[Question #1380] Genital Warts Concerns (LONG POST)
94 months ago
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Edward W. Hook M.D.
94 months ago
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Welcome to our Forum. I'll provide some information and try to help. Let me start by congratulating the two of you on deciding to get tested for STIs early in your relationship- it is a sign of mutual respect and a great way to begin a relationship. At the same time, I wish your testing had not included HPV testing. Your experience is precisely the reason that experts recommend against testing for HPV. Many studies show that when persons become sexually active they acquire HPV very rapidly and that within three years of a person's first sexual encounter over 50% of persons, even those who have had only a single partner, have HPV. It is not conservatively estimated that over 80% of sexually active Americans have or have had HPV. Thus it is in to way surprising that you were found to have HPV and if anything, a bit surprising that your partner did not have infection found. At the same time the infections sometimes generates disproportionate concerns and reactions, often based on misunderstanding of the science behind the infection and often fueled by mis-information commonly found on the internet.
In addition, I would argue that your partner's gynecologist over stated things and was more alarmist than I or most experts would have been. As mentioned above, most sexually-active persons have HPV. It is, at most, a nuisance for nearly everyone who gets infected although in a very small proportion of persons, the infection can lead to development of genital tract (mostly cervical) cancer - it is for this reason that PAP smears are recommended as they allow early detection of pre-cancerous lesions and therapy. Her GYN also presented one side of a controversial area related to HPV- the persistence of the virus. In most people with HPV, even without therapy, the infection is controlled by the immune system, warts if present go away, and the virus is no longer detected. Viral DNA may be detectable in some persons despite apparent resolution but this is typically inactive, not transmissible to others, and of no consequence. Most experts feel that this sort of persistence is not a health hazard to individuals or their partners.
With this as background, specific comments in response to your questions:
1. Gardasil is recommended for all women under 26. It is good that your partner has been vaccinated as the vaccine is highly effective at preventing new infections. It has not effect on existing infection.
2. If you have had sex 12 times to date, I see no reason to continue to abstain or even use condoms unless they are for birth control. Your infection was treated, you both know each others infection status and other than the HPV apparently do not have anything to worry about. If your partner is going to have become infected, this will have already occurred (n.b. it may that on average, three months for infection to become apparent)
3. With your liquid nitrogen treatment, supplemented by the imiquimod, your HPV has been treated.
I hope my comments are helpful. EWH
94 months ago
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Edward W. Hook M.D.
94 months ago
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94 months ago
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Edward W. Hook M.D.
94 months ago
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More good questions:
Interestingly, the immunity generated by a naturally occurring infection, as measured by antibody levels is not as high as it is with the HPV vaccine. thus there does appear to be a risk of re-infection but that risk is probably low.
Most experts suggest that, in established relationships in which partners have had sex on multiple occasions in the past, there is little benefit to use of condoms or other protected measures for sexual exposures of any sort. I agree with this perspective and doubt that barrier methods will benefit you or your partner at this point.
As you acknowledge, this is my third reply to your questions and hence, as per site guidelines, this thread will be closed later today. At this juncture I would not be worried further about transmission of HPV between you and your partner. Wishing you the best.
Thanks as well for your comments on the site, I will pass it on to our web master. EWH