[Question #767] Transmission of HPV after genital wart removal

52 months ago
I have been in a monogamous sexual relationship with my current partner for the last year. When we first got together he disclosed that he had an active case of genital warts (the particular type of HPV was not identified, but he was tested and diagnosed as low-risk HPV). He had three warts removed the first month he discovered them, and had begun taking AHCC based on initial promising results of clinical trials in women. Six months later he had another GW show up and had it removed. It's been almost six months to the day the last one was removed and another just showed up. We're both pretty disappointed as we were hoping he'd be in the percentage of people whose bodies get rid of the virus within 12 months.

During the first six months of the relationship we used condoms when practicing oral and vaginal intercourse (I understand I was still at risk even w/ condoms from potential virus load in surrounding tissues not covered by the condom or GW too small to see) and abstained from sex when there was an overt wart until it was removed and the skin healed. About three months ago (so 3 months before last one and 3 months before new GW), we decided to start having unprotected oral and vaginal intercourse. My question is, once he has the new GW removed, how long should we wait before having unprotected sex? I assume there is a good chance I've already been exposed, I was willing to take the risk three months after the last time and I'm comfortable with even a smaller window this time, but I also don't want to get warts on my mouth (or genitals). Is it common for GW to appear like this - one every six months? The timing seems oddly regular.
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
Welcome to our Forum.  Your thoughtful questions are good ones and, unfortunately questions that there are not great answers for.  I'll share some thoughts which I hope will be helpful.  I think my responses might be a little different if I knew your age, had a rough idea of how many sex partners you have had in the past, and whether or not you have received the HPV vaccine.

Irrespective, my suspicion is that, given the duration of your relationship, that you have already been exposed and, if susceptible (I.e. If you have not had the vaccine- if you have had the vaccine, I doubt that you are at all susceptible to acquisition of infection from him) infected by your current partner.  Hence, I cannot think of any reason to be concerned about infection from him or to not engage in unprotected sex because of concern about infection going forward.  Your susceptibility to his infection should not be a concern.  

As far as the continued appearance of additional warts in him, this is challenging to predict.  Typically it takes at least three to six months after exposure for genital warts to become apparent and in some cases it can take far longer.  There are fewer data about wart recurrence following treatment after treatment (i.e. Treatment failure)  but I suspect that your partner's rate of recurrence is not atypical.

I hope these comments are at least partially helpful to you.  EWH
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52 months ago
Sorry! Should have included that information. My partner is 37, I'm 41, so never received the HPV vaccine (although I've read that the vaccine is only for a limited number of HPV types, so I'm surprised to hear you say I wouldn't be susceptible if ages were completely different and I had been vaccinated prior to becoming sexually active?). I've had around 15 different sexual partners in my lifetime (including oral and/or vaginal intercourse), all male. If infected with the same type that's causing the appearance of genital warts in my partner, do you know what the percentage of likelihood is that I will have overt genital or oral warts as well (vs. having the virus, but being asymptomatic)?
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
Thanks for this helpful information.  The reason I made that statement about vaccine related protection is that two types of HPV, types 6 and 11, cause nearly all visible genital warts and the vaccine contains these two types and offers nearly complete protection from infection by these HPV types.

 While we have clear data that nearly all visible warts are caused by these two types, we have less data about the converse question (what proportion of infections with these viruses do (or do not) cause visible warts).  Thus you may have this infection without symptoms.  If you do, that is Not a health problem for you as infection with HPV 6 or 11 is not significantly associated with risk for cervical cancer or dysplasia.  Thus, in terms of consequences, having visible warts or a partner with them is a nuisance and possibly a cosmetic problem but has virtually no long term health consequences,  EWH
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