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Wife with cervical cancer and question on fidelity

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After 7 years of marriage and 4 years after having children, my wife was diagnosed with cervical cancer causing HPV. I do not recall ever having physical symptoms of HPV, and did not have physical symptoms during the marriage. After our children, we had unprotected sex on possibly 2 occasions. My wife was tested for HPV in connection with the pregnancies. Additionally, she complained of infections when we did have sex, which was no more than monthly and mostly quarterly, for which she was treated with antibiotics. Is it likely she obtained HPV from someone other than me during the marriage? And, do the infections occurring after we had sex evidence multiple sex partners?

Category: OBGYN

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Category: Infertility Specialist
 29 Doctors Online

Hello,
Thanks for writing to DoctorSpring.com with your health concern.

Males are most often asymptomatic even if they harbour HPV.
There is also no screening test for males having HPV.

Hence, your wife having HPV cannot be taken as a pointer of infidelity on her part.
She might very well have acquired the infection from you, and you might be totally asymptomatic, and without manifesting warts, you might not be diagnosed ever too.

Also, having infections does not point towards multiple sexual partners.
Genital or urinary infections are very common in women, even with just one sexual partner all through the life.

All the best.
Please feel free to discuss further.


Patient replied :

Dr. Vazirani,

I understand your point regarding latency and HPV being asymptomatic. However, my wife tested negative for HPV for 2 pregnancies 4 years before a positive test result for HPV.

So, either, I had HPV before the marriage, yet only transmitted it to her after 7 years of the marriage and 2 pregnancies. Or, she had HPV before the marriage, yet had false negative test results for 7 years. Which is it?

Please note that my wife and I are separated for over a year now. And, I did not have unprotected sex with her after the pregnancies. So, I am trying to determine my risk of HPV. Your opinion has no practical impact, legal or otherwise. I am only seeking information to ease my mind.

Seth


Hello,

Please allow to explain.

The HPV test your wife had during her previous pregnancy should have missed the HPV infection. This is the most likely cause. HPV has over 40 sero types , and routine diagnosis is not at easy. It is unlikely that she had DNA based tests to identify HPV infection during pregnancy. (HPV virus is NOT routinely screened during pregnancy ).

Regarding your risk - Upto 50% of adults are infected with HPV (Who are sexually active). Being an adult male itself gives you 1 in 2 chance of having HPV. Since your partner have HPV you are at a higher risk. But HPV viruses are common and you should not be overly worried about this.

Hope this helps
Please feel free to ask followups / clarifications. Let me know if I have missed anything.
Thank you


Patient replied :

Hi Dr. Vazirani, Thank you for the response. My wife's 2 pregnancies were both high risk, and she advised me that her ObGyn did screen her for HPV during at least the last pregnancy. She is a Doctor herself and accused me of giving her HPV outside of the marriage. When I truly denied this, she suggested that transmission would have been delayed from our prior relationships as HPV is "latent." I have blamed myself for giving her HPV on account of a relationship prior to marriage. I guess the answer is: that she could have had false negatives (unlikely for the DNA tests); the tests during pregnancy could have not tested for her specific strain, although the particular strain is a known dangerous cancerous kind; or she went outside of the marriage. Please provide me with further comment, if any.


Hello,

Allow me to list down my opinion here.

1. Yes, the HPV test could be false negative during the pregnancies, as the usual tests done like Pap smear examination can easily miss this.

2. As I said earlier there is upto 50% prevalence in general population. Plus there are some non sexual means of transmission. So it is very difficult to say who is source

3. It is possible that you had transmitted her the virus , which remained latent in her

4. If she had a sexual relationship (not recent) it could also cause HPV transmission. But we could never know for sure who is the original source in any case.


Hope this helps
Thank you


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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