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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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how to proceed

My fiancee was diagnosed with genital warts today by her obgyn, 1 month before our wedding.  I do not have any warts as far as I can tell.  We have been having unprotected sex for maybe a year now and she thinks she probably has had the warts for at least that long.  She told me they were just much smaller last year and that the obgyn dismissed them at her checkup last year.  They are testing to make sure she doesn't have any of the high risk types.  I was not sexually active before her for over a year and have never had any warts.  I am not considering leaving her over this as I understand it to be common.  My questions are:  

1)  Is it possible I gave her hpv and just never had warts even though it was at least a year since I had sex?
2)  Should I be concerned about catching hpv at this point and is there anything I should do?
3)  My biggest concern is that since I didn't have warts if I did give it to her and her warts go away (she was given aldara) will I reinfect her?
4) Is this something that she will have to deal with for the rest of her life?(the obgyn told her they may keep coming back, especially if she gets pregnant)
5)  Last I read it is worse in immunocompromised people, if it is life long does it case problems later in life?

Thank You
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Welcome to the forum.

First and foremost, I hope you can gain the correct perspective on genital warts:  a somewhat unpleasant inconvenience, but no more than that.  Certainly not an important health problem, with rare exceptions.  Also, it take months and soemtimes years before warts appear after acquiring the HPV infection that causes them.  To your specific questions:

1) Yes, you could have been the source of your partner's HPV infection.  But you'll never know for certain.  It is not possible (and for the most part not necessary) to know when and from whom most HPV infections were acquired.

2) You have been repeatedly exposed to your partner's HPV infection for a long time, and could have been the source.  If you were not the source, you can assume you have been infected -- whether or not you devlop overt warts.  There is nothing to be done at this point except to be on the lookout for warts and seek medical evaluation if warts appear.

3) Once someone is infected with a particular HPV strain, s/he probably is immune to a new infection with the same type.  Couples probably do not "ping pong" their HPV infections back and forth.

4) The large majority of genital warts resolve entirely within several months, sometimes a year or two, and do not recur.  It's possible, but unusual.

5) The "low risk" types of HPV, i.e. those that cause warts, rarely cause any important health problem, regardless of immune system problems.  In any case, there is no reason to suppose either you or your partner have any immune system impairment, so this really shouldn't be a worry.

Please understand that almost all sexually active persons acquire HPV at one time or another; and that probably 10-20% of all persons have overt genital warts at some time.  It really should not be nearly as big a deal as you seem to be making it.  Genital HPV is a normal and expected consequence of human sexuality.  Of course nobody wants genital warts, but as I said, it's an inconvenience, not an important health problem.  I hope you and your fiance are avoiding the "blame game".  Just deal with her warts and stop worrying about it.

I hope this helps give you some perspective on a very common and not particularly serious problem.

Regards--  HHH, MD
Thank you for your help.  We aren't blaming each other.  I actually would prefer she had it first because I've been blaming myself.  She is the same way.  We are going to do our best to put it in the proper perspective.  Hopefully it won't matter in the future as obviously we are getting married and spending the rest of our lives together, but if we were to split up in the future, would we be able to give someone else hpv?  I guess I mean is it contagious forever?
No, neither of you is likely to be "contagious forever".  As I said, most HPV infections clear up, cause no further clinical problem, and cannot be transmitted.  Viral DNA may (usually? always?) persist in tissues, with a potential for late recurrence and transmission.  But these are uncommon, and one the virus can no longer be detected by standard tests, and overt warts or pap abnormalities are cleared up, usually there is no future problem of any kind.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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University of Alabama at Birmingham
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