[Question #7271] Need advice

7 months ago
Dear Doctors,
I have a few questions about HPV

I am female, late twenties. Started seeing a man in march and we’ve been having unprotected sex for 6 months now. Before him I was with my ex for 8 years. 
Full panel pcr test done in march, all negative (low risk types included).
Few weeks ago, routine pap, doctor noticed a small rough spot next to my cervix, pcr swabbed, its HPV 6. Im good cancer wise. Since then I noticed a single texbook wart on my clit. 

Partner doesnt have warts. Ex didnt have warts (visible).

1. I know the tests aren’t perfect and I will not know when and from whom I got it. But is it likely coming from my new partner? Would be happy to think that. If I had it before, 8 years is a lot of clearance time right? Plus the pcr would have probably picked it up in march..?

2. We started using condoms, that we hate. I know that by now we’re both infected. I read replies saying its not necessary in this case. But in my situation, warts next to my cervix, the head of his penis rubbing against it wont make the infection worse for him? Or he has it, period, repeated exposure doesnt make any difference? So he wont break out on the tip (more, compared to condom use from now on).

3. If its coming from him, my warts wont trigger an outbreak in him?

4. If its coming from me, in 6 months he didnt develop warts, is it likely that he wont? He is in his late forties, 10 partners before me, i heard warts are rare after 30. Does it happen often with type 6 that people dont develop warts?

Thank you for your service.
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
Welcome to the Forum and thanks for your question.  It appears that you have investigated the topic of HPV infections and I thank you for that as well.  I’ll do my best to answer your questions.  As I suspect you know, within a year of the onset of intercourse, irrespective of partner numbers well over two thirds of women will have acquired HPV; subsequently cumulative infection rates rise slowly.  The great majority of those infections will become undetectable in the year or two following acquisition.  Detection is also subject to sampling error which, unless a visible lesion is present, may miss an infection on any single specimen collection.  While sampling problems typically do not impact management, the add to the great difficulty in determining whom infections have been acquired from.  The time sequence you describe is most consistent with having been infected by your current partner.  Presuming that the visible lesion on your cervix was the HPV, the appearance of visible warts most typically takes 3-6 months.

In answer to your specific questions:
1.  See above.  As you point out, hard to tell but most probably this is a relatively recent infection.

2.  At this point, condoms are of little value.  Repeated exposures and location should not make a difference 

3.  Correct.

4.  There are no data to provide a good answer to this but, given his history, it is unlikely he will now develop warts, either because he already has the infection (many HPV 6 infections do not lead to visible warts) or has had the infection in the past and resolved him, making him somewhat resistant to further infection.

Finally, I note that you do not mention previous HPV vaccination.  You may wish to consider it if you have not had it.  It will provide protection from infection with other HPV types and emerging data suggests that vaccination MAY reduce recurrence or contribute to sustained resolution.

I hope these replies are helpful.  If not, questions for clarification.  EWH
7 months ago
Thank you Dr Hook.

I actually need some clarification on question no.2.,condoms. 
What do you mean by little value? 
If we are both infected, the virus is in our system, so repeated exposure of his corona to my cervical warts will not make him develop more warts in that area than he otherwise would? Is that correct? If he is the type who doesn’t get warts, it will stay the same regardless of my warts? 

And do I need to get them cryoed off? If they dont cause any pain, and I stay monogamous with the same person? 

What about shaving? Maybe I have very small or flat ones externally that I don’t see, is shaving ok? Is it only bad if there is a risk of shaving a wart off?  

Thank you! Your service is very helpful
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
I’m sorry if I was unclear regarding condoms. Irrespective of whether he was infected or not at the time you met, he has now been exposed over a period of months. Starting to use condoms at this time will not change his risk for developing HPV if he did not have it before nor will it make an existing HPV infection worse or persistent.I hope this addresses your question.

Other than cosmetic issues, I see no reason that you need to have the visible warts that you have treated.

Shaving over an existing wart can contribute to spread of the warts to other sites.

I hope these clarifications are helpful. EWH