I'm a heterosexual male who has never had anal sex. About 2 years ago I had one unprotected instance of intercourse and developed genital and anal warts. The genital warts went away after 12 months, but the anal warts have not. I have three questions.
1. My current girlfriend (who knows about my warts) has never developed genital or anal warts or an abnormal pap. My doctor says that since warts take hold on specific areas of the body, it's likely that the HPV around my genitals has cleared and there is no viral load there which explains why my gf has not got them. Is this true that the viral load could be eliminated from my genital area but continue to be active around my anus? My gf doesn
I'll try to help - but this is an area without much data, mostly just various providers' experience and opinions.
1) Your doctor may be right about your not having HPV in and around your genital area--but I don't think there are data to prove it one way or the other. Even if your HPV infection is limited to the anal area, With or without direct contact with your anal area, you and your girlfriend should assume she will be exposed to HPV. But as you probably know (I recognize your username from previous dialogs on this forum), if she gets infected she'll probably never know it.
2. I'm more in agreement with Dr. Rockoff. When anal warts first appear, it is reasonable to attempt to eradicate them when they are small. But if that doesn't work and they keep returning, most experts would say the main indication for further therpy is when they enlarge to the point they produce discomfort, get irritated, or interfere with anal hygiene (difficult to keep free from fecal contamination, which in turn can lead to irritation, odor etc). The downside, as the proctologists will be quick to point out, is that delaying too long can make treatment more difficult.
3. Yes, eventually the vast majority of warts resolve over a few months to a couple of years. There are exceptions, but that's the rule.
Thank you, if you and Dr. Rockoff believe this, I'm sold! One quick follow up, doesn't leaving the anal warts alone slow down the clearance process? I would think by continuing to eliminate the anal warts, this would help the immune system get a handle on the viral load. By letting the anal warts sit there, my body will take longer to clear that particular strain of the virus. Or is that just a ridiculous assumption as it sounds as I typed it?
To my knowledge, no definitive data document whether ultimate resolution of HPV/warts is delayed, accelerated, or unchanged by treatment. The "common sense" arguments can go either way: as you suggest, the inflammation that accompnanies most treatments plus debulking (ie, reduced viral load) might enhance clearance; or that maximal exposure to a high viral load (ie, leaving the warts alone) might have the same effect.
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