my questions are

1.) how likely is it that i will have reoccurrence of a new wart? It’s been almost 2 years and no new ones have appeared.

2.) will the vaccine have any effect on my body to prevent new ones since i was vaccinated after already having a genital wart? 

3.) Can my body really get rid of HPV or will I forever be worried about reoccurrence? My doctors have told me I will have it for life, but I’ve read so many different articles and opinions that say otherwise. 

4.) As a kid i’ve occasionally had warts on hands/feet.. Did that make it easier for me to get the hpv that causes warts on genitals? 

——- Before I got the genital wart, My PCP treated me for 3 plantar warts, and told me i will possibly get warts on any part of my body (including genitals) Is there any truth to this? 

Thank you for your time and I hope to hear from you soon.

I'm sorry to hear of your genital wart diagnosis, but I believe you'll find my responses reassuring. There's a lot of scientific uncertainty in the questions you ask, but the main bottom line is that you are at low risk for recurrence of warts and, most important, little or no risk of a genuinely serious outcome, like cancer. I'll start with the general statement that getting and having genital HPV is a normal, expected, unavoidable consequence of human sexual activity, especially in a modern dating context. Half of all sexually active people become infected within their first three lifetime partners, and 80-90% are infected at least once, often several times. However, with proper management dangerous or highly stressful outcomes are easily prevented or minimized.

3) Answering this first because it gets to generalities about HPV that affect your other four questions. The immune system almost always suppresses HPV to a point that it causes no symptoms and is not transmissible to sex partners. However, HPV DNA can persist in tissues -- it's not clear whether this always happens, but probably it does for at least half if not all HPV infection. So in many or most (maybe all) infections, there is a potential for reactivation. However, most infections do not reactivate, or at least reactivation is never apparent -- no warts, no abnormal pap, no transmission to partners. These facts largely explain the varied opinions you can find online or elsewhere:  for all practical purposes most infections are cured by the immune system, even if DNA persists. Some advisers emphasize the persistence and reactivation potentials, whereas others confidently state that once the initial infection is gone, it stays gone for the large majority of cases. Now to the other questions:

1) Most warts don't recur; when they do, usually it's within a few months. You could have recurrent warts in the future, but after two wart-free years, I would estimate over 90% likelihood this will not happen.

2) The HPV vaccine is only reliable in preventing new infection with any of the 9 HPV types covered by the vaccine. Regardless of vaccination, your prior infection makes you immune immune to the HPV type that causes your wart (probably HPV 6 or 11). There is some evidence that immunization also may slightly reduces the likelihood of reactivation of previous infection with the vaccine-covered virus types. The 9 HPV types covered by the vaccine cause 90% of all genital warts and cancers caused by HPV; you could still acquire any of 30-40 types of HPV, but these rarely cause any health problem -- no warts, no abnormal Pap smears, no cancer, so they can pretty much be ignored.

4) There is no evidence that prior infection with the HPV types that cause common hand and plantar warts have any effect on susceptibility or disease from the genital (sexually transmitted) HPV infections. You were misinformed about genital infection from the HPV that caused your plantar warts. This is rare if it occurs at all. 

You also should be following standard guidelines for Pap smears, ideally with HPV testing -- in the US, that's every 3 years for women your age. Vaccination has lowered your risk of an abnormal Pap smear, but it's still possible due to reactivation of prior infection or new infection with an HPV type not covered by the vaccine.

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

HHH, MD

i did have a few follow up questions. i hope you can help me out. i was with a man (Jan-march2023) who after being sexually active with the wart appeared. after getting it removed in august 2023, i never saw another one again and i entered a new relationship with my now partner. (starting november 2023) these are my questions

….

1. i understand because it’s been so long without a reoccurrence of a wart since i first got one, it’s somewhat unlikely for a reoccurrence at this late stage from that prior diagnosis. (i didn’t disclose my prior history with my now partner and haven’t felt the need to unless another one appears). but given the circumstances, if a new wart were to appear, would it be morally unethical to ask my doctor to not disclose my prior history with my partner and only inform them of what HPV is and answer questions for us? I’m afraid if we go to the doctor together, they will tell him i have a history with this and my partner will feel i was lying to him. But i also don’t want to ask my OB to do anything morally unethical. 

2. Given that me and my partner have almost been together with no issues as far as warts for this almost 2 year period, is it likely that it will not occur again from prior infection , unless my new partner has reinfected me? 

3. As far as preventing another wart, i know it’s always BEST to take care of yourself, but does having a drink/smoke occasionally put you at more risk for reoccurrence? Some people say that taking vitamins helps, but is there any truth to this? 

I also wanted to say i greatly appreciate you and Thank you for taking time out of your day to answer my questions doctor. You have significantly put me at ease, i finally feel better about this and have a more positive mindset due to your support and information!!

2. Warts probably will not recur, regardless of your current sexual partnership, or anything related to that. Since you’ve been partners for two years, you also can safely assume he is at no risk of infection from you.