[Question #7853] Follow up question #7601 Information needed

51 months ago

Hello dear doctors,

I hope you are well and had a happy Easter !

I came back to you with some additional question. After the blood tests that we have discussed on my previous post, ( question #7601) I have done the following analyzes:

- 97 days after the encounter :

Ag HBS ( ECLIA) - negative

Anti Hiv 1+2 ( hiv Combi ECLIA ) - negative

Anti HCV - ( ECLIA) - negative

RPR - negative

Treponema pallidum antibodies - negative

I also have done a complete blood test ( Complete blood count, Transaminases, Red blood cell sedimentation rate (ESR), Albumin, Range - glutamyltransferase (Glutamyltranspeptidase) and a lot of other tests - all normal.

-182 days after encounter i have done again complete blood test ( Complete blood count, Transaminases, Red blood cell sedimentation rate (ESR), Albumin, Range - glutamyltransferase (Glutamyltranspeptidase) and a lot of other tests - all normal.

HSV 1 - index 128 ( i have HSV 1 since childhood) is it of great value or does it not matter?!?

HSV 2 - index 0.07

So my question is , after all that test do you think Am I risk free from all STI ? Am I clear?!?

My only concern remain HPV. After 6 and a half month no visible lesions. After the encounter in November there may appear warts around the anus? I think i have something there ( two white little spots that feel palpable). After what period of time HPV infection becomes non-transmissible?

And the most important question: can transmit HPV infection to my wife?????

Once again my exposure was vaginal protected, fellatio protected and cunillingus not protected.

Thank you and hope to hear from you soon!!!

Edward W. Hook M.D.

51 months ago

Welcome back to the Forum. As I told you in our earlier interaction, your risk for acquisition of any STI from the exposures you described were very, very low-virtually zero even before you were tested. Since then your multiple negative tests have absolutely proven that you did not acquire an STI. Believe your test results. There is no reason for additional testing or concern. You can certainly confidently resume unprotected sexual activity with your wife without concern that you might have acquired an STI that you could transmit to her.

The lesions that you describe in the area of your anus are almost certainly NOT HPV acquired through the events you describe. As you described it, the encounter of concern did not involve anal contact and HPV is transmitted by direct contact. The lesions that you describe may be hemorrhoids, cysts, or some other irregularity and not warts. I would have no concern that the encounter you described resulted in HPV infection and would urge you not to let your concerns about HPV keep you from having unprotected sexual contact with your wife. She is not at risk.

I hope that these assurances are helpful to you. Please don't worry. EWH

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51 months ago

Hello dear dr. Hook

Thank you for your prompt and reliable response!

If you are kind enough to answer some questions just to clarify:

1. Is it true that in men HPV infection is often asymptomatic (no visible lesions)?

2.Is it possible that HPV infection can be transmitted to men from the anus even if there was no anal contact in any form (only vaginal sex with a condom, fellatio with a condom and unprotected cunilingus)?

4. Statistically speaking, what are the chances of the infection occurring in my situation and what is the period of time until the virus becomes non-contagious, or heals?

5. I did the last tests for HIV and Hepatitis B ,& C , 97 days after exposure. From 100 days to 182 days we did complete blood tests including liver enzymes. All normal. I don't think I need to repeat hepatitis B tests anymore. Correct?

6.For HSV 1 herpes, IGG antibodies had an index of 128. Is it normal or not important? I have had oral herpes since childhood. Regarding HSV 2, the index for IGG antibodies was 0.07 at 182 days after exposure. Does that mean I don't have the infection?

Thank you !

51 months ago

When I said that I did complete blood tests between day 100 and 182 they were without HIV tests or hepatitis B and C. The last tests for HIV hepatitis b and C were 97 days after exposure- All negative.

Edward W. Hook M.D.

51 months ago

Straight to your questions:

1. Is it true that in men HPV infection is often asymptomatic (no visible lesions)?

Yws

No, nearly all HPV is transmitted through DIRECT contact. What you suggest here is indirect contact.

4. Statistically speaking, what are the chances of the infection occurring in my situation and what is the period of time until the virus becomes non-contagious, or heals?

Repetitive. Your chance of infection from the contact you describe is VERY LOW

Correct, no further testing is needed

This value only confirms that you have HSV-1. It is not something to worry about.

EWH

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51 months ago

Thank you dr Hook!

Given that this is the last question, I would like to clarify some general aspects. I don't want to be repetitive but I would really like to understand in the future how this infection works

I don't think I expressed myself well in the previous question. What I wanted to ask is the following

It is biologically possible to get infected with HPV through protected vaginal contact or unprotected cunilingus and after a few months to appear lesions around the anus. It is possible? Or lesions around the anus appear only in men who have anal sex with men?

Please be so kind to tell me if hypothetically I could be infected how long it takes to become non-transmissible?

Must there be visible lesions to transmit the infection from man to woman or men being mostly asymptomatic can transmit the infection without knowing it?

And the last question. Oral HPV could cause lesions or any symptom ?

Please answer my questions in order to put all behind because the last 6 months were very difficult for me

Thank you very much for your support and encouragement.

Edward W. Hook M.D.

51 months ago

Final responses. I DID understand your earlier question. You expressed yourself clearly. I

1. Condoms are not completely protective against HPV acquisition but the risk of infection from the exposure you describe is quite low. Condoms provide partial protection and, even without condoms, most single exposures do not result in acquisition of HPV. the risk from unprotected cunnilingus is also quite low. Neither sort of exposure would result in anal HPV infection. As I said before "The lesions that you describe in the area of your anus are almost certainly NOT HPV acquired through the events you describe." This answer will not change. HPV is almost always transmitted through DIRECT contact.

HPV infections typically resolve without therapy over a variable period - 6 months to 2 years. Treatment accelerates clearance. Lesions which do not recur in 3-6 months following treatment are considered no longer transmissible,. Similarly, when HPV infections resolve without treatment there is little risk of transmission.

Asymptomatic HPV can certainly be transmitted. Visible signs of infection are not required.

Typically oral or pharyngeal HPV is asymptomatic.

As you know, I feel that your concerns are not warranted and would not worry if I were you. I hope that my comments have been helpful. this completes this thread. Repetitive, anxiety-drive questions are not appreciated and may be deleted or receive very brief answers without return of your posting fee, Take care. Please don't worry. EWH

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