[Question #10020] new questions regarding hpv

26 months ago

Hello, I’ve asked here a question a month ago and received really helpful answers for which I’m really grateful but I was advised to look at other posts on this forum and honestly maybe not understanding them properly made me quite anxious so I would appreciate some clarification on this topics:

1. I was provided the information that in some studies 55-70% of hpv infections which are so common are caused by Hpv 6/11 what really eased my mind cause I felt really depressed that I had this “bad luck” of catching exactly a wart-causing strain so the thought that so many people have and pass it being completely unaware made me feel better, but then I found a comment of dr Handsfield in which he mentioned that hpv 6/11 infections are usually not asymptomatic and that the majority of them (60% in some studies) manifest as visible warts what somehow argues with the previous statement because genital warts are not so common. And now I feel again like a carrier of the virus who should feel bad for not informing partners about previous infections – could you refer to it?

26 months ago

2. I’m really anxious about recurrences – I know that after being e.g. for 1 year warts-free they are uncommon but they are possible (that’s also the reason why I was informed by my doctor to go for follow up appointments every 6 months for a few years to check if warts in anal canal haven’t returned) and this makes me extremely worried cause I’d feel really guilty if the infection reactivated without me noticing it and I would give someone warts. I’ve found here a comment which stated that it could be some reason for disclosure. I felt devastated reading that cause I was hoping that I could have normal sexual life again without informing anyone. I don’t want to feel unethical but I also wouldn’t stand disclosing and constantly thinking about this STI cause I have extremely low self-esteem already – how can I do that? I feel even more frustrated cause it happened to me after having literally only 4 intercourses in my entire life ☹.

H. Hunter Handsfield, MD

26 months ago

Welcome back to the forum. Thank you for your continued confidence in our services, but I'm sorry you're still so concerned about your past anorectal warts.

That up to 60% of HPV 6/11 infections cause visible warts (in women who have been advised to keep looking and how to do it) still leaves lots of room for asymptomatic infection. In other words, the comments you found in that particular discussion should not have changed your perceptions about the proportion of infections that do and do not cause overt, recognized warts. Many or most HPV infections are lifelong, at least to the extent that viral DNA probably persists. That doesn't mean overt recurrences (e.g. regrowth of warts) or viral transmission necessarily occur. Most HPV infections remain dormant once overt manifestations, such as warts or abnormal Pap smears, have cleared up. The doctor managing your warts (a proctologist or colon & rectal surgeon) probably has advised follow-up visits to assure warts don't recur, or are promptly treated if they do. Follow that advice -- or if uncertain, ask your doctor about it.

As we have said in many previous threads, and one of the main points of Dr. Hook's reply to you a month ago, nobody's sex life ever should be seriously modified or impaired because of HPV. You can expect that 80-90%already have been infected with HPV, often including HPV 6/11, and that at any point in time, 50% have active, transmissible HPV infection. All of them are immune to new infections with the HPV type(s) they already have had. And others will not usually develop symptoms. And the large majority of infections never cause overt health problems. Thus, the bottom line is that your past HPV infection (and infection with other types you have had but were never diagnosed) really make no difference in your partners' health. This is why we generally advise against any need to inform new partners of past HPV infections. Finally, any potential partners who have received the HPV vaccine are not at risk at all.

Which brings me to my last point: You should be vaccinated yourself. Although you likely have had HPV 6 or 11, probably you have not yet been infected with most of the 9 HPV types covered by the vaccine, which will give you complete protection against those strains; and in turn will also reduce the potential that you are a "carrier" of any of those types.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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H. Hunter Handsfield, MD

26 months ago

FYI, in case you didn't notice, I made a few changes to my initial reply above. If you saw it within an hour, please re-read it now. No major differences, just a few clarifications.---

26 months ago

Thank you very much for the response. So, can I assume that the statement "55-70% of all hpv infections is caused by hpv 6/11 in some studies" is right (in case of informing anyone?)

And one more question- can I follow the rule that after 6 months of no recurrences I'm no longer infectious and can return to normal sex life without feeling any ethical obstacles? I have OCD so clear messaging around this topic is really helpful for me.

And as for the vaccine - I'm already after the first dose even though in my country it's not refunded for adults (for children only since this year) and unfortunately extremely expensive but I guess it's worth it.

26 months ago

https://pubmed.ncbi.nlm.nih.gov/37079383/

In this article it is mentioned that hpv 6 is indeed one of the most common types in males so I probably shouldn't feel worse because of having this exact wart-causing strain if it's so prevalent, is it right?

H. Hunter Handsfield, MD

26 months ago

Yes, that's correct.

That completes the two follow-up exchanges included with each question and so ends this discussion. Please note that repeated questions on the same topic are discouraged, so this should be your last on your anal warts and HPV. I do hope the discussions have been helpful. Best wishes and stay safe.

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