[Question #1654] Hpv and skin regeneration
72 months ago
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Edward W. Hook M.D.
72 months ago
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72 months ago
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72 months ago
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"None of this also replaces the possibility that you may have had cervical infection which ....?"
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Edward W. Hook M.D.
72 months ago
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As I said in my original reply "Once the tissue (and therefore the virus in the tissue) has been destroyed it is no longer viable or Infectious to others. In addition, your own experience over the past decade serves to reinforce the fact that you are no longer infectious to sexual partners." Thus the virus is destroyed and no longer present, therefore it cannot be transmitted. On the other hand when the body's immune response eliminates detectable HPV as it does in nearly every one with the infection over time, small amounts o viral DNA remains detectable with sophisticated detection methods. It is this "persistence" that people so often fixate upon and lead to discussion f chronic HPV. Most (but admittedly not all) experts agree that once the body has reacted to and eliminated detectable HPV, persons are no longer infectious. My advice, based on your response to therapy, your experience over the past decade is to assume that the virus that caused your visible warts has "left your body".
As you point out, this is more of a psycho-social issue than a medical one. Even if the virus were present and detectable, its true medical importance would only be its association with cancer in a tiny fraction of persons witht he infection. For those people, routine PAP smears and other recommended reproductive health care is designed to detect, treat and therefore prevent the bad outcome that we want to avoid.
Finally, sorry about the incomplete sentence. You anticipated my response in your reply however, I meant to state"None of this also replaces the possibility that you may have had cervical infection which might persist and intermittently be detectable. The appropriate response is to do just what you have done and to get regular health care checks which assess you for risk of LSIAL or other sentinel events." I would also point out that all LSIL is not due to HPV and that HPV can be present without cause LSIL (or SIL of any grade). Your follow-up seems to impl that you are aware of this anyway. EWH
72 months ago
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Edward W. Hook M.D.
72 months ago
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The issue of residual virus/DNA depends on whether or not the treating doctor destroyed all of the tissue containing virus, allowing normal cells to regrow in their place. HPV infections and warts for sure are sort of "iceberg-like" in the infection may extend into the visibly (but not microscopically) uninvolved skin surrounding the wart. Thus when warts are treated with destructive therapy, providers try to include a "margin" of visibly normal cells which might contain virus even though the skin looks normal. I hope this makes sense. Think of the iceberg analogy.
Certainly for ASCUS but also for some LSIL other inflammatory processes (infection are most common) can cause abnormalities which are sometimes classified as LSIL. Remember that even with published and agreed upon guidelines, interpretation of PAP smears has a subjective element and there is a bit of overlap between classes (such as ASCUS and LSIL). This has been shown in numerous studies of PAP smear interpretation.
I hope my responses have been helpful. As for Forum Guidelines, . we are permitted up to three replies per question. Thus this thread will be closed later today. If there are further questions you will need to start a new question. Take care. EWH
72 months ago
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Edward W. Hook M.D.
72 months ago
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Final answer. I have answered this question to the best of my ability but it is really a "what if" question. If the destructive treatment destroys all cells containing HPV the virus and its DNA will be gone. If the treatment is not complete, I suppose there could be residual, quiescent DNA present. No real way to know.
The thread will be closed now. EWH