HPV Long Term - Monogamous Relation

[hpvanalwart]

Dear Dr.,

I'll appreciate if you could answer the following.

I found 2 months ago that I had anal warts. The warts are present only in anal area. Treatement started 2 weeks later. Biopsy of 1 wart confirmed HPV (no-sub type confirmed).

First 2 were removed surgically but then warts spread in the anal area. Then 1 week later after complete healing of those areas I started using podollin (3 day regular treatment) and didnt improve my situation.

Every week I go for cyrotherapy procedure and apply aldara as per procedure since last 2 weeks. Aldara is gng to be on 3rd week now & looks effective.

My questions:
1. My wife hasnt seen any symptom of warts or HPV since I noticed my breakout. Couple of months earlier than breakout, her HPV came negative and Pap Smears was normal.
2. We have regular unprotected sex and she doesnt go near my anal infected area. My penal area hasnt shown warts. Is she infected with HPV or not as we only indulge in non-anal intercourse? or she is just symptom free? I understand u can't give 100% definite answer but her chances (low/medium/High) of having HPV?
3. How long aldara with cyrotherapy usually takes to clear this up? Median(?)
4. Wart Free scenario: After my procedure is done and hopefully I am wart free, will my system clear up HPV (all strains) in 2 years or not? What is probability here as absolute answer can be no?
5. For next 2 years, if my wife doesnt exhibit any HPV symptoms, is she clear of virus also in 2 years starting with my timeline? If her Pap comes normal and HPV negative for 2 years and beyond, is it safe to assume that she was not infected with HPV or her system cleared it up the strains?

Lastly, after 2 years any reason to worry in a monogamous relationship of running into HPV again if system has cleared our strains?

My above said questions havent been answered on the forums or threads.

I fully understand this is your opinion drawn upon your highly value experience in this field.

[hpvanalwart]

Dear Dr,

Thanks for your encouraging response. It helps me relax a lot. There are few assumptions which you made and I would like to know if my extra info below changes your answers #1 - #6

I recently had transgression outside my marriage and understand that HPV contraction came from there. I dont want to say anything more but assumption should be changed to that I stepped out of my marriage.

I am an hetero-sexual male hence no male-male genital/other contacts...This is another surprising part that my penis never got any warts. only anal outside (nothing inside) I am glad about it though

For Question #1: She never had warts until now..So no treatment of warts. We just went for regular checkup few months ago and her doc asked her to do the test and results came fine.

Does this change your answers from Question#1 - #6 and thanks to both (Dr HHH too) for providing such service.

[Edward W Hook, MD]

Welcome to the Forum.  I presume that your relationship with your wife is monogamous and that the warts you identify were an incidental finding of some sort.  If so, your wife has been as  "exposed" to your infection as she is going to be.  Once your therapy is complete, if the warts do not recur in about 3 months, there is little chance of further recurrence.  If you have had sex with other men in the past and have received rectal intercourse, it would be in your interest to get a rectal PAP smear done.  Otherwise you have little to worry about.  As for your wife, regular PAP smears will allow early detection and therapy of progressive infection should it develop and is all that is necessary.  With this as background, let's address your questions:

1.  Not a question.  She is not at risk for becoming re-infected pr relapsing at this time as long as it has been about 3 months since her warts were treated.
2.  Low at this time. High in the past.  As I said above, either way, regular PAP smears are the follow-up needed.
3.  Most patients treated with Aldara respond within 10-12 weeks although therapy is recommended, if needed for up to 16 weeks.  Some take longer
4.  High probability >98%
5.  yes it is
6.  Unlikely

EWH

[Edward W Hook, MD]

Your comment is right on target.  This is an area where the internet can raise havoc with a person's psyche.  Although it is widespread, HPV is just not such a huge concerrn.  Please don't let the internet get to you.   EWH

[hpvanalwart]

Thank you very much for response. I hope I can put this behind me and move ahead with my life

Just a comment:
This is for my piece of my mind, according to CDC etc 1% of sexually active adults i.e 1-2 million ppl have warts any time and are treated over the time (~9-12 months)... There are not many postings on internet or postings which correspond to that many ppl or panic. Google just gives this random search of panicked people and messed up information..

I dont know how many people further even return after they go 6 month symptom free and are basically cured in 2 years. Is this more a mental stress problem for a person as there are too many variants of HPV?

[Edward W Hook, MD]

No change in my answers. In fact, if this wasa a recently acquired HPV infection it is, if anything, more likely to repsond well to therapy than an infection which has been present for a longer time.  EWH