Questions about warts

1.)  Can you give me a rough % of how many people actually show signs of genital warts.

2.)  I was treated for warts but some of them have not gone away, I found out I had HPV a little over a year ago.  While I was treated and warts still appear after they've been frozen, could the virus still have cleared my body?  When the wart is frozen, but still doesn't fully go away, is that wart dead or still contagious?

3.)  What's the normal time frame for HPV/Genital warts to clear the immune system

4.)  Are genital warts the lowest risk HPV, do they ever lead to cervical cancer, and is cervical cancer hard to cure?  Can you still have kids after having cervical cancer?

5.)  Will most people have HPV/Genital warts at some time in their life?

6.)  I had sex with my current girlfriend 3 times with a condom, do you think she has HPV.  I read somewhere that 2/3 of people will get it.  Do you think the condom prevented anything?  The sex wasn't long at all either.  Please help me with these questions.

Thanks in advance for your responses

[H. Hunter Handsfield, M.D.]

1) The most common HPV infections involve virus types that don't usually cause warts.  Among people who get infected with HPV 6 or 11, the usual wart-causing types, half to 2/3 get visible warts--but this depends a lot on how hard people look for small or internal lesions.  Probably less than half actually get warts they notice.

2) After treatment, scar tissue can form a bump.  You need to have an experienced provider determine whether the wart really has persisted or if the bump doesn't mean anything.  If it's an actual wart, you should assume it contains active virus and is contagious.

3) Most HPV infections clear up over several months to 2 years.  However, HPV DNA may persist longer, perhaps for life, which is why warts sometimes reappear years later or women develop abnormal paps many years after they were infected.  However, most persistent DNA probably isn't transmissible to partners.

4) All HPV causes cancer rarely.  Even when the highest risk types, like HPV 16 and 18, are untreated, almost all infections go away without causing cancer.  The cancer risk is even lower with HPV 6/11.  Most women can have children after cervical cancer, unless of course the disease is diagnosed very late and a hysterectomy is necessary for cure.

5) It is unlikely that "most people" get genital warts.  It's a lot, certainly several percent, but nowhere near half.  But well over half get genital HPV of one type or another, mostly the higher risk types.

6)  Based on your first question, it isn't certain you currently have an active HPV infection to transmit. But if you do, and if your wart is covered by the condom, the chance of HPV transmission was reduced.  But not to zero, because there is skin contact beyond the areas covered by the condom, and in people with warts usually there is HPV in areas near the wart that look normal.

Good luck--  HHH, MD

[monkeyflower]

I've read in the past that virtually everyone who has had more than two or three partners will have contracted at least one type of HIV. I take it from your post that's a gross overstatement?

[H. Hunter Handsfield, M.D.]

No, that's correct.  That's what I meant by "well over half".  It might be a bit of an overstatement if I said "virtually everyone with 2-3 partners".  It probably hits 50-60% after 3 lifetime partners; maybe 5 or more partners are needed on average to get to "virtually everyone".  But it's splitting hairs; the statistics don't allow quite that much precision anyway.

HHH, MD

[monkeyflower]

Thanks. I actually think I read the "virtually all" comment somewhere else, but it generally echoes your advice. I just wondered if I remembered correctly or was way off base :-)

[ryred12]

So if you have warts and your partner has never show warts. It would make sense to have her get the vaccine from merck 3 shots over 6 months she might already been exposed to other strain but like the doctor said most people who were exposed to strain 6 and 11 will show signs of warts. The vaccine is good for strains 16 18 6 11.  6 and 11 cause 90 percent of warts. Just an idea.

[Aussie5]

Hi Doc

I apologise if this sounds like a really unintelligent question, but if there are no routine tests for what strain of HPV a person has, then how is it known that 16,18,6 & 11 are the most common strains?

[H. Hunter Handsfield, M.D.]

Research tests, not available as routine diagnostic tests.

HHH, MD