9 year HPV infection

[jojled]

My infection has lasted a minimum of 5 years, but has likely been around for 9. You said that the type is more indicative of cancer risk than length of infection and that the wart causing types are less dangerous.
1. If I've had this one type for so long, isn't it likely I have the dangerous types, too, and am unable to rid myself of them, as well?  In this worst case scenario, what are my odds (numbers if you've got them, even estimates) of developing cancer?  I ask because all literature warns of persistent infections.  What are the odds if I only have the non-dangerous type?
2. Is a flat, brown wart indicative of any particular strain (I heard those are from dangerous types)?
3. Do you have an estimate on oral cancer risks (numbers....to help me sleep) for those who don't get rid of the virus?
4. Are the low odds of cancer only low b/c most people fight off the virus, so, my odds would be much higher?
5. Is it possible to rid the body of one strain, but keep another? Am I likely to ever be rid of it (I'm 32)?
6.I don't know if I have it, but what does HSV2 do to the odds (an ex got it after we broke up, but who knows)?
7. Most importantly, if my wife gets rid of it as most people do, will my ongoing infection continue to re-infect her (I know you said people probably don't "ping pong" it, but that assumes most will get rid of it within 2 years, I think)?
8. We've had anal intercourse about three times, how likely is it she'll get cancer from that (odds) and should she be concerned or mention it to her gyno so they can look out for any trouble (she's already getting the paps).
9. Should we refrain from oral sex to avoid possibly transferring it to her/my mouth/throat, especially if she has rid herself of it once? Same for anal sex?
10. Finally, do I need to take special precautions since I obviously have an active outbreak and may continue to have one for a long time and should I contact past partners (I've been with my wife exclusively for 2 years)?
Thank you!!

[Edward W Hook, MD]

I would not worry.  EWH

[jojled]

PS.  I'm referring to the fact of possibly having the dangerous type for so long.

[jojled]

You are the most patient, informative doctor I've ever spoken with. Thank you.  I wanted to get all issues off my mind before going on my honeymoon.  Just curious, I need not worry about unseen oral or anal cancers for me or my wife?  

[Edward W Hook, MD]

The fact is most people may have multiple HPV infections.  You may have had a persistent low risk type.  That does not mean that IF you had a high risk type, it persisted.  

As far as your continuuing concern over cancer.  If you were developing a cancer, you would see skin changes - they take years to form.  At that time you could go to a dermatologist for a diagnosis before it did you harm.  Early skin cancers, if they occur and they hardly ever do in men, are not a big deal when diagnosed early.  As I said earlier. I really think you are overthinking this.  The anallaogiies between the female and malle disease course are few.  EWH

[jojled]

Sorry for the bother, this is my last follow up.  My point was that since I've had the low risk type for so long, it's likely I've had a high risk type as well.  In that worst case scenario (that I've had the high risk type for a long time, along with the low risk), wouldn't I be at higher risk for cancer, as well?  

Again, sorry if I appear stubborn, I just want to really understand.

Thanks!

[Edward W Hook, MD]

You are taking two different posts out of context.  In women persistence of high risk HPV types (i.e 16, 18, others)  is associated with somewhat increased risk of abnormal pap smears and, over the course of years, cancer.  Visible warts are caused by HPV types 6 and 11, the types that are deemed low risk and are not associated with cancer.  Furthermore, your lesion was removed at biopsy.  Removal takes away the infection and ends any risk.  EWH

[jojled]

I read in a different thread where Dr. HH mentioned that people with warts/infections that persist are at increased risk (ie the ones who get cancer from HPV).  With that in mind, how does your statement that I'm not at increased risk no contradict what Dr. HH said?

Thanks

[Edward W Hook, MD]

Correct.  EWH

[jojled]

Thank you very much.  So, to be clear, the fact that the virus has remained active for so many years (and the fact that there may be other, more dangerous strains also active for as long) does not pose an additional risk of cancer, correct?

[Edward W Hook, MD]

No biopsies are typically quite accurate.  If the lesion is gone, teh issues of future risk are very, very low.  EWH

[jojled]

Sorry for the confusion, but, the dermatologist said it was HPV after the biopsy of the brown spot came back.  Do you think there may be a mistake?

[Edward W Hook, MD]

Your long list of questions is more than can be dealt with on this site.  You need to see a dermatologist and have your lesion looked at.  In turn, the dermatologist can field many of these questions.  From your description I suspect that it may not even be HPV but some other dermatological process.  The dermatologist will be able to make a diagnosis and remove the lesion, which should put an end to many of your concerns.  As for your questions, briefly:

1.  Visible warts are almost never caused by high risk HPV types and if this is a wart, persistence does not mean it is likely to become a cancer.
2.  See my comment and no. 1 above.
3.  No numbers available.  Tiny. The major risk factors for coral cancer remain tobacco and excessive alcohol use. These risks far outstrip all other risks.
4.  Your reasoning is faulty; you don't know that this is a wart.
5.  Yes one type can be eliminated and replaced by another.  
6.  Debated.  Some suggest it may increase cancer risk.
7.  First make sure you have a wart.
8.  Close to zero, don't worry.
9.  Find out if it is a wart and get it taken care of rather than engaging in anxiety provoked "what ifs" of little relevance to your situation.
10.  No.

One last time. I think you are over thinking this.  You would be far better served by making sure of the diagnosis, having the lesion treated and moving forward from there.  Worry about possible complications of what may or may not be an HPV infection which would occur decades in the future is simply no a fruitful use of your time.  EWH