[Question #13123] genital warts

2 months ago

I'm a mother diagnosed with genital warts and I've been experiencing significant anxiety recently and my child is 5 months old

1. I'm concerned about potential viral contamination on my fingers. I often touch my baby's hands, cheeks, toys and other fomites without washing my hands. he frequently put contaminated fomites and his hands in mouth and hands may pick up hpv6/11 virus . sometimes i wiped him down with my towel. so the behavior I described above can lead to oral HPV infections or recurrent respiratory papillomatosis ? What is the probability of occurrence ?

(Several online cases describe children with oral condyloma acuminatum, potentially caused by parents with genital warts transmitting the virus through shared towels or hand contact with contaminated surfaces)

2. I was diagnosed with genital warts several months after birth and I do not know whether I was infected with genital warts during pregnancy. i wonder to know even if infected with genital warts during pregnancy,is the probability of it causing the newborn to become infected with RRP very small? Is the probability below 1%?

Thank you !

2 months ago

3. I known oral HPV infection is fairly quite common. Is infection with HPV 6/11 in the oral cavity or larynx also relatively common? because as i know RRP is a disease predominately caused by hpv6/11 .recently I saw a research paper. the original text stated: It is estimated that 1% of the general population has commensal HPV 6 and 11 DNA in their larynx, yet only a small fraction of those exposed develop RRP due to variations in immune susceptibility link is here : https://pmc.ncbi.nlm.nih.gov/articles/PMC8035934/#lio2521-bib-0025 In your assessment, is the reported 1% figure statistically reliable? can I understand it like this : infection with HPV 6/11 in the oral cavity or larynx is relatively common, only a small fraction of those exposed develop RRP due to RRP patients have immune problems . do you agree with my opinion?

Edward W. Hook M.D.

2 months ago

Welcome to our Forum and thanks for your questions. I understand why you would be concerned about your child and hope that I can provide some reassurance. As you point out, genital HPV infections are very common in unvaccinated persons and pharyngeal HPV is far less common and far less frequently transmitted. I'll go straight to your questions:

HPV is rarely, if ever, transmitted through transfer of infection on a person's hands. There are no good scientific data to suggest that HPV is transmitted on contaminated towels. This is true for other STIs as well. While I understand the concern, there is little reason for concern. I would not deprive or alter your care for your son based on concern that you might transmit HPV to him. While there are online instances as you mention, this is simply not a major concern.

There is a tendency for HPV infections/warts to become more apparent during pregnancy. The risk of a newborn developing RRP is a small fraction of 1% following exposure.

Most oral HPV infections are HPV 16, not 6 or 11. RRP however is typically HPV 6/11. I agree with you that only a small proportion of exposed persons develop RRP.

I hope this information is helpful. EWH

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2 months ago

Thank you for your reply!

My husband and I currently get treatment. Our doctor told us that if there is no recurrence within six months, the chances of recurrence later are very small.

In your opinion:

1. How long should we wait to have unprotected sex? How long until the virus is no longer contagious?

2. How can we detect if there has been a recurrence? Is it assessed by naked eye or are there other detection methods? as I know, there are currently no HPV tests available for males. are there HPV tests for females, and What is the diagnostic accuracy?

3.Do small lesions or subclinical infections require treatment? cdc claims that most HPV infections (9 out of 10) go away by themselves within 2 years

Edward W. Hook M.D.

2 months ago

You did not mention that your husband has warts as well. I strongly recommend that you search on the Forum for other questions on the topic of warts. These previous threads extensively discuss treatment and transmission and contain answers from both of us on all of your questions. In addition I’ll provide brief responses to your follow up questions below.

In general warts and HPV infections are more of a nuisance than a major health problem. Most sexually active persons who have not received the HPV vaccine ( over 80%) have the infection and in most cases warts or HPV infections go away without treatment over 2-3 years. A very small proportion can go on to progress to PAP smear abnormalities which can then be treated. Briefly with regard to your specific questions:

1. Effective treatment will usually make the infection resolve. You and your husband have already been exposed to each other’s infections so the is no need to abstain from sex, particularly if you are getting treatment.

2. Recurrence of warts are typically visible. For you, routine PAP smears will also be helpful for detecting HPV. They are quite accurate.

3. As I said above, most infections will resolve on their own. Treatment of recurrences may accelerate resolution.

I hope this information is helpful. Please search for other past discussions of HPV and consider discussing your questions with your own health care provider.

You have one follow up remaining. EWH

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1 months ago

Sorry, my English isn't very good( I'm from Korea)

My husband was diagnosed with genital warts and has had no recurrence for 6 months after treatment.

Based on what you answered on the Forum for other questions, my husband can be considered cured, with low risk of transmission.

However, his doctor recommended HPV testing to confirm whether any residual virus remains. To my knowledge, there isn't a standard HPV test method available for men. We're really puzzled about this.

1. In your opinion, is visual examination sufficient for monitoring recurrence, or is microscopic testing necessary ? How to determine if there's recurrence?

2. I was diagnosed with genital warts several months after birth and I do not know whether I was infected with genital warts during pregnancy.

If I had genital warts during pregnancy and delivered vaginally, could this pose health risks to my baby? I'm worried about passing the virus to my child.

thank you very much

Edward W. Hook M.D.

1 months ago

I share your confusion about why your husband’s doctor has recommended testing. You are correct that here in the U.S. HPV testing is not recommended or typically offered for men. I am also aware that in Japan ( and thus perhaps in Korea) testing for men is available but I am not aware of how it might be used. Reflecting what I have already stated and in response:

1. Visual examination should be sufficient. You and your husband are already exposed to each other. There is no need to change your sexual practices. If either of you experiences a recurrence it should be treated but is not a threat to either of you or your child.

2. There is close to no risk to your child. If you were infected at the time of delivery the risk of infection for your child is close to zero.Respiratory papillomatosis occurs in less than 1 in 10,000 exposed children. I would not be concerned.

As you know. We provide up to 3 responses to each client’s questions. This thread will be closed shortly without further responses. Please don’t worry. EWH

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