should know that based on what you've described, it's still entirely possible (though perhaps less likely based on what I just said) that you already had HPV-51 prior to your relationship to your ex. And you may well have past it on to her as opposed to vice versa. It's also quite possible that either you went into the relationship with it, or contracted it early from her and cleared it at this point. In fact, statistically speaking, it's more than likely that after 5 years of unprotected exposure, and in the absence of any symptoms, you contracted and cleared the virus already.

In any event, I agree with the others. While your level of discretion is a credit to you, you're overthinking this. This virus is ubiquitous.
posted by drpynchon at 2:05 PM on March 16, 2008

There is indication that Gardasil offers partial protection to other strains of HPV than the ones it explicitly mentions, and hpv-51 is one of those that it offers partial protection for. So the vaccine is still a good idea.
posted by hindmost at 2:14 PM on March 16, 2008

Thanks, drpynchon. I checked if HPV-51 was one of the types that caused cancer and, having seen that it is, I assumed it was covered in the vaccine. That was a poor assumption on my part.
posted by Justinian at 2:44 PM on March 16, 2008

Type 51 is now considered a intermediate risk virus, not high risk. I will post a reference if the moderator says is all right, since it is based on research done in the lab where I work.

HPV testing is not advised for women under thirty, since infections do clear up a lot of times. The prevalence of infections in the general population is high, most people are not aware of being infected unless a lesion is present and that does not always happen.

I have tested the urine of males for the presence of HPV using the Hybrid Capture II methodology, but only for research since this particular use is not FDA approved and needs validation in each individual laboratory. Your doctor might be able to find a lab that offers the test for males, but I do not think is really necessary.

The Digene test is the best that is currently available, but, like all tests, it is not perfect. Vaccination is wonderful, along with frequent (mostly once a year or two years if consistently negative) paps. In other words, prevention and awareness of consequences.

There is no need to terminate the relationship, in my opinion, but I suggest complete transparency to your partner.
posted by francesca too at 7:33 PM on March 16, 2008

francesca too: the prohibition against self-links is for Metafilter proper; it's perfectly acceptable to post a self-link if it is directly responsive to a question being asked. So go for it.
posted by WCityMike at 7:58 PM on March 16, 2008

(But I'm not a moderator.)
posted by WCityMike at 7:59 PM on March 16, 2008

Follow-up from the OP

First off, thanks for all your replies.

To re-iterate and clarify a few things: (1) I have already disclosed this to my girlfriend, and (2) I had no sexual contact with anyone prior to the ex with HPV-51.

drpynchon: Am I to understand from your comments that (1) it is possible to clear the virus whilst being continuously exposed to it, and (2) clearance of the virus = immunity from subsequent infections by the same strain?

hindmost: Thanks for pointing me to that study! I must have missed that in the course of my research.

posted by jessamyn at 9:05 PM on March 16, 2008

OP: In my opinion, the answers to your questions are yes and yes -- though I'm sure there's weird qualifying complexities to this as there is to any immune response (things like waning immunity). But think about it: we have vaccines for multiple strains that essential induce an immune response that's no different than clearing the virus on actually exposure and these vaccines are quite effective.
posted by drpynchon at 10:13 PM on March 16, 2008

Here the link that classifies HPV type 51 as moderate risk. Disclosure: I work with the people who wrote the paper.
posted by francesca too at 4:26 AM on March 17, 2008

OP: I know you're asking drpynchon, but I said both of those things outright in my response. Yes, it is possible to clear the virus while being continually exposed to it. Yes, you can become immune. Go have sex with your girlfriend.
posted by timory at 5:23 AM on March 17, 2008