[Question #13294] GW and HPV

 
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18 days ago
For many years I was depressed about having contracted GW in the early 90s. Then I got  HPV in early 2000s. In an online support group for Herpes  I felt singled out. It apparently cleared since subsequent Paps were normal and didn't warrant an HPVtest. I sent in a question about whether  to disclose the 1990s gw episode (it was treated/removed) and I received encouraging words that based on clinical exp. it was not an expectation for something so long ago. Now I have a +HPV (high risk) & normal Pap result that occurred 2 1/2 years after a normal Pap and one partner. I just wanted to check @ recommendations . I think it's recheck in 1 year instead of 3 . And for my partner what can I inform him? Thank you. 
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H. Hunter Handsfield, MD
18 days ago
Welcome back to the forum. I'll try to help.

As you likely know, there are many types of HPV -- 30-40 different ones are sexually transmitted. Up to 90% of all people are infected at one time or another, and probably half of these have had more than one infection. Your recently diagnosed cervical infection almost certainly is not the same HPV strain that caused your warts all those years ago. Based on the years of sexual activity implied -- i.e. you probably were at least in your teens back in the early 1990s -- you must be in your forties or older. The large majority of HPV in Pap smears at that age represent reactivation of infection acquired years or even decades earlier; and warts are rarely caused by high risk HPV types, so it's likely a different HPV than the one that caused your warts all those years ago.

I have no advice about follow-up of your current infection; follow the advice of your doctor. Being rechecked in a year makes sense, however.

As for your current partner, just tell him what I said above. You probably have had it for years; it recently reactivated, causing the abnormal pap smear; and although he likely has been exposed, it is not likely to cause symptoms or harm. Assuming he has had an average sex life, he probably already has had HPV, perhaps more than once; and his relationship with you is not likely to significantly elevate his low risk of someday having a complication. That said, of course he should be aware of his genital health and if any wart-like or genital sore should appear, see a doctor for prompt diagnosis and treatment. But that probably won't happen.

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

HHH, MD
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17 days ago
Hi that is a little different from what I understood from a previous answer. But  I think I understand. 
Followup question 1:
I do wonder why is it likely a reactivation of my previous hr HPV? It's been years since. could it also be an HPV type I picked up from my partner?  It seems both might be equally possible. 
Followup question 2: if I need to pay for this one b/c it's a different STD I will. 
Does HSV 1 always produce a cold sore on the  lip or can it also be located below the waistline? 
Thank you.




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H. Hunter Handsfield, MD
17 days ago
Please let me know what you understand differently from a previous reply. HPV is a complex topic and I'm happy to help sort this out, whatever it is.

1. This was answered above, but to add some detail, I'm guessing at your age which must be over 40. Beyond age 30 or thereabouts, the large majority of newly abnormal Pap smears are from reactivation of past HPV, not a new HPV infection. Normal Pap smears over the years do not change this:  most HPV becomes inactive (with normal Pap smears) but can reactivate from time to time. Could it be from your new partner? Yes, but the odds are your abnormal pap is from a distant past HPV infection. There is no way to know for sure.

2. No need for a new question! Yes, HSV1 commonly causes genital herpes ("below the waistline"). In fact, almost half of newly acquired GH is caused by HSV1, not HSV2. Genital HSV1 almost always is acquired by receiving oral sex from a partner with oral herpes. However, repeat outbreaks are uncommon with genital HSV1. Therefore, most people with recurrent GH have HSV2. On the other hand, someone who already has oral herpes due to HSV1, with typical cold sores on or near the mouth, is extremely unlikely to start having new HSV1 outbreaks at any new location on the body.
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