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Concerns about HPV

Hello Doctors:

I have some concerns about HPV and am hoping you can help with that:

Here is a timeline:

june07-sept07-unprotected intercourse with both of us being tested for stds prior to engaging

Dec.07-unprotected intercourse with different partner both of us being tested for stds prior to engaging

May 08- hpv test positive/ pap smear normal

Aug08-hpv test positive/ pap smear abnormal with moderate dsyplisia

Sept08-had abnormal cells removed via cryosurgery.

I am concerned about the possibiltly of genital warts. Does having hpv mean that I will most likely develop them??

I try to examine myself reguarly and in Aug and Sept my doctor said he didn't see any signs of it. Both of my partners have said they have never had or seen any signs of genital warts.

Would I most likely have gotten them if I had the virus by now??

Does an abormal pap mean I most likely have the virus that causes genital warts??

Do I need to see the doctor every month or so to make sure I don't have warts?? I haven't seen any signs from what I can tell.

This abnormal pap and hpv test has made me very stressed out, I am just waiting for the day the warts will show up. I have really learned a lesson about using condoms even if you are in a monogamous relationship!

Thanks for taking the time to answer my questions.

1 Responses
239123 tn?1267651214
There are at least 100 different types of human papillomavirus (HPV), of which 30 or more types commonly infect the genitals.  Of all those, almost all can infect the cervix and cause pap smear abnormalities like you describe, but only 2 types, HPV-6 and HPV-11, cause genital warts.  Therefore, it is unlikely that the HPV causing your abnormal pap smear will cause genital warts.  Further, most HPV-6/11 infections cause warts as the first sign; if warts were going to develop from this infection, probably they would have shown up by now.

There are exceptions to these rules, but most likely you don't have a wart-causing HPV infection.  And in the chance you develop genital warts, what will be the big deal?  Warts are unpleasant but not dangerous, and they are easily treated and carry no serious long term health threats.  It really isn't something to be very worried about.

Finally, please talk to your health care provider about getting the HPV vaccine (trade name Gardasil).  The vaccine protects against both wart-causing HPV strains, and against the 2 types (HPV-16 and 18) that cause most cervical cancer.  Every woman under age 26 should be immunized with Gardasil, including those who have already had an abnormal pap smear.

I disagree with your comment about a need to use condoms in monogamous relationships.  It would prevent the occasional HPV infection or other STDs, and of course is a good idea if one partner is known for sure to carry a serious STD, such as HIV.  However, condom use is not necessary or practical in most monogamous relationships.

I hope this helps.  Best wishes--  HHH, MD
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