[Question #6330] HPV Transmission after clearance

17 months ago
Hi there,

I asked Dr. Hansfield a question on this forum a few weeks back about disclosure of a past hpv infection. I'm not aware if you're able to see past questions from specific users, so I will copy/paste my background from my previous question.

background: 28 Female, I tested positive for HPV16 9 yrs ago w/ CIN1. I was told to wait it out a year and ended up clearing both HPV & CIN1 without treatment within ~13 months. I've since tested HPV negative on my past 3 pap/HPV co-tests and have also gotten vaccinated.  I have limited background in microbiology (bachelor's degree) so forgive some of the specific questions I have.

I previously asked about the ethics of disclosure. I am now curious to know my chances of transmitting this past infection. I'm asking because I was reading up on the other HPV questions from this forum and noticed that Dr. Hansfield mentioned that there is no safe window for HPV contagiousness because it can reactivate periodically "sometimes as often as 20 - 50% of the time". I don't recall the exact context of that question and/or Dr Hansfields answer to it so I'd like to ask the question relative to my personal circumstances that I've noted above.

I understand that there is no guarantee of not transmitting. However, I would like to know the likelihood. How likely am I to give this strain to another person? I'm just getting back into the dating game and although I realize HPV is common and mostly harmless, I'd still like to feel that my chances of transmitting this are slim to none. Please correct me if I'm wrong.

I understand my chances of  transmission increase with old age, illness and pregnancy (since my immune system will less able to keep the virus in check)-- none of these 3 things currently apply to me.


17 months ago
it says this was just updated "15 minutes ago" but I don't see a response.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Welcome back to the Forum.  On this occasion, I happened to pick up our question and will be answering.  I did review your earlier interaction with Dr. Handsfield and agree with all that he said.  Like him, I think that you are overthinking this. 

The information that Dr. Handsfield mentioned and that you saw on had looked at past posts related to HPV reactivation - thank you for doing that.  In your case however, the fact that there is no evidence of reactivation in your case now, 9 years following your prior diagnosis, as well as your decision to go on and get vaccinated make is most unlikely that you are going to reactivate.  The data about reactivation that you have found refers to reactivation occurring within a few years of infection, not about a decade later.  Please remember that most unvaccinated persons acquire HPV early in their sexual lives and then resolve them.  If age-related recurrence were frequent we would see lots of HPV with PAP smears and tests of women over age 30 yet we do not.  In fact, as I suspect you know, screening recommendations are for less frequent screening on older women.

I really think you are over processing this and misapplying data regarding early recurrence to fuel speculative questions.  This is simply not productive.  I urge you to put these concerns aside, continue your regular (no more frequently than yearly) screening and move forward with your life without concern that you might be infecting partners. 

EWH. 

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Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Please be more patient.  There are often delays between we sign on to a reply and when it is received. In your case, the time involved reflects, in part, the time I took to review your earlier post and reply to you.  I would point out however that that your are watching so closely for a reply appears to confirm that you are overthinking this issue, particularly given that your own infection resolved a number of years ago and has shown no signs of recurrence.  EWH
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17 months ago
I'm very sorry about the lack of patience, I noticed the time change and was just making sure there wasn't a web glitch.

I appreciate your response. Just to make sure we are on the same page, by reactivation I am not necessarily referring to a reactivation of symptoms. For example, I'm not worried about getting CIN1 again. I'm worried about a-symptomatic viral reactivation (cellular changes or not). Secondly, my question was more about transmission likelihood.  I would like to know the likelihood of transmitting this strain of my virus (strain 16) given my personal circumstances.

I agree with you, I do believe I am overthinking this. I really wish I could stop - trust me, it's not fun.
17 months ago
I know that a reactivation of past symptoms (such as CIN1) is highly unlikely; again, Im worried about A-symptomatic reactivation and potential transmission (outside the realm of illness, old age and pregnancy)
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Not to be too pedantic but symptoms are the wrong term.  Symptoms is the term used to describe sensations and experiences that you can report.  HPV infections, including reactivation is very often asymptomatic although a portion of persons with the infection may become aware of their infection if they observe visible warts.

That said, the odds are against your experiencing a recurrence of your HPV or your transmission to others in the future.  The likelihood of all of these diminishes with time and as we have noted, now nearly a decade after your initially diagnosis you remain without signs of recurrence. I would urge you not to continue to worry about potential transmission to others.

Finally, knowing  that you have read other threads on this forum relating to HPV, I presume you also are well aware of our stance that even if your infection should reactivate (unlikely) and even if you inadvertently transmit it to others (also unlikely), this is simply not a major health risk.  EWH

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17 months ago
Thank you,  Dr. Hook - your answers have been useful
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Thanks for your thanks.  I do appreciate your concern for future partners and hope that my comments have been helpful.  Take care.  We'll close this thread shortly.  EWH
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