[Question #1564] hpv

47 months ago
Earlier this year, via question # 764 answered by Dr. Handsfield, my wife and I (monogamous)  were well advised on no ping pong risks from many years prior genital warts. I have two questions: (1) is thorough self examination showing no lesions or warts on my penis sufficient evidence of no reactivation  of original warts 20 years ago and (2) Dr. Handsfield informed us that indirect contact (non sexual) cannot spread HPV. Does this exclusion include touching infected semen (rest room, hotel, etc.) then touching my genitals?  Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
I'll welcome you back to the forum, but only with reservations. More about which below.

As you know -- or certainly should know from your previous quesitons and replies -- that STDs, including HPV, are not transmitted by indirect contact. Direct sex with an infected person is the only way. STDs are not simply infections that happen to involve the genital area. The bacteria and viruses that cause them evolved to require sex itself for transmission. If less direct contact could do it, they would be far more common than they are and would not be classifed as sexually transmitted.

1) Absence of warts 20 years later is pretty good evidence that the HPV that caused the warts is long gone. However, HPV DNA can persist indefinitely, so this is no guarantee. However, warts are harmless and in the off chance you still harbor HPV DNA, probably it will never reactivate, never cause symptoms, and never cause any sort of health problem again in you, your wife, or any other sex partner. Further, as discussed in one of your earlier threads, I am not convinced you ever had warts anyway.

2) This is true. Even after touching infected semen, or an infected partner's genital area with your hands, it is very unlikely you could infect yourself. If this occurs at all, it is extremely rare. This is an unjustified worry -- especially given that HPV is pretty much harmless anyway.

Repetative anxiety driven questions are not permitted. Such quesitons have little educational value for other users (one of the main purposes of the forum); rarely terminate the questioners' concerns, which are typically driven by emotion and not assuaged by facts and statistics, no matter how scientific and reliable; and ASHA declines to keep accepting money from people asking queations with answers that are obvious (or should be). So this will have to be your last question; any future ones will be deleted without reply and without refund of the posting fee. I trust you understand.

Best wishes--  HHH, MD
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47 months ago
Dr. Handsfield,

Thank you for your reply. I did understand from your previous response that I could have indefinite DNA from HPV in my system and had a small chance of reactivation therefrom. My current question, perhaps worded badly, was a different one regarding the meaning of “reactivation" of old genital warts should it occur: if i have no new/visible warts on close exam (and no new infection), does this mean that I am not reactivated/contagious via skin, body fluids or any other way? I had been told 20 years ago that HPV could be invisible and also referred by our family physician to a 2012 post from Dr. Hook saying some strains of 6 and 11 did not have visible warts. Logic told me this didn’t apply to genital wart reactivation from an old infection which did have warts, but I had not mentioned the question in my earlier post. There was no intention here to be ignoring of your previous response.

My second question was redundant, for which I apologize. Of course, i will honor your decision to not submit new questions although I would prefer to remain theoretically capable of future submissions but on my “honor” not to do so anxiously or redundantly. I understand you may not even see this reply but, in the event you do, I will honor my promise should you reconsider my status.  Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
In the absence of visible warts, it is unlikely you are infectious. If and when infectious for genital HPV, transmission to other people occurs only directly by sex. There is no known transmission by other contact with body fluds or by nonsexual skin-to-skin contact. If this happens, it is rare.

I'm not sure I follow your "logic told me" statement, but I think you're asking if once someone has developed genital warts, if and when their HPV infection reactivates, would they be assured of having visible warts? And therefore, is absence of warts good evidence of no reactivation. My guess is that these are correct on average. But there are few absolutes in biology or medicine, especially when it comes to HPV. And to my knowledge there are no data on this, and I suspect some reactivations of HPV 6 or 11 could occur without visible warts.

If you have new questions about STDs you haven't previously asked about, or perhaps a new high risk sexual exposure, of course you are free to ask about them. But the moderator who picks up the question will be the judge of whether a new question qualifies as redundant or anxiety driven.

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