HPV/Genital Wart Question

Hello,
Im a male, 23 years old.
about 4 weeks ago, I was diagnosed by my dermatologist to have genital warts on the shaft of my penis. I have 7 small bumps, some are more visible than others and are around the shaft. I have been treating them with Aldara (Imoquimod).  Of the 7 warts I have now, 3 of those appeared after my diagnosis.
I am pretty confident after my Aldara treatments, my warts will be gone. However I am worried they will keep coming back. I have read that HPV remains in your systrem the rest of your life, and I have also read that it can also work itself out by the immune system. Which leads me to my question. How will having this affect my life? I never discussed it with my dermatologsit, but what does this mean for future sexual activity? When Im married will I give my wife HPV/warts? Also, is the strand that I have a strand that will cause abnormal paps in women? I have had a girl friend for the past year and I am worried I may have given her a cancer causing virus. (She didn't get the gardisil vaccine until recently)

Thank you for the help!

[Edward W Hook, MD]

You have a lot of reasonable questions about warts and HPV.  The topic of HPV and genital warts is a complex one.  I will try to provide some facts however the amount I can provide through this medium is a bit limited.  For additional information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA)..

HPV is the most commonly acquired STD.  More is known about HPV infection in women than men, in large part because the infections more often (but rarely) lead to troublesome consequences.  Over 85% of sexually active women will have HPV infection at some time in their lives and it is reasonable to think that the figure is similar in men.  In some HPV will cause genital warts as you have, in others it will not cause warts but may lead to inapparent infection in men or changes in PAP smears in women.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy, typically in 8-10 months.  For persons with visible warts, therapy with topical agents can accelerate resolution.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  With this as background lets deal with your specific questions:

1.  Will they recur?  With the treatment you are taking, after resolution there will be recurrences about 10-20% of the time.  If this happens, they just need to be re-treated and your dermatologist will help you on this.
2.  Do you have infection forever.  this is an all too common myth.  While the topic is debated. most believe that once treated and once you are 3-6 months out from treatment without recurrence, you do not need to worry about recurrence or giving infection to sex partners through unprotected intercourse.
3.  The strains that cause visible genital warts may cause abnormal pap smears in women but they are not likely to cause cancer.
4.  If you have warts, your GF is exposed and may have infection. I don't mean to sound un-caring but it is just not that big a deal.  If she develops them she can be treated.  That she has had the vaccine reduces her chances of having warts dramatically.

I would also suggest you discuss some of the lingering questions you might have with your dermatologist.  

I hope this helps.  Please check out the web site.  EWH