[Question #10494] Genital wart disclosure w/ info on typing
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22 months ago
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I attempted to ask this as a follow-up to my initial question but was unable to, unfortunately. Original question is #10424, for reference.
A few weeks back I noticed, on close inspection, a tiny irritated area on shaft of penis. Asked dermatologist to biopsy it, came back as being HPV/genital wart.
In my initial question 10424 I already covered basic questions about disclosure, etc. What is slightly confusing now is that I have received back the typing results from the biopsy.
+Derm said that the wart in question came back as NOT being caused by HPV 6 or 11 (nor any presence of HPV 16 or 18). In his mind this was "good news." The typing report apparently does not say WHICH other hpv strain was present, only which strains it is NOT.
+In my mind this was...complicated news. I had kind of been hoping that the wart would be due to 6 or 11, as these are subtypes defended against by the Gardasil vaccine. Hence, if I were to sleep with someone new and discussed this with them, I could say "hey, if you have gotten the Gardasil vax this might all be pretty moot, since you are pretty well protected against this."
+Derm said that the wart in question came back as NOT being caused by HPV 6 or 11 (nor any presence of HPV 16 or 18). In his mind this was "good news." The typing report apparently does not say WHICH other hpv strain was present, only which strains it is NOT.
+In my mind this was...complicated news. I had kind of been hoping that the wart would be due to 6 or 11, as these are subtypes defended against by the Gardasil vaccine. Hence, if I were to sleep with someone new and discussed this with them, I could say "hey, if you have gotten the Gardasil vax this might all be pretty moot, since you are pretty well protected against this."
1. What's your take? Is it maybe the case that this IS good news in that the remaining HPV strains that can cause genital warts DON'T actually cause them as frequently as 6 or 11 do? (I'm going mainly off my attempt to read this study, https://academic.oup.com/jid/article/202/8/1181/926992). In other words, could it be the case, or likely, that if I were to pass this non-6 or 11 strain on to a partner, the chances of them developing actual warts are low?
2. Would a partner having Gardasil vaccination matter at all in this scenario, given that I apparently have an HPV strain not included in the vaccine?
2. Would a partner having Gardasil vaccination matter at all in this scenario, given that I apparently have an HPV strain not included in the vaccine?
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Edward W. Hook M.D.
22 months ago
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Welcome back to the Forum. That your warts were due to an HPV type other than 6 or 11 does not change my recommendations regarding disclosure. Data on visible warts due to HPV types other than 6 or 11 are quite limited however the limited data available still indicate that about half of such cases are still due to HPV types covered by the vaccine. Further, I will remind you that most HPV infections are self limited in duration, and, in your case, your warts are now surgically absent. I see no reason for disclosure to future sexual partners.
Was your wart tested for HPV types other then 6 and 11? Receipt of the HPV vaccine is a good idea for virtually everyone and we recommend it..
EWH
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22 months ago
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Thanks! I am requesting the actual report, since I only spoke over the phone with the derm. But basically he said that the typing test confirmed the wart was NOT due to strain 6, 11, 16, or 18. The typing evidently provides no further info beyond ruling out that quartet of low- and high-risk types.
Not 100% sure what you mean here: "Data on visible warts due to HPV types other than 6 or 11 are quite limited however the limited data available still indicate that about half of such cases are still due to HPV types covered by the vaccine."
If Gardasil defends against 6, 11, 16, 18, 31, 33, 45, 52, and 58 types, is it possible that my warts were caused by strains 31,33,45,52, or 58? Or do those strains never cause visible warts?
Not 100% sure what you mean here: "Data on visible warts due to HPV types other than 6 or 11 are quite limited however the limited data available still indicate that about half of such cases are still due to HPV types covered by the vaccine."
If Gardasil defends against 6, 11, 16, 18, 31, 33, 45, 52, and 58 types, is it possible that my warts were caused by strains 31,33,45,52, or 58? Or do those strains never cause visible warts?
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Edward W. Hook M.D.
22 months ago
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Just as many HPV 6 or 11 HPV infections will not cause visible warts, on occasion other HPV types which can certainly cause visible warts (I tried to indicate this is the portion of my reply that you copied above) ; this is part of the reasons why I still do not feel that disclosure is needed. As I also said, there are limited data on just how often this occurs or what proportion of visible warts not caused by HPV 6 or 11 are covered by the vaccine.
I will close your other thread now. this one will remain open and you have one follow-up remaining. EWH
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22 months ago
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Thanks! Want to make sure you indeed meant to write that disclosure is still NOT necessary ;).
So in conclusion this is what I have gleaned from your very helpful responses...let me know if I have interpreted correctly!
+a lot of hpv 6 and 11 infections will not lead to visible warts. Ditto for other wart causing strains. Just because mine developed into visual warts doesnt mean that if I passed this on to anyone else that they would be more likely to develop warts than if they had picked up hpv 6 or 11 or etc from an asyptomatic person.
+even if the strain causing my warts isnt one of the strains explicitly defended against by Gardasil, it is possible (likely?) That the vaccine would still confer some protection, although data is scant.
+there are plenty of men walking around with hpv 6 or 11 or another wart causing strain who do NOT have visible warts. Those men could pass the strain on to a partner who COULD then develop warts.
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Edward W. Hook M.D.
22 months ago
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Apologies- I did mean disclosure is NOT necessary
Your summary is correct EWH
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