Qusstions for Dr HHH Please - HPV

[chicachica888]

Hello,
I research viruses so I would like some tech answers please.

1.    I have been dx with gws (Aug) although I have been with the same person for 15 y. As I have obviously been carrying this infection this long (it didnt even rear its ugly head  during pregnancy with my child in '02) would I assume that I am now somehow unhealthy and  immunosuppressed? In the same vein, If I was infec by this by someone other than my husband (one of my 2 prior partners), Is it possible that Ive now infected my husband?

2.    I know the "common" can live on surfaces, in fact there was an outbreak of foot warts at my gym . I am very anxious about possibly passed this to my child (she has used a path puff and towel on her gen that I previously used to clean my genbefore knowing I was infected in the past). My Dr has tried to assure me that the gws are spread through sexual contact only. What is it (structurally) about the "gen strain" that is different than the common strain such that it cannot survive on surfaces?

3.     The strains that can cause cervical cancer apparantly grow & develop into  cancer women who "cant clear the virus naturally" apparantly If I have had this 15y, Im not able to clear it despite a healthy lifestyle. Am I now more susceptable to cervical cancer, is it likely that Im also carrying the cancer-inducing  strain(s)? Also, because Ive been carrying it so long am I more likely to have a recurrance or may I "clear" it in 2 years as indicated??

4. (& final ?) To my understanding, this virus passes into skin that has been damaged in some way & settles into a deep layer of tissue. If I continue to have sex with my husband & if he has a wart outbreak (presumably he is infected although we have never seen evidence of anything) Could more virus particles be deposited into different locations and presumably grow? Or does it work that now I have the virus, it can grow anywhere on my gens or "gasp" mouth?

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

The topic of HPV and genital warts is a complex one.  I will try to provide some facts.  For additional information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA)..

You have been diagnosed with genital warts and you are now concerned about where you got it from and that you may have passed it on casually to your child.  It should not worry you.  For better or worse, at present HPV is a "fact of life" and most sexually active people have HPV infection or will have it at some point in the future.  On the other hand, genital warts are not regularly passed on through casual contact or from the sharing of towels, etc.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  For men there is far less risk of any sort.  With this as background, let's address your questions:

1.  Statistically, is more likely that you have recently acquired this infection than that it has been dormant for years and only recently become apparent.  Trying to sort out who gave HPV to whom however is really not a very rewarding activity and we try to encourage our clients not to do this.  Clearly your husband has been exposed and may well have them.  Other than the issue of their presence, this really is not a health hazard or matter for concern.  If he has or develops visible genital warts, he, like you should just get them treated.

2.  I agree with your doctor.  The factors which cause some types of the over 100 different HPV types to favor infection of some locations over others (such as why some types cause foot infections and others cause genital infections) is a function of subtle variation in their genetics.  For all warts, their transmission is facilitated by abrasion or other small openings in the skin which  facilitate transmission/acquisition.

3.  No on both counts.  Neither of us really knows how long you have had this.  Either way however there is no reason to think that you are now at increased risk for cancer.  You may well had had a cancer associated virus at some point.  Most people have.  This is still not something to worry about as I said above.

4.  No, for whatever reason, warts tend to stay where they are inoculated and do not pass easily from one part of the body to another.

I hope these answers are helpful to you.  Please check out the web sites.  EWH

[chicachica888]

Thank you for your prompt response. Im hoping you might clarifty a few things.. I agree that Statistically, is more likely that my infection was recently aquired and that its exhausting trying to blame someone. However my husband vehemently denies infidelity. I do want to believe him (even despite my own dr telling me not to). Ive read that it CAN lie dormant for years. If this is the case, could I have infected him with this infection or would he probably have been exposed to it along the way through microscopic warts? Also, are there any papers you could refer me to that outline the structural differences of the strains? Lastly, if we PRESUME the scenario that I would like to, that being that this has been dormant for so long, then recently flared up due to stress etc (Ive had several deaths and illnesses of people close to me recently), is it still likely to "resolve ...without therapy in 8-24 months" ???
Thank you for your time and patience and also for providing this invaluable service
PS, am I to understand that a woman is more likely to present clinical signs of HPV infection in the form of pre-cancerous leisions than genital warts?
Which strains are more common?

[Edward W Hook, MD]

Breif answers:

I cannot comment on the issue of dormancy and late appearance beyond what I've said.  Not much more is known and people are infinately variable.

You will need to review the scientific literature on your own.

Yes, your warts would still be likely to resolve in 8-24 months.  Yours however, I believe have been treated making this irrelevant.

Type 16, on o fthe precancerous HPVis is most common.

EWH

[chicachica888]

One more question please.
If I perform oral sex on my husband and he has a wart outbreak that i cannot see, is it possible for me to get this virus in my mouth and grow them orally or would there be antibodies in my body to this that would fight them off?
Thank you again

[Edward W Hook, MD]

Oral HPV infections do occur but are infrequent.  I would urge you not to worry about this.

This ends this thread.  There will be no further answers.  Take care.  EWH