hpv question

[yellowhouse]

Recently, I was in a relationship with a woman that had abnormal paps due to hpv infection for 14 months or so.  We split 8 months ago and prior to, she had a pap that came back normal without any corrective procedure performed.  (I’ve read that most hpv infections clear on their own?)  She also mentioned that during the 14 month period of abnormal paps, she did have a pap come back normal only to receive the next one as abnormal.  Many years ago, I had a wart removed from my penis without any recurrence and I realize different strains of hpv cause different conditions.  But is it essentially, “once you’ve gotten hpv, you’ve gotten it” or is it dependent on the strain involved?  I think it’s important to share this with someone new, but I’m not really sure how to describe my past hpv infection (wart) and the abnormal paps with my recent relationship.  Was wondering if you could provide some direction in explaining my ‘status’ to a future partner.  Thanks in advance!  

[Edward W Hook, MD]

The question you ask is one that is still debated by experts.  Restated, it is, "Once a HPV infection (warts or on Pap smear) goes away (with or without treatment) is the infection cured?  The possibilities being that the person cured their own HPV infection or it just became somehow latent and therefore undetectable.  I favor the former, that the infection is indeed cured.  If it was still there (i.e. "latent"), it should be detectable and the fact is it is not.  So, in answer to your question of is the case that "once you've got it, you've got it for life", our answer is no.  If an infection goes away (treated or by itself) and is not detectable after 3-6 months, then we both feel that the infection is no longer present and that persons need not worry about the possibility of transmitting to partners.  As for disclosure, different persons use different criteria.  If the criterion is do you have an STD, the answer is no.  If the question is HAVE you ever had an STD, then the answer is yes.  Remember however that, whether they know it or not 85% of sexually active women and likely a similar proportion of men have had HPV (is ignorance bliss?).  Within a year of starting to have sex, several studies show that about half of women have acquired HPV (again, whether they know it or not),

As for your question regarding strain dependent immunity, the data from the HPV vaccine studies indicate that immunity is strain dependent so that indeed, a person who has gotten one type of HPV can get others.

Hopefully this information will help you to figure out how to deal with the disclosure issue.  From what I have heard from you, there is little to indicate that you are any more likely than anyone else to have HPV at this time.  EWH

[Edward W Hook, MD]

No, many, perhaps most abnormal Paps are NOT due to HPV.  The more abnormal the Pap, the more likely HPV is to be presnet.  Even if abnormality is present, most of these infections clear themselves.  

I think that statement, as well as the data that most peole do or have had HPV should suffice (refer them to a website)  EWH

[yellowhouse]

Yes Dr. Hook, ignorance is bliss.  Does an abnormal pap automatically indicate high risk hpv?  

And because there is continued debate, what else could I say to a new partner other than I was in a recent relationship with someone that had hpv and her last pap came back normal?