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HPV Infections Can Return as You Age Without New Sexual Exposures

Recent breakthrough research shows that the sexually- transmitted, cancer-causing Human Papilloma Virus (HPV) can come back to cause an infection many years after an old sexual contact that gave you the infection in the first place (Journal of Infectious Diseases, December 15, 2012;206(12)). It can do so without any new sexual contact, just as the chicken pox virus causes shingles many years later, without additional exposure . This recent study confirms the findings of a previous study that showed that HPV infections increase after menopause (Cancer Epidemiology Biomarkers & Prevention, December 2010). However, the postmenopausal women most likely to have HPV symptoms are the ones with new sexual partners in the last six months. The data show that a new infection is far more common than a reactivated one from a previous infection.

HPV CAUSES CANCERS: HPV can cause cancers of the head, neck, tongue, mouth, tonsils, cervix, vulva, vagina, penis and anus. It is the most common sexually transmitted disease in North America today. The use of condoms can help to prevent HPV infections.

SHINGLES: When you were a child, you probably acquired chicken pox and had blisters all over your body. Then the blisters went away and you thought that you were cured. However the virus remains in your nerves for the rest of your life. For one out of three Americans, the virus comes back in later life to cause horrible pain and blisters in one nerve.

HPV, LIKE SHINGLES, can also return many years later. Men and women over 50 who develop mouth, vaginal, urinary or penile spots or rashes, could have a recurrence of HPV without a new sexual partner, or they could have acquired a new infection from a new sexual partner.

THE MORE LIFETIME PARTNERS, THE MORE LIKELY HPV IS TO RECUR. In this study, about 77 percent of the infections were detected in women who had five or more sexual partners in their lifetimes. The more partners they had, the more likely they were to suffer recurrent infections later in life.

HOW COMMON ARE HPV INFECTIONS? Sexually active women have a probability of being infected with HPV at:

AGE : INCIDENCE OF HPV
14-19 ; 24.5 percent
20-24 : 44.8 percent
25-29 : 27.4 percent
30-39 : 27.5 percent
40-49 : 25.2 percent
50-59 : 19.6 percent

The Centers for Disease Control (CDC) estimates that at least 80 percent of sexually active women have been infected by age 50 (CDC, 2004).

TYPES OF HPV: You can get more than 150 different types of HPV. Only 15 percent of infections are from the types that are called high risk for cancer. At least 24 percent of women have two types of HPV, and 16 percent have three or more types detected. The types that put you at high risk for cancer are types 16, 18, 52, and 59. These four types are associated with more than 90 percent all cervical cancers.

NATURAL HISTORY OF HPV INFECTIONS: When you are infected with HPV, your immune system appears to clear the virus in six to nine months. That does not mean that the virus is gone. It means that doctors cannot find it. More than 150 different HPVs exist and with each infection, you acquire immunity to that specific HPV, but usually not to any other type. So you are still susceptible to getting any of the other HPV types. With each sexual exposure, you can pick up any other one or more of the HPVs. The data clearly show that the more partners you have, the more likely you are to have HPV persist. Men and women with the most partners are most likely to have the most different types of HPV. People who have had the most partners are the ones most likely to have a recurrence of HPV in later life, even though they may not be acquiring any new viruses.

DOES EVERY WOMAN WHO HAS HPV ALSO HAVE AN ABNORMAL PAP SMEAR? Many women with proven HPV infections will not have an abnormal PAP smear. The women infected with the high risk 16, 18, 52 and 59 are the ones most likely to have abnormal PAP smears and be at higher risk for cervical cancer.

A man or woman who is recently infected with HPV can usually expect doctors to be unable to find the virus six to nine months later. However, if an infected person's immune system is depressed by menopause, pregnancy, chronic illness, or immune suppression drugs, the virus can be activated. The person can develop burning, itching, pain, or irritation in the infected site, and the virus can be found in the skin, vagina or mouth again. The high-risk subtypes are the most likely to come back.

IMMUNIZATION: The available vaccines contain only four of the more than 150 different HPV types. One vaccine protects against HPV 16 and HPV 18, while the other protects against types 52 and 59. They are of no value after a person is infected with these HPV subtypes. The CDC recommends the vaccines for all girls and boys before age eleven.

CASES OF GONORRHEA AND CHLAMYDIA RISE THIS YEAR: The CDC just reported increases in these sexually-transmitted diseases: • Chlamydia rates increased eight percent, to 457.6 per 100,000; and • Gonorrhea rates increased four percent, to 104.2 per 100,000.

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Reports from drmirkin.com

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Diet Affects Prostate Cancer Risk

The prospective Malmo Diet and Cancer study followed 8128 healthy men, aged 45-73, for 15 years and found no association of prostate cancer with total carbohydrate or fiber intake. It did find an association of prostate cancer with refined carbohydrates in foods such as low-fiber cereals, cakes, biscuits, white rice and pasta. (American Journal of Clinical Nutrition, 11/09/2012).

Nature packages all carbohydrates in foods with fiber. After you eat, the pyloric sphincter at the end of the stomach closes and allows only a liquid soup to pass into the intestines. Since humans cannot break down fiber, it takes a long time for fiber to pass into the intestines. Removing fiber from nature's sources of carbohydrates increases the rate of absorption and raises blood sugar levels considerably. It takes an orange up to six hours to pass through your stomach, compared to minutes for orange juice (liquid sugar) to pass. The higher blood sugar rises after you eat, the more sugar sticks to the outer membranes of cells and damages them, which can increase cancer risk.

The same applies to whole grains and flour. Whole grains are seeds of grass that have a tight capsule that cannot be broken down by your intestinal enzymes. Therefore, eating whole grains causes very little rise in blood sugar. However, grinding a whole grain into flour breaks the capsule and markedly increases the rise in blood sugar that follows eating bakery products or pastas. This high rise in blood sugar is probably what increased the men's risk for prostate cancer.

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This week's medical history:
What Killed President Andrew Jackson?

For a complete list of my medical history biographies go to Histories and Mysteries

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Recipe of the Week:

My favorite holiday "cookie" --
Fruity Pebbles

You'll find lots of recipes and helpful tips in The Good Food Book
- it's FREE

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December 23rd, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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