oropharyngeal HPV

oropharyngeal HPV testing
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flanagan.laura
Message 1 of 3 , Feb 18 10:05 PM
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I have a patient concerned about possible exposure to STIs in December. I am not sure how to proceed with a throat "pap." Specifically, where is the sample from? --there is more area to test than just a cervix. What swab or collection kit is used? Is this a reasonable time period to do the test, 2 months after exposure, or should she wait a bit longer? And finally, if we are testing for vaginal STIs and HPV, is it necessary to check oropharyngeal too?
I am embarrassed to ask such basic questions and appreciate your advice.
Thanks
Laura Flanagan ND
Spokane, WA

natmedworks
Message 2 of 3 , Feb 20 10:21 AM
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Hi Laura
I have treated a few (3) patients with oropharyngeal HPV. All had the diagnosis via oropharyngeal biopsy done via (1) dentist or (2) otolaryngologist. I suggest you refer to an otolaryngologist for biopsy.
It is my understanding that the areas biopsied were visually suspected tissue. And if the person has exposure the HPV is often on the vocal cords (2).
As far as a reasonable time period to collect the sample.... So every patient I had saw/ hear changes that led them to seeing a doctor. The changes seen were mouth sores (1) and/ or voice hoarsing (2).  None of the adult patients (2) knew when/ where they got it. Except I had a child patient and we suspect she got it from her mom at birth. I do not know when you would first see lesions after exposure.
Yes it is necessary to check separately vaginal and suspected oropharyngeal areas. (also anal tissue if exposed) But if there are no oral symptoms, I would watch and wait. It is my understanding that it is difficult for HPV to live in the oral cavity.

I am curious what other would say
Dr. Coleen Murphy
Orange County, CA

Eric Yarnell
Message 3 of 3 , Feb 20 6:50 PM
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Just throwing out treatments for oropharyngeal HPV just in case:

Drink cabbage juice 1/2 head of cabbage per day, or indole-3-carbinol 200 mg bid

Drink green tea

References and stuff in my article about this in Alternative and Complementary Therapies, full text available if you sign up on academia.edu which is free and just search on my name.



Eric Yarnell, ND, RH(AHG)
Seattle, WA