[Question #6691] Understanding what it means when HPV is "cleared"
12 months ago
I'm a 31 yo male who had a genital wart removed in June 2019. Coincidentally, I happened to have completed a Gardasil vaccine prior to this, in August 2018. I assume this means I was infected prior to vaccination, since I ended up getting a wart anyway. In any case, in Dec 2018 I noticed a small bump at the base of my penis and at first thought nothing of it, but in June 2019 while at a dermatologist getting some moles removed, I asked about it and found out it was a wart. It was frozen off. I suppose I am lucky since I have had no further reoccurrences.
I’ve looked into my HPV a little more since then, and asked some questions about it to medical professionals. In one instance, my GP told me that my HPV is forever, and will have no symptoms (despite explaining to him that I had a wart), and there is no such thing as “clearing”. On the other hand, my dermatologist told me that HPV can sometimes “go away” within a few years, and to forget about it (this seems consistent with advice on this site). I have seen some other studies on the internet discussing “clearance” rates of high/low risk strains, etc, effectively stating that within 2 years most individuals stop showing HPV on tests etc.
What I wish to understand is around
the term “clear” that I often see. Am I correct in understanding that clearing
HPV simply means that either the body’s immune system has completely eliminated
the virus, or that the virus continues to exist in such low levels that it
cannot be detected through tests/devices? Or perhaps the science on this isn’t
quite fully understood, so we use the word “clear” to best describe what seems
to be happening to most people who have warts, then later stop having them.
I guess I am hoping that an answer to this question will better help me understand how I should go about disclosing it to future partners (if needed at all), and what my odds are of a reoccurrence in the future. Thank you in advance for reading and answering my question, and thank you for this site as I’m sure it’s helped many people.
Edward W. Hook M.D.
12 months ago
Welcome to the Forum and thanks for your question. It is a question which we get here on the Forum VERY commonly and for that reason I would encourage you to go on and review some of our past interaction with other clients. I think this will be informative and will allow you to see what both Dr. Handsfield and I say about this topic.
By way of background let me point out that virtually all sexually active, unvaccinated persons will get HPV. Having gotten the vaccine you have reduced your likelihood of getting another HPV infection by one of the vaccine type HPVs more than 95%. Further, in your case, because your wart did not "clear" because it did not have time to and was destroyed by treatment (see below), your chance of having to worry about transmitting infection to future partners is very, very low.
The term clearance is used to describe the fact that most HPV infections will become non-detectable without treatment over several years following infection. With clearance the virus is no longer detectable and transmission to others does not seem to be a problem. Despite no longer being detectable however, most scientists agree that this virus may still be present in a quiescent form and may occasionally reactive and become detectable once again. Clearance is a good thing and indicates that your own host defense is responding to control the infection.
Finally, regarding disclosure. In an ideal word everyone would disclose their past HPV infections to future partners. Unfortunately however, because of the huge amount of misunderstanding regarding HPV, disclosure can often me misunderstood and lead to unwarranted tensions in relationships. We do not feel that past HPV infections need to be disclosed to partners and suggest that the decision to do so me made on a case-by case basis. In your own specific case, between your successful treatment for a wart and your receipt of the vaccine, I think you can consider yourself cured of HPV and need to feel that disclosure is required.
I hope that this information is helpful. EWH