[Question #7332] HPV related health problems

4 months ago
First thank you for providing this resource. More than two decades ago and even as recently as a month ago I could not get complete information about these issues.
I ended up getting partial information from a STD support group that I did not get from my health care providers: 
The HPV test is NOT a status test.
As I'm sure you're aware these issues are complex and some hcps are not as well informed as others. 
I was told two decades ago by an obgyn that the GWs that resulted from HPV wouldnt be an issue "by through time I graduated" in two years.
I took that to mean it wouldn't be an issue for me (after treatment) or others. This was confirmed via a CDC post that said there was no benefit to telling future partners ..or at least no recommendations could be made. This seemed to mirror the fact of no further issue aside from a HPV+ test (no LEEP procedure required). I am still very concerned about how to discuss this with a potential partner. 
Now that you have background. 
What would you say to single women who have a history of treated GW after five years of no further issues and only one time + test for HPV that cleared on its own?  
What would YOU tell a potential monogamous  partner? 
Ive seen different answers here. This is Such a taboo subject many people, health care professionals included avoid the subject all together or give curt answers like "be careful".
Concern for giving information that is both accurate and not unnecessarily alarming. 
2nd I heard a famous actress state that she had cancer three times -breast CA, and cervical hyperplasia and condylomata ...but the later two arent cancer, are they?? 
Thank you much in advance for your detailed attention to these questions. 
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago

Welcome to the Forum.  thanks for your confidence in our service.  I'll do my best to provide answers to your questions.  In addition however, I would strongly encourage you to seek additional information by reading some of the numerous other threads on this site regarding HPV infections- we leave them up on the site to make them accessible to clients for the information we provide.  Secondly, the sponsor of this forum, ASHA, also has a very good web site with lots of helpful information.

Regarding your questions.  To start with, there are well over 100 different strains of HPV.  Not all infect genital sites and of the ones which do infect genital sites, two- types 6 and 11-cause over 90% of visible genital warts.  HPV infections of these types do NOT progress to precancerous lesions or cancer and can be considered a nuisance and, on occasion, a cosmetic issue of they are particularly large.  OTOH, other types which typically do not cause visible lesions are the types which rarely (less than 2-3% of the time) progress to pre-cancerous lesions of the sort detected by PAP smears.  Even many of these pre-cancerous lesions however will regress/resolve without therapy.  Substantially less than 1% of all HPV infections progress to cancer and routine, recommended GYN evaluations are very good at detecting such problems early so they can be treated before they progress. 

Regarding partners. Optimally it is a good thing to let partners know that you had HPV in the past but you can also say that it was treated and be confident that it is not longer transmissible.  Further, it turns out that nearly 80% of sexually active persons, including most who are monogamous, will get genital HPV at some point.  For this reason, since just about everyone already has, or will have it, we do not feel terribly strongly about disclosure of past HPV since unvaccinated partners are likely to already have it. 

Regarding what I would say to you- first, if you are not yet vaccinated, you should be.  It will protect you from future infections by the most common HPV types causing both visible and non-detectable HPV infections.  Second, if your prior infection has been successfully treated and not recurred, I would not be worried further about the issue.

Neither cervical hyperplasia nor condylomata are cancers but they do reflect HPV infection.

I hope that this information is helpful.  Please take a look at the resources I suggested.  EWH

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4 months ago
Thank you very much. I will check out the additional resources. It really helps to hear from an expert. If I may with one followup question. How do you all feel about the age cut off of 45 for the vaccine? If a person is older than that would it still be beneficial if the person already had two shots of the three shot regimen? 
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago

Good question. The efficacy of the HPV vaccine declines as persons have more partners which, in a vague sense, corresponds to their age.  Currently the FDA has approved the HPV vaccine for persons up to age 45.  This impacts at what age insurance companies will pay for vaccine.  Further, as we age, vaccines are somewhat less efficacious.  In my opinion, vaccination is a good thing but each person has to make their decisions.

Two injections of the HPV vaccine offers protection for most who receive it.  The third injection tends to prolong the duration of antibody detection which appears to correspond to protection.

Hope this helps.  You are asking good questions for which their are not clear, absolute decisions.  EWH

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