[Question #1035] HPV time

71 months ago
Hello doctors.
First I wanted to say that I'm familiar with your work from other websites and it is a relieve to know you can still be accessed by this website, this is the reason I joined.

I will try to make my question quick and to the point.

I got married perhaps too young and 3 years ago I had encounters with randoms right before getting married, I developed a bad case of anxiety thinking I had infected my wife with every single disease in the book, I got obsessed with every infection and therefore tested. Everything negative, there is however something I cannot test for and that is HPV. I have been reading literature and your own answers and it seems like pre 2008 the advise for the period between infection and potential developing warts if any were going to show up was just a few weeks, after 2012 the advise was different and many months or even years was advised. I know that new studies show up nonetheless.

My question is the following. After 3 years neither I or my wife have developed visible warts at this point is this a very good indicator that they will not show up in the future? if not, how many years is enough to know I wont get any from my encounters 3 years ago? I look at my penis very closely every day with magnifying glass, I even have nightmares where I wake up and find some or my wife, it is terryfing for me. I appreciate your thoughts and course of action you think I should take. finally. finally, no pap done from my wife in this time.

Thank you very much.
Edward W. Hook M.D.
71 months ago

Welcome to the Forum and thank you for the vote of confidence.  I also commend you for your concern for your wife and her health.  I'll try to help.  If some of our earlier posts suggested that warts might appear within a few weeks of exposure, that is not correct.  Genital warts rarely develop in less than six weeks following exposure and by six months nearly everyone one who is going to develop warts has done so.  Given that you had other sex partners before you got married (and perhaps your wife may have as well), you were probably exposed to HPV but if nothing has appeared on you, it is time to stop worrying.  Further, it is now past time for you to stop worrying and examining yourself so closely.  There is no need and no benefit from this.

I wasn't sure what you meant when you wrote "finally, no pap done from my wife in this time" above.  Were you saying her PAP smears were normal or that a PAP smear had not been done? 

Finally, you do not specifically mention either your or your wife's age.  If either of you is less than 26 years of age, I would recommend the HPV vaccine, as I do for all of my patients. 

I hope this comment is helpful.   EWH

71 months ago
Hello Doctor Hook,

Thank you for your very fast response. You also confirmed what I suspected intellectually but may be not emotionally. I do have however a couple of questions to follow up if that is ok with you.

When I examine myself too closely, I start noticing what I suspect are normal variations on the skin like cebaceous glans or little white bumps sometimes with hair sometimes without hair. If this were warts they would start small and change the apperareance that will resemble unmistakeble abnormal in a matter of weeks or months? I do not wish to make you repeat your answer but I have seen posts from Dr HHH where he mentions the studies stretched the show up period from 6 months to 2 years, being out of that, have you seen cases where they show up years after assuming the person is telling the truth in regards of his last encounter?

I understand HPV is a complex subject and I know I'm getting hang up on this I will take your last word on this issue.

Finally, she has not done any PAP at all, should hers come back abnormal would that be proof of infidelity? could she have developed warts that are just not visible becuase they are inside the vagina even tho I didnt get any?

Thanks and sorry for the long follow up.
Edward W. Hook M.D.
71 months ago

Several questions here.  When warts appear, they should be obvious and not require a magnifying glass to detect.  If you need a magnifying glass, it is not important.  Should a wart appear, it might well grow larger but this growth would be gradual, taking place over weeks to months. On the other hand, in some people small warts appear and then stay present for a period of months to a few years when they resolve spontaneously.   While warts may take several years to appear, this is a small fraction of all warts.  Thus my advice that if you have not developed a wart in the past three years (or more) then it is unlikely that you will.

As for your wife, visible warts and PAP smear changes are two different things and the natural history of HPV is different in women and in men.  If she has not developed warts in the three years since you were married, she is unlikely to although, as mentioned above, in a small proportion of infected persons appearance of visible warts may take longer than the six month figure I mentioned to you.  PAP smears are good for HPV detection in women and more sensitive than demonstration of visible warts.  PAP smear changes may take years to resolve and if your wife were to have a PAP smear showing HPV-related changes, this WOULD NOT be a sign of infidelity. 

I hope these comments are helpful. There is a fair amount of imprecision in our understanding of HPV infections. At the same time, they are not typically a big deal and I urge you not to spend as much time worrying about HPV infection as seems to be the case. EWH

71 months ago
Thanks for the clarification Doctor. I will choose to take your advise and stop looking for warts if its unlikely to happen.

Before I close this thread I have to take the risk of sounding annoying with yet another question related to testing if you allow me.

I performed 2 rapid tests for HIV (finger prick ) on a year and 2 years mark. came back negative. the name of the lab who performs this is Biolytical. Are you familiar with this test? would it be reliable taking in consideration that there are no medical conditions or mechanical failures of this devise to measure my HIV status? in other words do you think 2 rapid tests are enough to know my status or should I take a traditional lab blood test? reason is I am not sure if this rapid test picks up HIV2 infections as well or if there have been any defective badges of devices.

I do know I sound axious but Im sure you get this all the time, it makes me feel less bad knowing you are in some way, I hope used to borderline ridicuolous questions. Having said that all that remains from my end before I close this post is to thank you very deeply for all your help ( We have talked on other forums in the past along this 3 years, and I have read many of your responses.)

Take care and have a great weekend.

70 months ago
What percentage will you estimate of probability of in my case developing warts for HPV at this point? and how about HIV?

Thanks and sorry for the bump
Edward W. Hook M.D.
70 months ago

I am not familiar with the Biolytical Rapid test but that does not worry me as there are many tests available and ALL must past the same FDA standards in order to be approved for sale.  With two negative tests at 1 and 2 years you can be 100% sure that you did not acquire HIV form your encounter years ago.  There is no need for further testing.  You are in the clear.

As for HPV, the data are less clear but barring major changes in your health, you can likewise be confident that you will not develop genital warts as a result of your prior behavior.  I would not worry further- time for you to move on with your life, including your unprotected sex life with your wife without concern. 

As you know, as this is my third reply, this thread will be closed later today. Take care and stay safe.  EWH

70 months ago
Thank you Doctor, but I have to take my chances here, If I am abusing of your good faith I have no problem on paying for a separate question but here it goes.

is it possible that my wife developed warts on the cervix or anywhere inside the vagina (not noticeble visibly) and still not showing any signs outside the vagina or me in the penis? is this a reasonable concern? all this questions come after I read here the FAQs on stds stating that warts could take years to appear and they could be in the cervix of the woman. I had to ask you regardless.

Thank you for your PATIENCE!