[Question #1204] HPV question

49 months ago
Dear Experts,

I am 26 years old heterosexual man who had about 5 partners before coming into my current relationship a year ago. I am not aware if I had any high risk HPV or not but to the best of my knowledge never had any warts or anything usual there. Both myself and my current girlfriend were not vaccinated for HPV.

My current girlfriend had a history of constipation specially when stressed. Recently she is developing anal fissures too that is hurting her a lot.

So far our relation had been condom protected, except a brief anal attempt that we had less than a year ago.

Can anal fissures be due to HPV ? I only knew that it takes a long time for high risk HPVs to develop ?
Have you esteemed experts seen similar cases before ?
What is the best course of action ?

Please please help






H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Welcome to the forum. Thanks for your question.

HPV doesn't cause anal fissures. You can be pretty confident you and your partner have had genital HPV infections. Almost all sexually active persons are infected at least once by the time they have had 3 or more lifeltime partners. However, having been mutually monogamous for a few years, any infections either of you brought into the relationship probably are long gone. Anal fissure is an extremely common condition, experienced by a high proportion of entirely healthy people. There is no reason at all to suspect that HPV has anything to do with your partner's problem. Her intermittent constipation is a far more likely explanation -- but even that may not be the problem. Most anal fissures occur with no known cause. Certainly I and Dr. Hook have never seen patients in whom anal fissures turned out to be caused by HPV.

So "the best course of action" is for your partner to follow her doctor's advice about management of her fissures. But to not worry at all about HPV as a possible cause.

I hope this information has been helpful. Let me know if anything isn't clear.

Best regards--  HHH, MD

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49 months ago
Thank you very much Dr.Handsfield for your answee. That was a relief.

a quick general question as an academic career hopeful: I think that HPV is one of those problems that the medical community has considered solved already. But other than vaccination, is there any light at the end of the tunnel that one day these viruses can be dealt with altogether and cleared by some treatment ? are some people researching on that or not a all ?

it is certainly creating a lot of anxiety and problems.





H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Thanks -- it's nice to hear you have an objective and obviously intellectual perspective on HPV (and perhaps other STDs?). However, I'm not sure how you might have gained the sense that the medical community considers HPV a solved problem. The development of vaccines has been extraordinarily important; biologically, it is the most effective vaccine ever developed -- one of only a few that can legitimately claim 100% effectiveness in preventing infection with the covered HPV types. OTOH, getting people, insurers, governments, and people at risk to adopt widespread vaccination is a difficult and so far not very successful challenge.

There certainly is continuing active research on the biology and immune response to HPV. The success of immunization has stimulated more such research, not less -- nobody is resting on their laurels over vaccines. However, curative treatment is a very difficult challenge, and absent some major breakthrough I don't expect such therapies will be available in the next 10-20 years. 

Most people don't have all that much anxiety about HPV. (If they did, people would be clamoring for the vaccine, but only a modest of those who should be vaccinated have done it.) My advice is to look at HPV just as for millions of other bacteria and viruses that are part of the human conditition -- normal to catch, normal to carry (sometimes permanently) that mostly are not harmful. Take common sense precautions against the uncommon serious outcomes (vaccination, pap smears for women, early care for symptoms) and then not worry about it. Aside from those things, sexually healthy people don't give much thought to HPV, and that's the right perspective. I encourage you to try to achieve it.

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49 months ago
Thank you very much Dr.Handsfield for the great and informative answer and for sharing your knowledge with us.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Thanks for the thanks. That's why we're here. You're welcome.

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