STDs Expert Forum
HPV Outbreak 5 years later...
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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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HPV Outbreak 5 years later...

Hi Docs -
I struggle with OCD and have visited your site with regards to HIV in the past.  I have gone through therapy and can happily say that with therapy and medicine, I am doing MUCH better...and you'll be happy to know this is unrelated.

I had a long time girlfriend in college through 2004.  In that relationship I was given HPV that resulted in a case of genital warts.  The warts were reoccurring from 2003-2005 or so in my pubic region and base of my penis.  Generally, they were the same warts in the same places.  My doctors told me they would go away on their own in time and I had nothing to worry about.  I abstained for their recommended period of time, and I was given valdara I believe and had several frozen off.  Eventually, they dissapeared for good in 2007...

This morning when showering, I recognized I had two small warts in my pubic hair.  I have not had any warts in 2+years (and had not gotten "new" warts in 3 or 4) and have only been with the same woman throughout that time.  we have unprotected sex, but she has been cleared by her gyno as not having HPV or any other STDs.  

Clearly I suffer from concerns with regards to my immune system but I am very confident this has nothing to do with HIV or any other immuno-suppressive disease.  I just dont know why they are back or whether they are something to fear as contagious given my current relationship.  I have not told her my past experience with HPV because it was "ancient history" according to my physician. can you please let me have your expert opinion?

Many Thx Docs
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Welcome back to our Forum.  Your story has several unusual aspects which cause me to suggest that what you have noticed may not be a wart of HPV.   Warts are really quite rare in the public hair.  That your prior lesions went away after freezing does not necessarily mean that they are warts.  There are many dermatological processes which can occur that resemble warts (skin tags for one) and freezing is effective at making nearly all of them go away.  Before you assume these are warts, I would suggest you ask a dermatologist to take a look and, if appropriate, biopsy them (this will cure the wart if it is indeed a wart as well) to verify what it is.

If this is a wart, figuring out where it came from is going to be difficult.  It is doubtful however that this is a manifestation of meaningful change in your immune status and your body's ability to fight off infections.

A agree with your doctor’s advice about the lack of need to disclose your prior infection to your current partner.

Hope this helps. EWH  
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TO RLS1919.  Sorry, even though your quetion is related, it is against MedHelp rules to allow others to "jump" clients' question threads. If  you wish to ask this, you will need to start your own quesiton.  EWH
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Avatar_m_tn
Thx Doc!

To clarify - 5 or so years ago, my physician did do a vinegar solution and decided they were warts...but those have long since been gone after being frozen a couple times.  

I also got warts on other body parts often as a kid...can that be related to getting them in my pubic region or is this exclusive to an STD? I am an athlete and my "bumps" are right on the waistband of my undergarments which can at times be sweaty...if that is at all valuable info.

I am going to see a dermatologist after the Holidays.  If it is determined these are warts, would that mean it is definitely my former case of HPV from 5 years ago flaring up?  would I need to be concerned of my immune system at all if these are confirmed warts?  will I need any other STD tests in lieu of this revelation or can I just accept them as an indpenedent issue and move on?

Thx sir - happy holidays.


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Your additional history serves to solidify the recommendations I made earlier.  We now know that the vinegar test is wrong at least half of the time, identifying skin lesions which are not warts as possible HPV.  Furthermore skin tags and other non-HPV bumps are common in areas where there is a lot of friction, thus your athleticism may have contributed to you lesions as well.  

The are over 1000 different types of HPV virus and for the most part different types tend to infect only certain places.  On the other hand and since in science we can never say never, given your history of warts in other locations  I suppose it is possible that the lesions you note are warts which are more typical for a different location, but I continue to doubt it.  

Finally, if these really are warts, I really doubt that they are a recurrence of infection which has been gone for 5 years.

Please let me know what the dermatologist says.  Happy Holidays.  EWH
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Avatar_m_tn
Hi Dr Hook.
I went to the dermatologist here in SoCal today and updating you as requested.  Since we last emailed I found another small bump in my pubic hair that I scratched off like an idiot…it has yet to return after bleeding a lot and I know it was dumb and could have spread the virus.  A week or so later I found a few raised bumps on my penis that look more like scars with a light whitish color (not very noticeable unless you really examined it – I was doing a THOROUGH search - and nothing like the mole-like wart/ skin tag in my pubic hair). Immediately upon a quick glance my Doc told me the spot in my pubic hair my be/ probably is a wart.
He decided to freeze the spot in my pubic hair regardless of what it is and then gave me the option of freezing or taking a biopsy of the spots on my penis. We both thought a biopsy would be a better/ more definitive answer so we chose that and should have those results in a couple weeks.
He told me he thought I either caught a new strand of HPV or had an inflammation from my strand in 2004-2005 though it has not flared in 2+ years.  He said if that were the case it would be due to a weakened or disrupted immune system (I did have a bad sinus infection most of December).  Lastly, I told him my GF took the Gardasil shot and has always had “clear” pap smears…but he didn’t seem to be too worried about any of it really.

Dr Hook – whats next? Is this something to be very concerned with?  Should I look at this as a totally isolated incident relative to my fears of HIV or is the concern regarding my immune system’s functioning mandate further STD testing as well? I have been with committed and faithful to my GF of 2+ years and I tested negative beyond 12 months after my last sexual exposure (tested in April ’09 following October 2007 experience with CSW) prior to her.  Is this my OCD illogically connecting two unrelated occurrences?

Thanks much Doctor.  I’ll also keep you posted on biopsy if you wish.
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First I would emphasize the before it was frozen the dermatologist said it was PROBABLY a wart.  Probably is not a certainty and I suspect he did not appreciate that you might be likely to focus on the possibility of the lesion being HPV as much as you are.  I wish he hadn't one that.

I continue to doubt that what you are worried about is HPV and am gla d to hear that the lesions on your penis were biopsied.

Even if it is a wart, I doubt that it is related to your warts in 04-05.  At the same time, to be honest, what if it is.  Stuff happens.  I say  this not to be cavalier about this but from the perspective of the FACT that at least 85% of adults will get HPV.  If the lesions are warts, it just is not the end of the world by any stretch of the imagination.  Just deal with it and move forward.

Also, do not associate whatever these skin lesions are with HIV. It is not a realistic concern.  Hope this perspective is helpful.  EWH
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Avatar_m_tn
Many Thx.
My concern was that the warts/lesions reflected a larger problem - a weak immune system that could invalidate other antibody tests (HIV) or be a concern to my health in general. your reassurance has squalched that concern - it must be OCD/ anxiety making me illogical - all of the information out there on the internet has quite honestly been my worst enemy - our healthcare system will buckle under man made hypochondriacs. I'll conquer my fears in time though.
whatever these tags/warts/lesions are themselves do not scare me - i have been through it before and i am with a very understanding partner with whom I plan on spending forever with...we can get through it.
i'll keep you posted on the biopsy. many thx Doctor - Happy New Year
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H. Hunter Handsfield, M.D.Blank
University of Washington
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