[Question #11685] HPV Questions

12 months ago

Hello,

I am a female who had four 1mm by 1mm warts on her perineum without ever having anal sex. One month ago I had cryotherapy that removed all of the warts. I just met someone new and am afraid to transmit the virus to him but also do not plan on disclosure. How long should I wait before having vaginal sex? What are the risks of transmission now?

In addition, I read a prior thread in which you stated “ non-genital HPV types are so rare on the genitals that it seems the genital area must not be highly susceptible, in which case genital-genital transmission might be rare”

I had all three shots of the vaccine in 2013/2014 (gardasil 4). The biopsy shows that histologically the warts appeared to be a non genital strain. Would this mean there is less chance of transmission now that the warts have been removed and it is (presumably) a nongenital strain? The lab was unable to do typing and now I have no more warts to biopsy (and hopefully never have them again). I have been taking 220mg of zinc sulfate daily to prevent recurrence - Is there anything else I can do to prevent recurrence (AGCC or Turkey tail?)

I have OCD so I wipe very rigorously after using the bathroom right. This caused cuts and scratches which must have made it more likely for this type of HPV virus to enter. If this is most likely the case, so long as my partners don’t have scratches or cuts, is it less likely for them to get this type of HPV?

H. Hunter Handsfield, MD

12 months ago

Welcome back. Looking at your previous thread, I thought you were male. I even referred to the occasional occurrence of anal HPV in heterosexual men without anal sexual exposure. But anal HPV is much more common in women than in straight men. I'm sorry if my misunderstanding caused any confusion. To your specific questions:

"How long should I wait before having vaginal sex? What are the risks of transmission now?" There are no certain data. As we may have discussed last time, removal or successful treatment of visible warts probably reduces the amount of virus in the infected area, but not entirely. Therefore transmission risk probably is reduced immediately, but not to zero risk. Some experts advise 6 months as a safe interval, assuming no new warts appear in that time.

"The biopsy shows that histologically the warts appeared to be a non genital strain." I am not aware of any difference histologi8cally in warts due to genital versus non-genital types of HPV. Testing for HPV type (i.e. genetic testing) is necessary to make that distinction.

"I have been taking 220 mg of zinc sulfate...." I am unaware of any data that zinc compounds have any benefit against HPV, in preventing warts, etc.

I also doubt that the amount of irritation from overly vigorous wiping after toilet has any benefit in preventing HPV; or that such genital irritation increases the risk of HPV infection if exposed.

I hope these answers are helpful.

HHH, MD

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12 months ago

Thank you for your response. A few more questions -

Does the washing machine kill the HPV virus or should I bleach the washing machine after washing my underwear so my family members aren’t exposed?

Would putting hand sanitizer on the area or washing it with soap and water kill the virus at least on the surface of the skin?

What percentage of people who are infected with wart causing strains of HPV actually show symptoms (get warts)?

And since I was vaccinated and still got warts, does that mean vaccination will not protect my partner from my strain? :( What are the most common HPV warts you’ve seen that are not 6/11?

Do warts take longer to show up in males? Or is it 3-6 months for both genders? If I do get a recurrence, I will get my wart genetically tested to check for the strain.

H. Hunter Handsfield, MD

12 months ago

First, you cannot get a second infection with an HPV strain you already have. You probably could not create a new wart even if you intentionally scraped a wart and rubbed it into the skin elsewhere. But even for other persons in contact with your clothing or environment there is no risk, whether or not the virus is killed or washed away. But yes, detergents etc inactivate HPV. Same for hadn't sanitizer.

With the main wart-causing types of HPV (HPV 6 and 11), about half of newly infected people develop visible warts. If you received your HPV vaccine before you acquired HPV 6/11, you are immune to those types. The percentage with visible is a lot lower for other HPV types, probably under 5% of the time. I do not know which other HPV types sometimes cause warts -- probably several different types.

If you were vaccinated before you had sex the first time, you are immune to HPV 6/11. If not, you could have been infected back then, with warts now the result.

I am unaware of any data to suggest warts appear any more frequently, or more or less rapidly, in males versus females. Warts can appear anywhere from a couple of months to years after acquiring HPV -- although 3-6 months probably is right most of the time.

I see no need to test for or know the particular type of HPV causing your warts. It won't change anything in terms of treatment, risk of reactivation, or transmission to partners.

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12 months ago

Thank you for your response. When does the gardasil vaccine start working? I received two doses 3-4 months from each other before ever having intercourse and the third dose 7 months after that (third dose was after sexual intercourse with two partners). Would the vaccine have protected me after the first two doses?

H. Hunter Handsfield, MD

12 months ago

The vaccine provides substantial protection within a month of the first dose, and 100% protection a month after the second dose. The third dose assure's prolonged protection (at least 10 years, probably for life). The timing of doses makes little difference. Any sequence of 3 doses within 1-2 years is 100% effective.

If your first sex was a month or more after dose no. 2, you were totally protected against the 9 HPV types covered by the vaccine -- and with three doses, you are protected against them for life. It seems you were just unlucky to be infected a type not covered by the vaccine.

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12 months ago

Thank you I must be very unlucky. At least maybe this strain of HPV doesn’t usually cause warts. Hopefully my partner who I was having sex with while I had the warts does not show visible warts (although he is already infected at this point). As for my future partner, I think I will wait 3 months with no occurrence before having protected sex.

H. Hunter Handsfield, MD

12 months ago

I'm glad to hear your reasoned, rational perspective. Always remember that HIV -- even with warts -- is mostly a trivial inconvenience, not a serious health problem.

We're beyond the usual two follow-up comments and replies, so that concludes this thread. Best wishes to you.

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