Anogenital wart with HPV type 1, 2, 4

[confused20112]

Hi --

I was recently diagnosed with a wart on my anus. I am a straight male with no history of anal sexual exposure, and I have no sign of warts on my genitals.

A biopsy was performed, and the lab did a subtype test as well.  The results said the type was one of the strains that cause "common warts," most likely HPV type 1, 2, or 4.  Apparently the lab did not narrow it down farther than that.

My questions are:

1. I thought that ano-genital warts are almost always types 6 or 11.  Isn't it very strange to have a "common wart" type in that region?

2. What does this mean for contagiousness? Is it reasonable to assume that transmission is less likely since this is a strain of HPV that usually sticks to the hands and feet? I only plan on having traditional intercourse and no direct involvement of my anus.

3. How nervous should I be about also transmitting this to my genitals? I've never had warts on my hand before, but now I think I notice one or two, and I'm terrified about touching my genitals during masturbation or while going to the bathroom.

Thanks.

[Gaurang Krishna, MD]

Hello confused20112,

Oh yes. I am so sorry about that.

I did mean HPV (Human Papilloma Virus) and not Herpes.

Thanks for correcting me.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Gaurang Krishna

[confused20112]

Thanks -- it has been removed completely. You mentioned herpes a few times, but you mean HPV, right?

[Gaurang Krishna, MD]

Hello Confused20112,

Here are the answers to your queries:

1. Yes, sexual transmission of the Herpes virus would be highly unlikely though the risk is not zero, through the normal vaginal intercourse.

2. Yes, your statement regarding the recurrence of Herpes infection is true. More so with common warts than genital warts, that your own immune system plays a major role in eradicating the infection. But this immunity is not 100% and reinfection may occur.

I strongly advise you to get this wart removed if it has not been completely removed during the biopsy.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Gaurang Krishna

[confused20112]

Thanks for your response. Just two quick follow-ups:

1. To clarify, even though the virus has now affected by ano-genital area (just the anus, as far as I can tell), sexual transmission would still be extremely unlikely through traditional intercourse?

2. Most STD experts advise that if symptoms of genital HPV don't recur within 6 months to a year, the immune system has probably "cleared" the virus or suppressed it to the level where it's negligible.  Would the same thing be true of my infection, since it's an unusual type?

Thanks again.

[Gaurang Krishna, MD]

Hello confused20112,

You have asked some very important questions.

Let me answer your queries one by one -

1. It is true that Anogenital warts are mostly caused by 6, 11, 16 and 18 strains, but this rule is not absolute. Strains causing the common warts i.e 1, 4 etc may also infect the genitals (due to their sheer number-they are omnipresent). As a matter of fact infection may be transmitted from a common wart to the genitals, but the reverse does not happen.

2. As for the sexual transmission of these warts, it may happen, though it is extremely rare.

3. As for your risk of infecting your genitals, yes, it is theoretically possible. But I’d say avoiding masturbation to prevent this is being over-anxious.

The best way forward is to get the wart removed. There are many different treatment options available- excision, RF, Cryotherapy, Laser etc. Discuss the option that is best for you, with your dermatologist.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Gaurang Krishna