Recent HPV Diagnosis...have some ?'s

[curious1231980]

Hello again gentleman,

I was just recently diagnosed with high risk HPV. I am always consistently with my annual pap exams. My August 2008 pap came back normal, and my June 2009 pap came back abnormal, with HPV. I have some specific questions about how the virus behaves and transmission. I don't see my doctor again until December for another pap. I recently had a bump removed that was located below my vagina, right where the normal skin turns into the wet skin (the bump was sitting on regular skin), my doctor now believes that the bump he removed was a genital wart. Here are my questiosn:

1. Is it likely that I contracted the virus between 8/08-6/09? How likely is it that I contracted this earlier and it laid latent?

2. I'm in a relationship now, and we've been sexually active for over 3 months (unprotected)...is the likelihood high that i passed this virus on to my partner?

3. Since my doctor removed that bump and didn't tell me it was anything to be concerned about, I've continued intercourse with my partner during the healing process. His penis has rubbed against the skin that's healing (and actually rubbed it to the point of minor discomfort), does that raise his chances of getting genital warts if that's, in fact, what it was? His penis, I know, touched the bump during intercourse over the past months. How long would it typically take the warts to show if he did get infected?

4. I've read on here that most people rid themselves of the virus within a couple of years, does that mean you can't infect someone anymore? Will your warts never come back if that happens?

5. I was cultured to see if I have low risk hpv, and have yet to get the results, if that test comes back positive should I tell my partner at this point?

This whole thing has really thrown me because I go through great measures to get screened for STDs...and I couldn't believe I had this! I am sad because I'm afraid I unknowingly infected my new partner :'(

[H. Hunter Handsfield, M.D.]

You're asking some very broad questions.  Here are some main take-home messages.  Even though genital HPV is sexually transmitted, it doesn't behave like most other STDs.  Almost everybody gets it; catching genital HPV is a normal and expected consequence of human sexuality.  You need to follow your provider's recommendations about follow-up and possible treatment of your abnormal pap; if you do so, you will be completely protected against a bad outcome (i.e., cancer).  There are few implications for your partner's health, except that he needs to keep an eye out for penile warts.  To your specific questions:

1) There is no way to know when you were infected with HPV.  Given your negative pap last August, it is likely you have a recently acquired infection.  But sometimes dormant HPV shows up after many years of normal paps, and you could have caught it any time from a few weeks to many years earlier.

2) Your partner probably has been infected by now.  He could be the source of your infection but if not, he probably has caught it from you.  If he was infected with the same type of HPV in the past, he might be immune it and therefore not infected this time.  There is no way to know these things.  Fortunately, whether or not he has it has no significant implications for his health or yours, with the possible exception of genital warts.

3) If the bump was a wart, it likely was caused by an entirely different HPV strain (i.e., a "low risk" type) than the one that caused your abnormal pap (usually "high risk", as your test apparently showed).  Was the tissue sent to a pathologist for examination under a microscope?  That would tell for sure.  In any case, your partner should be on the lookout for warts of the penis and get examined if anything shows up.  

4) It is true that most HPV infections clear up on their own within 6-24 months.  Once they go away, the infection usually cannot be transmitted and it does not reappear.  However, exceptions are fairly common and might explain your situation. Reappearance of HPV is random and cannot be predicted or prevented by any known method.

5) Hard to answer this -- I'm not clear what test actually was done.  There is no culture test for HPV.  Maybe your doctor was referring to a biopsy, i.e. pathology exam of the wart.  However, this won't change anything for your partner.  You should discuss these things with him.  He should keep an eye out for possible warts and see a provider if something shows up, but that's all.

You should discuss the HPV vaccine (trade name Gardasil) with the provider managing your abnormal pap.  Even women with abnormal paps should be vaccinated to prevent infection with other HPV types.

All these things have been discussed innumerable times on this forum.  Before asking any follow-up questions, please use the search link and enter "HPV", "HPV transmission", "Gardasil", and similar terms and read those discussions.  Also read the excellent information available at several websites.  Two good ones are CDC (www.cdc.gov/std) and the American Social Health Association (www.ashastd.org).

Regards-  HHH, MD

[curious1231980]

Thank you so much for your responses. I'm trying to learn as much as I can, so I can be healthy and also inform my partner. I'm going to be more than watchful with my body, and stick like glue to my gyn appointments.

About the "wart" testing, I think my tissue was taken to a lab for pathology, just like you said. Last week (after my bump was burned off), my doctor swabbed my tissue on the inside (cervix), my labia/vagina, and also around the area where that bump was burned off. He placed the swab/brush in a vile. He said he'd know for sure in a couple of weeks if I have genital warts, so I have another week to go before I find out...does that sound like a biopsy procedure?

