[Question #4435] Genital Warts Biopsy

30 months ago

I’m a 28 year old male. I obviously have genital warts since multiple doctors have confirmed it. The woman I’ve been having sex with (25 year old female) recently told me she had an abnormal Pap smear and tested positive for hpv. She told me her doctor told her she has high-risk hpv. She also told me something about having a colposcopy done in the future to confirm this. My genital warts are still visible. My question is if I have a biopsy done on my genital warts and have it sent off to a lab, will it test positive for whatever high risk strain she apparently has? Or will it just show hpv 6/11 (wart-causing strain), because the strain that causes warts is different than high risk? Thanks for your help.

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to our Forum.  I'll be glad to comment.  Before I answer your questions, I have a few general comments and a question or two for you.  First the facts- judging on your ages, I am going to guess that both you and your sex partner have had sex with others in the past.  If that is the case, you can be confident that each of you probably has or has had infection with multiple strains of HPV.  Most sexually active adults have and the number of prior sex partners has relatively little impact on that.  In most people, HPV infections go away without treatment over time.  Thus having HPV or a genital wart is just not a big deal- most people have the infection and nothing comes of it.  In a smaller number of persons, HPV can cause changes in the female (and rarely the male) genital tract which are pre-cancerous lesions with a higher (but still not absolute) risk of progressing to cancer.  Since these abnormalities can be detected through tests like PAP smears, we have the opportunity to intervene and treat PAP smear abnormalities before they progress - more good news.  As you probably know, over 90% of visible genital warts are caused by HPV types 6 or 11 and almost never progress to cancer.  A variety of other HPV types cause the remaining 10% of warts but like the others, these lesions VERY rarely, if ever progress to cause cancer.    Here on this Forum, unless they start to grow or change, we consider visible genital warts more of a nuisance than anything else and see little reason to biopsy them.  If your warts bother you, I would recommend just having then treated with any of the many topical substances which are available in clinics and dermatologists offices.  

Should you chose to have your warts biopsied (which I see no reason to do), the odds are almost 10 to 1 that they will be found to be HPV 6 or 11.  

I hope this information is helpful to you.  Now for my question- have you or your partner had the HPV vaccine?  If not we recommend it.  It would be a very effective way to prevent other HPV infections. The FDA recently changed their recommendation for the vaccine and have now approved the vaccine for both men and women up to age 45.  I suggest you consider it.  EWH
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29 months ago
Thank you Dr.Hook. Can HPV be transmitted non-sexually? For example, I used scissors to trim hair in my genital area where warts are. It was in the sink and this morning the water hit it and may have hit my clothes/hands. Maybe I accidentally touched the scissors too, and went to the gym. I was thinking about wiping down every single piece of equipment? Is there anyway hpv can transmit through a hard object like that? According to this link, maybe so? Please let me know your thoughts. 
29 months ago
And also, how long does hpv survive outside the body?
29 months ago
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Before I address your three questions, I must say that I wonder why you perseverate on these issues related to HPV.  As I've already said, the virus is widespread and most unvaccinated, sexually active persons become infected  When they do, they are, for the most part, a nuisance and the rare consequences of progressive infection are readily detected if persons follow routine sexual health maintenance guidelines.  It seems like you are putting a lot of energy into something that you do not have a lot of control over.  

In answer to your questions:
Most experts agree that HPV may rarely be transmitted without sexual contact.  They also agree (as do the two links you provided) that this is uncommon and most infections are sexually acquired.  How commonly this occurs in not known as non-sexual transmission is too rare to be accurately studied.  Numerous studies do demonstrate that viral DNA can be found on inanimate objects, clinic countertops, etc. but how often this leads to infection is unknown.  It appears that exposures of this sort are far more common than actual infections.  Experts agree that transfer of infection through transfer on a persons hand, contact with contaminated inanimate objects, etc is rare.

No one can say precisely how long HPV survives outside the body.  HPV is detected by detection of DNA which is the same whether or not the virus is alive and infectious, alive and non-infectious, or dead.

The article in Glamour that you found during your internet searches is alarmist and overstates the risk for infection from transmission form inanimate objects.  The provider making the statements was a junior investigator who is not a leader in the field.  

I hope this helps.  EWH

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