[Question #2455] Hpv transfer

45 months ago
Hello Doctors,

Hello! I was recently diagnosed with having genital warts as I stated a few weeks back.  I recently decided to do a full inspection of my genitals back and front for peace of mind. I thought it would be a bad idea to use my bare hands, so I decided to use a pair of blue latex gloves. After the fact, I realized I was touching my penis with the infection and then  physically touching my anus afterwards looking/feeling for abnormalities.. So.. I've been stressing out thinking that the virsus may have attached itself to the latex glove and then spread to my anal region after contact. Does this seem like a probable or likely way of transferring it?. 

Thank You !
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Welcome back.

When genital warts are present, the virus is much more widespread than in the warts themselves, and most infected areas of the skin appear entirely normal. Not infrequently, the infection extends to involve the anal area as well.

Two conclusions from these facts:  1) There is no point in the compulsive sort of self examination you describe. HPV is all over, regardless of where you might see warts or bumps. What you might find (or not) makes absolutely no difference in your prognosis, resolution of warts, treatment needed, or transmission risk to partners. 2) The virus won't become any more widespread by touching infected followed by uninfected areas, with or without latex gloves.

This question implies you are seriously obsessed with this rather trivial medical problem. And you're just making things worse by doing things that stress you even more. Please consider asking your primary physician or perhaps your dermatologist about these behaviors and whether professional counseling might be a good idea. I suggest it from compassion, not criticism. In the meantime, stop examining yourself.

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

HHH, MD

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45 months ago
Hello Dr. Handsfield,

Thank you for your compassion. I do and always have had the tendency to over react, I'm a hard thinker. But my stress level was at probably a  #10 a month ago and I have managed to bring it down to a #3 so far. So with passing time, I'm much improving.  I've been very healthy for the majority of my life and conservative.  So this situation did generate a lot of new anxiety for me. But I guess it comes with the territory of being sexually active or having been. 

So if you could answer a few more questions for me I would greatly appreciate it!  After this, I'll put it to rest.

1. Does Imiquimod  attack the virus in its entirely? or just where the cream is placed?

2. Numerous sources state the majority of those that are infected with HPV or roughly 90-91% can eradicate the virus within 2 years. Is the an accurate statement?  What about the other 9-10%? Why are they unable to overcome it?.. 

3. All of my other remaining STD test came back negative. I did test positive for HSV 1.  I've been a suffer from oral blisters since being a young child.  So this wasn't new information to me. 

4.  I notice that the majority of questions posted are in regards to the accuracy of testing methods used to detect such virus's.  I was also tested for HSV 2 and that came back negative. The testing method used was Herpes Select IgG and IgM.  Can I assume this method is accurate? and that  I am in fact clear of HSV 2? 

Thank you, Dr. Handsfield. 



45 months ago
Hello Dr. Handsfiled,

I'm not sure if you missed my follow up questions... But, would you mind taking a another look @ them.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
For some reason I missed several follow-up questions recently. Sorry; I'll check with the web adminstrator about it.

1) Imiquimod's mechanism of action is such that it might have an effect on nearby HPV infected areas, in addition to those directly treated. However, this is theoretical only, with no actual research or knowledge. It is safest to assume it only is effective on directly treated tissues. If it has more widespread effects, they probably are minor.

2) We don't really know the answer; all numbers are estimates. The problem is partly that the definition of eradication is uncertain. For example, HPV DNA may persist but not the complete virus, perhaps with no potential for transmission, recurrent warts, or cancer progression. Some would say that counts as eradication; others would say as long as DNA is there, probably there is at least small risk for recurrence. And recent research has shown HPV DNA to be present in the genital area of many more people than we used to think:  even up to age 60, when new HPV infections are very uncommon, as many as 50% of people have HPV DNA detectable on penile skin. But we are quite sure that such persons rarely transmit infection to partners. In light of these several recent studies, the previous 90%/10% estimate may need revision. But as I said, it depends at least in part on definitions. And future research.

3) Sounds like you have oral herpes. Assuming you still aren't having occasional cold sore outbreaks, probably you are minimally infectious for others.

4) HerpeSelect is the main blood test used for HSV testing. (It's only for IgG antibody. The IgM result is by some other company. But IgM testing is to be ignored anyway. It's a horrible test whose positive resutls are always difficult to interpret and understand.) In any case, it is highly reliable in detecting HSV2; you can be sure you don't have it.

Apologies again for the delayed reply. Let me know if anything still is unclear.

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45 months ago
Dr. Handsfield,

Thank you for being so specific with your answers. Much appreciated.

Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
You're welcome. I'm glad to have helped.---