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Risk of HPV cancers
Sep 26, 2010

Hi, I am HIV+ and have a CD4 count just come up to 400 at last test - I started Atripla 2 months ago after it had dropped to 220. I tested positive in Oct 2006. My long term partner has been diagnosed with squamous cell ca larynx of HPV16 origin. It is stage 1, and has not spread on CT chest and neck. I wanted to know how HPV is transmitted and whether it is higher risk for the passive partner to catch anal cancer. Should we practice safe sex? Since I tested positive the doctor said there is no risk to me but with this HPV scare our whole world has been thrown upside down. Can we catch it from kissing? HIV is a treatable disease - but HIV plus cancer is very frightening. The doctors cannot seem to tell me much about HPV and whether I might have it, long term risks of new primaries etc. I have an anal fistula - is this a risk for anal cancer? Does HPV remain in the body long term? I also have enlarged lumps at the back of my tongue and swollen lymph nodes in the throat at the moment.

Response from Dr. Henry

Those are good questions-answers are not clear cut. HPV can be spread by direct contact. Anal pap testing screening for HPV related anal cancer is gaining traction as a modality to detect early pre-cancer when treatment may be more effective. Many/most HIV+ persons already have a range of HPV infections in genital area. HPV vaccine may be of some benefit and is under study. For most patients HPV related cancers progress slowly and have variable clinical course so studies are challenging to conduct since need long term outcomes to determine if a screening strategy or treatment is truly effective. Most HIV specialists are aware of HPV concerns and can make appropriate evaluations or referrals if the situation calls for that. KH

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