[Question #769] HPV

53 months ago

Hello Doctors,

I am 32 now. When I was approximately 24-25 I contracted genital warts while living in Taiwan. There was a cluster of approximately 5-8 warts around the shaft of my penis. I had them frozen. A couple came back and the treatment was repeated. None came back.

A couple months later another bump appeared on my shaft where the original wart appeared. However, it appeared different and my doctor at the time said it probably wasn't a wart so we didn't treat it at all. Throughout the following years I never had it treated but I periodically would tear and rip it off. Almost always it would reappear in a matter of weeks or months.

Fast forward to the present. I showed my doctor this bump when I returned to Canada. She said she doubted it was a wart due to the fact that none of the other warts had ever reappeared and it was just that single bump but she referred me to a dermatologist.

The dermatologist said he was 99% sure it was just a mole. We elected to surgically remove it for cosmetic reasons and he sent it for a biopsy. Much to my surprise I received a call from his office stating that it tested positive for being a genital wart.

I have read a lot of literature stating that the virus is usually cleared within a year or two.  My immune system is normal by all accounts. Did this wart just last this long because it was never treated correctly until now? All of the other warts that were frozen have never returned. Can I be confident that now that I have treated this one it will respond like the others and not come back? Does the normal prognosis still apply to me, that I can be fairly confident that if this wart does not return within 6-12 months that I am not contagious and that if it doesn't reappear within the next year or two that my body has cleared the virus?


Thank you so much!


 

53 months ago

I should also mention that during my initial diagnosis I was found to have a wart in my throat that was removed and has never came back (I was just at the ENT doctor a couple months ago for an unrelated problem and all was clear).

Also, although this wart would seemingly increase and decrease in size if I left it long enough without tearing it or ripping it off, it never multiplied or massively changed.

I have also had 3 long term girlfriends during the 6-7 years that I had this wart and none were ever infected despite having unprotected sex (I was under the impression that it wasn't a wart from the doctor so I didn't wear protection in monogamous long term relationships).


53 months ago

My apologies but the second post, second paragraph talking about the wart not changing in size significantly or multiplying is referring to the one on my penis and not my throat. The one on my throat was removed when I was 25 and never came back.

That wasn't clear, I am sorry.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
Welcome to the forum. Thanks for your confidence in our services.

Like you and the dermatologist, I am surprised the lesion turned out to be a wart. However, I don't think this has any implications for your immune system or for persisting HPV infection. There is a lot unknown about HPV biology and the immune response, but one possibility is that this was unrelated to your past genital warts. Perhaps the HPV causing it was a non-genital type. Your circumstance is very unusual, and I have never cared for a patient with this sort of occurrence. Your dermatologist probably is a better source of information than I can be. However, it is reassuring that your sex partners have never complained of acquiring HPV or warts, which suggests (but doesn't prove) that it is not communicable or perhaps not a genital HPV type. If I were in your circumstance, I would carry on my life (sexually, romatically, and every other way) as if this had never happened, and really wouldn't worry about it -- with the single exception that I would see the dermatologist promptly if there ever is a recurring bump or similar problem at the same site.

Sorry I can't be more helpful. Best wishes--

HHH, MD

---
53 months ago
Thank you so much doctor. Your work on this topic has always been a great source of reassurance and comfort for me. 

If I could just pose one  last follow up question. 

My last gf was immune suppressed as she was/is taking medication for Lupus. So the fact that she didn't get it seems to further your point. 

So, it is possible that it was a non-genital type and in that case they are not contagious from genital to genital? 

Are there any further tests that could be done to prove it wasn't a non-genital wart? 

Finally, if I don't see the wart appear again in the next couple months I can be reasonably sure that I am not contagious and just because it was there for that long doesn't mean my body can't still clear this virus in the following months considering how well I cleared all of the other warts without a single recurrence in 7 years. 

Sorry for the lengthy follow up but the uniqueness of my case has me worried despite your very reassuring and warm words. 

Thank you so much!!  


53 months ago
Sorry, meant to type 

* Are there any further tests that could be done to prove it was a non-genital wart? *

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
Your previous partner's immune suppression doesn't mean much one way or the other. Such persons probably are not usually susceptible either to catching HIV or getting warts if they do.

My comment about a non-genital HPV type was purely speculative. I can't comment further on how likely it might be. However, non-genital HPV types are so rare on the genitals that it seems the genital area must not be highly susceptible, in which case genital-genital transmission might be rare. But all this is just educated guesswork. As implied above, many dermatologists probably are more expert in these aspects of HPV than most STD specialists are.

If the wart doesn't reappear after a few months, most likely you are cured and the underlying HPV infection is gone. I cannot rule out the more pessimistic speculation, but I think it is unlikely. Anyway, what would it matter? You have experienced genital warts, I assume you will agree they have always been a nuisance only -- i.e. and inconvenience, not an important health threat. Even if you were to have a recurrent wart someday, it would probably again be a pretty trivial deal for you. The only thing to keep in mind is the low chance of penile cancer. It is caused by different HPV types than warts, but still you should have a low threshold to see a dermatologist if sort of bump or other genital skin problem appears someday. Even then, it would not be a big worry; if treated early (within a few months to a year) it would be immediately curable.

So while all this has obviously been upsetting to you, it really isn't a very big deal. Nothing serious is likely to ever come of it, either in you or your current or future sex partners.

---
53 months ago
Thanks for the further answer Doctor! I really appreciate it. You mean HPV if the first paragraph, correct? 

Final question before we close the topic. If the wart doesn't come back in the proceeding months to a year, it's been your position that telling any future sex partners is probably unnecessary, right? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
53 months ago
Yes, HPV. Excuse the typo -- with one letter difference between HIV, HPV, HSV, HBV, and HCV, such errors are pretty common, as I'm sure you can understand.

Whether or not to inform partners about past HPV or warts has no single answer. Many couples choose to discuss past sexual experiences including STDs, others do not. From a disease prevention standpoint, I see no need -- but from a relationship perspective, it might be something to consider.

Thanks again for your question. Best wishes.

---