STDs Expert Forum
Persistent Genital Warts
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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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Persistent Genital Warts

Dr.

I was first diagnosed with Genital Warts in December 2009. It took amount 8 months of on and off freezing to control them until September 2010.  After that, it seemed that my body had gained some control of the virus.

In February 2011 a small genital wart showed up which I physically rubbed off with my hand after some force.  Again, in November 2011, another gential (genital) wart showed up in the same spot in which I rubbed off in the same manner.  Then again in Decemeber 2011 it came back, I went to my dermatologist this time who said it was a wart and then froze it off.  

Today, January 24, 2012, I went in for a check up and my doctor found a wart on the head of my penis.  It was a different type of flat wart and more reddish.  I asked if it was a different type and he said to just think of it as you have genital warts and not different types.

I had my first gential (genital) wart in December 2009 and now in January 2012 I am still freezing warts.

Can you let me know where you think I am in the stages of treatment?  My understanding is that most people would have cleared this virus in the first 6 months and would have little chance of passing them on if they stayed clear for 6 months.

It has been over 2 years and I have not cleared the virus.  Do you think I will be prone to reoccuring genital warts for the rest of my life?

What do you think are my chances of developing cancer are from these warts?

I want to marry someone and have unprotected sex with them without constantly worrying if they will get warts.  Is this possible?  If my wife gets the vaccine before we have sex (assuming she did not have GW before), do I still have to worry about her getting GW?

If my future wife did get warts, what are the chances she could get cancer from them?

If I clear the virus for another long period of time, say 6 months, does this mean my body has likely cleared the virus or this not a good indicator of that?

Would I benefit from the vaccine?
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Welcome back.  But you continue to rely on a distant online forum that cannot give definitive answers about specific cases.  I will reply to these questions, but you should also address them with your dermatologist or other provider who has been managing your HPV/warts.  In addition, your clinical course has been so atypical that you might consider a second opinion from a different dermatologist.  It still seems possible to me that you no longer have an active HPV infection and are attempting to treat some other skin condition.  But my replies below assume the current diagnosis is correct.

1) It is true that most people clear genital warts within several months, but persistent cases beyond 2 years isn't all that rare.

2,6) Still, nobody has recurrent warts forever; yours will stop recurreing one of these days.  I cannot guess when.  I also cannot predict the future course of recurrent warts after the current crop clears up.

3,5) Genital warts and penile cancer are caused by entirely different strains of HPV.  Cancer is unlikely in this situation.  But to be maximally safe about it, continue to follow your dermatologist's advice about treatment and follow-up examinations.

4) Regardless of whether you are infected with HPV, and which strain(s), and whether or not you have warts, the chance of a partner getting cancer as a result are very, very small.  A potential partner can be immunized with Gardasil, which would protect her against the main strains that cause warts and cancer -- although the problem there is that it takes a few months for the vaccine to become effective, potentially requiring a substantial delay before starting to have sex with her.  Still, it probably would be worthwhile.  But even without immunization, if she just follows standard guidelines about pap smears, she would be protected against any serious health risk.

7) HPV immunization will have no effect at all on your current warts or other HPV infection(s) you may have.  It will effectively prevent future infections with the 4 types covered by the vaccine.

There really is nothing more a forum like this can offer you.  Let's dispense with a long string of follow-up questions as in your previous threads.  The more atypical a clinical situation, the more important it is to rely on personal care by a knowledgeable provider, and not on online searching or a distant forum, no matter how expert.

Regards--  HHH, MD
5 Comments
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Avatar_m_tn
Doctor,

What kind of timeline if any can I go off to consider myself clear or at least OK to enter into sexual relations?  I also am curious if you consider the lack of clearance to be a good indicator that it will take quite a bit longer for me to clear the virus.

I hope you can appreciate this question and it is the same quesiton I have posed to my dermatologist.  It is hard to live a life without knowing if I can take it to the next level with someone I may really care about.

I would appreciate your opinion on this question given my history.
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239123_tn?1267651214
I'm sorry, I just don't know and no way for anyone else to know for certain. Typical cases by definition are atypica and that much harder to predict.  My guess is you would not be infectious after 6 months with no warts, but I certainly would not guarantee it.
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Avatar_m_tn
Dr. Handsfield,

Thank you very much for your comments.  I know there are no cut and dry answers.

Dr. EWH,

I was wondering if you could add your opinion as well.
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239123_tn?1267651214
Sorry, but Dr. Hook and I never comment on each other's threads unless we invite each other to do so.  (Generally we never look at each others' discussions.)  Our opinions never differ, so there is no point.

That winds up this thread.
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This Forum's Experts
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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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