If i find out my biopsy showed genital warts...I'm obviously going to inform my partner, but he really has no way of knowing how long it'll take for genital warts to show on him? Seems like he'll just have to pay close attention just like me?

About our sex life, will we need to adjust in any way at this point? We both got tested for all STDs (obviously not all) before we started having intercourse, in which our tests all came back negative...so, we started our sex life without condoms. Now that warts might be a part of our relationship, is it even worth it at this point to start condoms?...or has the damage already been done? It sounds like it has.

Following up on HPV "running its course" in the system, does that go for both high and low risk types?

My biggest fear from all of this is that I'm finding this all out about myself after this relationship began, after we started having sex, and after I "thought" I was STD free (according to bloodwork)...and I could lose my relationship. I've informed my partner of my high-risk status (which he was extremely supportive), and was informed by my doctor to wait until I get my low-risk results before talking to him about this too (in case it's not even an issue). My partner has expressed that he loves me no matter what, and will remain by my side and support me...but I haven't told him about my "genital wart" situation. He only knows of the high risk HPV I have (which he knows is likely not to effect him). I just have a really GOOD man in my life, and I'd hate to lose him over something I wasn't even aware that I had, and that I possibly infected him with :'( I hope that my HPV behaves as you said it most likely will, and just go away :(

[H. Hunter Handsfield, M.D.]

Sounds like he did a biopsy.  Most genital warts become apparent within 6-8 weeks after infection.  If you have already told your partner about the high risk HPV infection, I agree it's fine to wait the biopsy result before discussing the other one.  And it's still possible it's all one HPV infection anyway.  In any case, it sounds like he is an understanding sort who won't be freaked out if your lesion was a wart.  There is no need to change your sexual habits and practices.  High risk types tend to take longer to resolve (often 12-24 months) than low risk (usually 6-12 months) -- but almost all infections eventually clear up.

If you want to return with a final question after the biopsy result is available, that will be OK  -- but please not until then.  The moderators generally don't have the time for a long string of follow-up comments as in your previous threads.  Also please note that MedHelp permits a maximum of 2 questions every 6 months in the moderated forums (see Terms and Conditions) -- in order to allow space for those with their first questions.

[curious1231980]

Awesome, thank you for all of this information! I feel better about my situation now that I know more about it. And thank you in advance for making yourself available for a follow-up question if I end up having one after I receive the biopsy results!

Have a great Father's Day, and thanks for making yourself available with your knowledge!

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  Take care.

[curious1231980]

Hello doctor, I found out today that my infection was positive for low-risk genital warts. I know I have to tell my partner. I'm upset because I have been having unprotected intercourse with him for over 3 months, so chances are now that I gave it to him already, right?

I'm going to go through treatment to remove the warts, and also to monitor my paps and stay on top of those. Do you know anything about that "Wartol" genital wart product and it's effectiveness? It claims to be very effective and all-natural, I was wondering if it was worth a try.

Now, should I be concerned for high risk hpv affected the throat? My throat has been sore for almost 2 months (moderate to severe), are there any symptoms to hpv/oral cancer? I went to an ENT and he kinda shrugged off my situation, even when I asked him about an hpv concern. I have performed oral sex, and since I do not know where this hpv strain came from...I'm scared that I might have this in the throat too. Is there a test that I can have run on my throat that would check for that, similar to the hpv pap test or biopsy? What do you suggest i do?

[H. Hunter Handsfield, M.D.]

Yes, you should inform your partner.  But this should not be a big deal.  If he gets warts, they will be detected early and easily and effectively treated.  Nobody wants genital warts, but it's a trivial condition, not worth any sweat

Wartol is homeopathic quackery, definitely not "worth a try".  It would have no effect on your warts.  Stick with whatever treatment your doctor advises.

You have no worries about oral HPV, which does not cause sore throat.  Even when exposed by oral sex, the virus usually does not take hold in the mouth and throat; and when it does, it goes away, usually without ever causing warts or anything else.

Please work to gain the proper perspective about genital HPV:  an unpleasant inconvenience, rarely an important health threat, that everybody gets at one time or another.  It is not worth the level of concern you have about it.

That's all for this thread.  Please ask any additional questions of your own doctor.  Or you can post additional questions on MedHelp's HPV community forum.  Best wishes.

[curious1231980]

Great, thank you so much for your help and information :) Take care!

[curious1231980]

Follow up question for my wart removal, I noticed that there is a white are within the removal site of my wart. Do wart removals usually scar, or could that be the wart coming back? I have an appointment for a follow up in about 2 weeks, but was just curious about scar tissue. Thank you!

[H. Hunter Handsfield, M.D.]

Most likely a scar, or just a skin pigment issue; new skin following any injury to the skin, including wart treatment, can sho variations in skin color.  The provider who treated you should be able to tell, but probably only if you return to see him or her in person.