[Question #556] Anal Hpv
104 months ago
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Edward W. Hook M.D.
104 months ago
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Welcome back to our Forum. I tried to go back and see your earlier interaction with Dr. Handsfield to provide context for answering this question and was unable to find it. That said, Dr. Handsfield and I work closely together and have done so for years and while our verbal styles may vary, we always agree on the basics of our advice.
That said, let me start by urging you to continue to work through your shame and depression related to your infection. As you point out, the infections are extremely common and rarely cause lasting damage/harm to those how are infected. Further, let me also point out that there are few infections of any sort in which knowledge has increased so much so fact. 30 years ago some still questions the role of HPV in causing abnormal PAP smears and cancer. Since then we have learned much, a vaccine has been developed and and knowledge continues to rapidly accrue. As a result, to beat yourself, or even your past doctors up about this topic and lack of knowledge about it is not productive- the knowledge still continues to come forward very quickly. HPV is nothing to be ashamed about. We just need to address the problem and move forward.
As for anal HPV, there is even less know about this infection than for genital infections. Like genital infections, anal infections are VERY common and only a tiny proportion of them go on to lead to anal cancer. We also know that the rates of anal cancer in women are 50% lower in women than they are in men who have sex with other men. How to best manage them is less clear than for genital infections and is a major topic of ongoing research conducted by the NIH which will take a few more years to provide guidance. Like genital infections however, anal infections most often nearly all resolve without therapy. Whether or not or how often anal infections should be followed with regular anal pap smears in unclear and no authoritative agency such as the CDC recommend routine anal pap smears at this time. Treatment approaches vary greatly and none are proven. My advice would be to repeat your anal HPV test in 6 months or a year. If it remains positive, you may want your doctor to refer you to a proctologist for further evaluation. the chance of this going on to cancer however, is certainly less than a fraction of 1%.
I hope these comments are helpful. EWH
104 months ago
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Edward W. Hook M.D.
104 months ago
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It is clear from your post that your worries about HPV are effecting you and your life. That is not healthy. The facts are the facts- virtually all sexually active persons, even those with one partner will have HPV. If this does not help and you still feel guilt and shame, I urge you to do two very important things - stop searching the internet for information as it will often mislead you and, secondly, consider speaking with a counselor or mental health professional about your persistent guilt. As professionals they much keep your information confidential and their perspectives may help you to work through your concerns, Now to your questions: