[Question #4399] Hpv

29 months ago
Hello I’m seeing what you doctors know about Squam us cell papillomas,  I recently had one removed the doctor biopsied told me what it was that is not contagious not to worry about it but doing research it says it’s caused by HPV six and 11 so does that mean I am infected with the HPV 6–11 I’m a little confused I know I had one papilloma not a wart removed about 20 years ago inside my anus , Is this all related? I never had any visual warts . I have also read on this forum  that many times if you have HPV 611 that warts  will appear but my research also says that a lot of times your immune system will clear it before the awards ever appear . 
29 months ago
I also forgot to mention when I researched it it says they commonly find it and people age 30 through 50 why is that if we get this HPV early in life
29 months ago
Does wanted to make sure you didn’t miss this since I added to my original question 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Welcome to the forum. Thanks for your question. All comments posted before a reply are seen by the moderators.

I'm not entirely sure what is meant by the term "squamous cell papilloma". Papilloma is just a different word for a wart; and all warts are comprised of squamous cells. My guess is that this is a term used in the pathology report of your biopsy, and not by your doctor. All this means is that the biopsy showed a wart. In addition, by definition, warts are caused by HPV. There are no other causes. 

You don't say the anatomic site of the lesion that was biopsied. Anal or rectal, as you had in the past? (As implied by the comments above, if you had a "papilloma" of the anus 20 years ago, it was an anal wart. That said, some doctors might mistakenly use "papilloma" for non-wart problems, such as skin tags. So I really can't say whether your current problem is recurrence of a distant past HPV infection, or a new one.

As for your current problem HPV types 6 and 11 cause 85-90% of genital and anorectal warts. That means 10-15% are caused by other types. So unless the HPV type was specifically tested, it isn't possible to know if you have HPV 6, 11, or some other types.

I am confused by your statement that your current problem is "not contagious".  All warts/papillomas and other HPV infections are contagious by sexual contact with the infected area.

Finally, your last question, which actually is the most sophisticated and perhaps most important.  STD and HPV experts are still trying to wrap their minds around the new data about the high frequency of detectable HPV in older persons. It is still likely that most HPV infections are acquired during most persons' most sexually active years, i.e. teens to age 30. Therefore, most likely explanations are 1) more infections persist in active form than previously believed; or 2) that there are more late recurrences than previously believed. It is possible that nothing has changed, except that HPV testing is getting better, i.e. technological advances in the HPV DNA tests, which might be more sensitive than they used to be. Finally, we really don't know whether all persons with positive DNA tests have truly active infection, or just detection of DNA (without active virus or active infection) that cannot be transmitted to partners. All I can do is advise that you stay tuned:  it is hoped that ongoing research will one day clarify these issues.

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

HHH, MD
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29 months ago
I’m still a little confused , the dr cut the growth out biopsied it and called back and said it was not a wart and said it was a typical squamous cell papilloma . 


Squamous papillomata (SP) are common warty growths 
found in the mouth (they account for 3 - 4% of all biopsied 
oral soft tissue lesions).

SP’s of the mouth occurs at all ages of life but is usually 
diagnosed in persons between 30 - 50 years of age.

There is no gender predilection and any surface of the 
mouth may be affected (most commonly though on the 
tongue, lips or cheek surfaces).

What is the Cause of a Squamous Papilloma?

Many are thought to be due to viral infection of the skin by 
the 
Human Papilloma Virus (HPV), a commonly occurring 
virus that is also responsible for the 
common wart 
(
Verruca Vulgaris).

Whilst all 
HPV lesions are infective, the SP appears to 
have an 
extremely low virulence and infectivity rate; it 
does not seem to be contagious.



29 months ago
I forgot to say The second  lesion was in my mouth 
29 months ago
 I will give you more detail so it will help I looked in my throat and saw something I went to the doctor she immediately said it was a Squam us cell papilloma and it was not a wart that she would biopsy it and be very surprised if it came back with HPV or a wart about seven days later she called and said it was not a wart and I was fine but then I started researching it on the Internet and found that most of them are related to  Hpv, So my big question is I guess when they biopsied it would they be looking for HPV?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
We are experts on genital warts and sexual transmission of HPV, and since this forum is limited to STD issues, I naturally assumed the lesion you are concerned about was genital or anal. Since it was oral, it's probably not a sexually acquired or transmitted problem. In any case, the resource you found clearly states that squamous papillomas are usually (always?) caused by HPV but that infectivity (transmission potential) is believed to be low. Presumably this explains your doctor's advice that it is not contagious. It would appear your doctor and the source you quote know more about this than we do. I cannot say whether most pathology labs would test such lesions for HPV, or whether the doctor doing the biopsy would request that they do. But even if not, you can assume HPV was the cause. This is something to discuss with your doctor. Sorry I can't be more helpful.---
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29 months ago
I have a couple more questions , if it is related to hpv and comes out later in life , does that mean I have an active. Hpv in fection now ? 
Also I have been doing research and a lot of sites and studies say that most people immune system will clear warts bevfore they appear but I know you have quoted a study in the past saying that most people with. Hpv 6/11 will develope warts ,  is there newer research and what % will develope warts . Do you still follow this belief or did newer info change this 
29 months ago
  • Most HPV infections, whether caused by low-risk or high-risk types, are transient (resolve within 2 years), asymptomatic, and have no clinical consequences.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
I'm not sure I understand the first question. When HPV "comes out later in life", it usually has not been "active" the entire time, but rather new activity of a long dormant infection. But that doesn't happen to most people; late recurrence of HPV occurs but not usually.

As for the second question, I think you don't understand entirely. The issue of HPV clearance and the proportion of people who develop overt warts are completely different things. Most HPV infections are cleared by the immune system without ever causing symptoms or being diagnosed. Of the more than 100 sexually transmitted HPV types, only a few cause warts; 90% of genital warts are caused by HPV types 6 and 11. When women (and presumably men, but the research was in women) acquire HPV6 or 11, roughly half develop visible warts in the next few months. (Those data come from only one modest sized study and the exact percentage that develop warts or when that happens might be somewhat different. OTOH, it was an excellent study by very expert researchers and the best data we have.)

Your last statenent is exactly right, but doesn't necessarily apply to HPV 6 and 11. And do not know whether or how often this statement applies to the HPV type(s) that usually cause oral squamous cell papillomas.

That completes the two follow-up comments and replies included with each initial question and so ends this thread. I hope the discussion has been helpful.
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