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Genital Herpes Infection
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Genital Herpes Infection

50+ male being treated with Aldara for genital warts (HPV)

Monogamous for 18 years of marriage; the same can be said of my wife.

Promiscuous before marriage but was never aware of any signs of genital HPV. Wife has shown no signs.

Life is currently very stressful: have not worked for 18 months; wife is unemployed; two children; working long hours as I start a business.

Is my experience evidence of a reoccurrence?  Can genital HPV resurface after 18+ years? Once current symptoms disappear, how long before full remission begins?  Is my wife safe from infection during past/future remission?

Thanks for your answers.
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239123_tn?1267651214
Welcome to the forum.

I'm a little confused by the title of your question.  My guess is that you did not mean to write herpes, correct?  The question itself only mentions HPV and genital warts -- and I will reply on the assumption that's your only concern.

The first thing is to be certain the diagnosis of genital warts is correct.  Although warts can appear (or reappear) despite 18 years of mutual monogamy, it is rare.  It's also uncommon for genital warts to first appear in people over age 30.  Please speak with the provider who diagnosed the problem to be certain.  If the diagnosis was made only by naked eye examination -- i.e. without a biopsy or a test for HPV -- discuss whether such testing would be wise.

The rest of this reply assumes the diagnosis is correct.  Although uncommon, warts can reappear many years after they went away; or if the initial infection was never noticed, it can seem to be the first infection.  Once someone has HPV, the virus's DNA often persists for life, so there often is a potential for recurrence.  By the same token, a woman with normal pap smears for many years can suddently have an abnormal result due to HPV that was initially acquired a long time ago.  Sometimes this happens when the immune system has been damaged by some other health condition.  If you are outwardly healthy, this is unlikely -- but if there is any doubt, you should discuss it with your doctor.

Almost certainly your wife is not at risk.  If you have been infected with HPV all the years of your marriage, your wife has obviously been repeatedly exposed.  Most likely her immune system has fought it off and she is immune to catching it again.  Probably she'll never have any problem with this.  However, to be safe she should be on the lookout for genital area bumps that might be warts and see her primary doctor if anything appears.  And next time she has her routine periodic gynecologic examination, she should tell the provider about your recent diagnosis of warts, then follow his or her advice.  Probably s/he will agree that nothing special need be done.

Feel free to let me know a bit more about how your warts were diagnosed and/or your doctor's confidence about the diagnosis.

Best wishes--  HHH, MD
8 Comments
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239123_tn?1267651214
Your new thread was inappropriate.  Only a limited number of new questions can be accommodated, and superfluous ones block others with their own questions.  Your follow-up questions should have been posted here. The new one will be deleted without reply.

You asked:

1. "Can genital warts HPV like other forms of HPV be cleared from the body by the immune system, thus ensuring no further outbreaks or risks to sexual partners?  How long does this take?"  Yes.  You answered the "when" part yourself; several months to 2 years is about right (usually a year or so).  But you already know you are atypical in having an apparent late recurrence.  So it is difficult to predict what will happen. But most likely there will be no additional recurrences once the present warts respond to treatment.

2. "After a breakout, when can one safely assume that remission has begun? I have read reports of 8 months to 2 years."  See no. 1.

3. "Is a person with genital wart HPV infectious during remission?" Usually not. But if your wife is your only sex partner, she probably isn't at risk anyway -- which I explained in my original reply.

4. "How long can the latency period of genital wart HPV last? I have read reports of months to years to decades in some instances."  I answered this above as well.  Some experts believe that every HPV infection remains latent for life.  Others aren't so sure.

I strongly reemphasize the main advice I gave above, to be sure the diagnosis is correct.  I'll be happy to make a final brief comment after you answer my questions there about the diagnosis. Until then, use the search link to find many other discussions about HPV and warts; or look at other excellent websites with HPV information, such as www.cdc.gov/std, www.ashastd.org, and www.westoverheights.com.  Do not start any new threads.
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Please accept my apology. I was confused and shall know better in the future.  Thank you very much for bearing with my excesses, driven as they are by my high anxiety.

Regards -
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239123_tn?1267651214
Don't let this be a bigger deal than it is. Assuming your diagnosis is accurate (and I still think it is possible it is not), you are infected with a rather trivial, impersonal virus that rarely causes serious problems. There are no implications for your fidelity to your wife, for hers to you, or for you long term health.  This is a minor health-related inconvience, nothing more.
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Thank you, Doctor.  I hope that in time my wife can share that view.  With respect to your advice, I am having a biopsy done next week.  Hopefully there will be something to biopsy since I only had one wart and it is healing quickly after cryotherapy and aldara at the prescribed dosage.  I must ask - if I don't, my wife will - is it possible that during the years we have been married I have remained in remission and she is, as a result, still uninfected?

Regards -
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239123_tn?1267651214
I suppose it is possible she isn't infected, but most likely she is.  If so, that's good:  if she hasn't had warts or an abnormal pap, it most likely means her infection has done no harm and never will.
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Dear Doctor Handsfield-

Please advise me whether a new string is necessary for the following questions.  If so, I shall pay the freight and get back to you with the following:

My wife went ballistic (and is still hysterical) when I shared my news with her.  Hopefully, she'll calm down. When we started to discuss the ramifications for intimacy between the two of us going forward (assuming she's not infected) she asked:

1. If one cannot see warts (either oral or genital) during an outbreak can one be infected?

2. She knows now the symptoms of genital HPV wart infection but she's most persistent about the symptoms of mouth and throat infection (early and full) , how and when it can be transmitted, the appearance of the infection (she can't find photos of throat infection).

She's convinced that all future intimacy is at risk.

Thanks in advance for our response.

Regards
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239123_tn?1267651214
Sorry to hear about your wife's overreaction.  It isn't warranted.

1) Yes she can be infected without visible warts.  But I stress that the most likely scenario is that she was infected years ago, her immune system has eradicated the virus, and she will never have a problem with it.

2) The genital wart virus strains do not readily infect the mouth and throat.  It can happen but is uncommon; and such infections rarely cause overt warts and quickly clear up on their own.  And the comment above still applies; i.e. it is unlikely she has to worry about a new HPV infection, despite your apparent warts.

What to do now?  Two things.  First, you have not said anything about my strong advice to be sure your diagnosis is correct.  It remains possible that all this concern is for nought, if you don't actually have genital warts.  Second, assuming your diagnosis is confirmed, you and your wife both need to see a health care provider, in person, who understands HPV.  Your doctor might be appropriate, especially if s/he is a dermatologist; or perhaps your wife's gynecologist, since most Gyns are up to speed on HPV and warts.  These issues are too complex, and you and your wife are too emotionally upset by it, for management by any distant online forum, this or any other.  In the meantime, consider showing this entire discussion to your wife.  It should help her calm down.

Until and unless you report confirmation of the diagnosis and that you and your wife are getting personal advice from your doctor(s), I will have no further comments on this thread, and we will not accept a new thread on it.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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