CDC vs, Dr. Handsfield

[CaliforniaMale]

Thank you for your great work.  Reading your work allowed me to sleep after my diagnosis of genital warts.

Question:  On this site and other sites where I have read your work, you are very clear that transmission is very unlikely once warts are gone and certain time periods have passed.  While you are clear that infection to another may be possible, you say the odds are remote enough to not mandate disclosure to future sex partners after certain time periods.  Obviously, you are an expert in the field and base your opinion on scientific research and/or your experience in the field.

However, the CDC makes no such statement on its website regarding infectiousness (at least that I can locate).  In fact, it states infectiousness is a very undecided issue.  Presumably the CDC is in the business of disemminating accurate information to American citizens, yet its position conflicts with yours.  This is the same position taken by my doctor.

To you attribute the CDC's stance to being extremely conservative, behind the times on research, head in the sand, politically influenced by some force outside science, or some other reason?

How can non-scientists like me reconcile the CDC's position with yours?

Once again, Thank you Dr. Handsfield!

[ioio82]

A related discussion, hiv was started.

[HHH,MD]

Another point of clarification:  To the extent CDC online information addresses infectiousness as "undecided", they are talking about uncertainty whether treating warts makes a person less infectious.  But the context is in reference to the short term, immediately (a few weeks) after treatment.  Tehre is no information about infectiousness over the next months and years.

HHH, MD

[H. Hunter Handsfield, M.D.]

I helped write the CDC information on HPV, so I doubt there is a real discrepancy.  As you say yourself, CDC doesn't speak at all about the duration of infectiousness, and there is no disagreement when one expert has a particular position on an issue and the other makes no statement about it.

There are no definitive data on duration of transmission of HPV after overt evidence of infection (warts, abnormal pap) have cleared up, and without such definite data, CDC stays silent.  My position is based on common sense, what we know about HPV immunology, and epidemiologic studies that give clues without definitive information--as well as the fact that 90% of HPV infections are asymptomatic and have no important health consequences and that HPV infection cannot be avoided anyway.  Those are positions that CDC is unwilling to take a stand on, which I think is reasonable given their special circumstances.

I hope this helps.  Best wishes--  HHH, MD