To Dr Handsfield
First of all I think you are doing a great job. I am in need of you expertises. Background in early June of this year I had a lapse of judgement and had protected vaginal intercourse with a sex worker, unfortunately my condom burst. Since then I have got a full sexual health screen and all my tests came back negative with one exception. I tested positive for Herpes 1, which was no surprise since I often get cold sores.
In or around six weeks after the episode in question the skin in genital area has become very sensitive to soaps and shower gels and the like and has remained so. The head of my penis has become tender and inflamed on a number of occasions, at this stage the only thing I had not been tested for was HPV. At the start of December 2008 I got a swab sample of my genital area taken and it was PCR tested for HPV DNA. It tested positive for HPV type 6. To date having been checked a number of times at a STD Clinic I have no visible warts. I am hoping you will be able to answer the following questions
1. Is it possible that I have a subclinical HPV infection, as this might explain why the skin in my genital area is so
sensitive to soap, shower gels and the like.
2. It is now 7 months since the time of my exposure, what is the time period for the body to clear a subclinical OR
visible HPV 6 infection.
3. I have read in the forums that the average time for the body to clear a HPV infection is 8 months to a year could
you please clarify if this time period starts from the time of exposure.
In my view, it was a mistake for you to be tested for HPV. No tests are approved by the US Food and Drug Administration for HPV diagnosis in men. Yours might be reliable but there is no way to know. It would have been better for you to adhere to Dr. Hook's advice and just let it go. Now you have to deal with more uncertainty, and in the long run there will be no health benefit from the information you now have.
To your questions:
1) It certainly is possible to have a subclinical/asymptomatic HPV infection. But if an infection is subclinical, it causes no symptoms at all; that's what subclinical means. HPV is not known to cause skin sensitivity to soap or anything else. Most likely your genital symptoms and your positive HPV-6 test have nothing to do with each other.
2,3) You have no way of knowing when you caught your HPV-6 infection. You might have had it before your sexual exposure last June. Most HPV infections clear up on their own within 6-24, usually faster with "low risk" types like HPV-6, longer for "high risk" types, but there is no way to predict with certainty for any particular case. The time is measured from the time of exposure. But as I said, there is no way to know when the clock starts in your case.
You don't say what the provider who ordred the test has said, or what was found on examination. Since you had a non-approved test of uncertain reliability, that's the place to go with further questions. If you tested from an online service or directly from a laboratory, without professional advice, you should make an appointment with a dermatologist for examination, diagnosis of the penile "irritation", and advice about your apparent HPV infection.
Your are correct maybe it was a mistake for me to be tested for HPV, but given that I am in a long term permanent relationship with my partner I felt that I needed to know.
You are also right that I have no way of knowing for certain when I caught my HPV infection, but given that I have no reason to doubt my partner’s faithfulness, in all probability my exposure was in fact in June.
In order to have the HPV tests carried out, I travelled to London to a private STD clinic and was tested for twenty HPV sub types, all of which with the exception of one were negative. It was recommended that I get retested again in 6 months time. I will take your advice and make an appointment with a dermatologist for examination. Could I please trouble you again and ask you one more question.
Is there any data on what percentage of people exposed to the genital warts virus go on to develop visible warts?.
I don't know the age of the older statement, which was once the "truth". But recent research has reversed the former belief. The newer work shows that the large majority of HPV-6 or -11 infections cause visible warts. The study was done in women and I am unaware of similar data in men, but there is no reason to believe it would be different. (The new research was reported 3-4 years ago, but I only became aware of the study sometime in the past 1-2 years, even though it was done by some of my own research colleagues.)
Which illustrates an important point: The research in clinical aspects and epidemiology of HPV is evolving rapidly -- so rapidly that sometimes the experts themselves have trouble keeping up with new information Think what that means about the knowledge level of the average health care provider, health department, or health education website, i.e. those who are not top-of-the-line STD/HPV experts. It is to be expected that other things we currently believe to be true will be disproved in the future. That is the nature of science.
Thank you for your reply. The incorrect information is contained in a thread in the HPV forum under the heading “I'm just full of questions.” by buttercup 219 dated Nov 08 2004 12.00, it might be an idea to have it removed so as to prevent any further confusion.
Given that this statement is correct “Probably 60-90% of people infected with HPV-6 or-11 develop visible warts”. It would seem that I am almost certain to develop visible warts.
If it is the case that I develop warts would it be feasible for me to put it down to a pass exposure going back 20 years ago that has reactivated is this possible?
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