Disagree with other web sites?

[fez]

I have read on many other sites that once you have an HPV, you have it forever, while you say on this site that the immune system can actually rid your body of the virus, making your no longer contagious (correct me if I got that wrong.)

My girlfriend and I both like your (more optimistic) answers better than these other sites' answers as I had warts frozen off 7 months aga but we both really want to share more sexually with each other.  You certainly seem to know your stuff based on a cursory examination of you online.  It is confusing to see two different assessments of the risk from different authorities though.  Are these other folks just needlessly paranoid, or do they perhaps have older information?

Thank you for your work on this site, it has been very helpful.

[monkeyflower]

I really appreciate your reasonable, rational, and non-judgemental approach. What a refreshing change :-)

And speaking of abstinence only education, the Waxman report makes great (and highly disturbing) reading.
http://www.democrats.reform.house.gov/Documents/20041201102153-50247.pdf

[H. Hunter Handsfield, M.D.]

Monkeyflower makes an important point--that much information about STDs in the media and on the web is colored by sexual politics.  For example, groups that promote abstinence-only sex education almost univerrsally exaggerate the permanency and danger of HPV, because it is the main STD for which the data on protection by condoms are weakest.  (They ignore the fact that absence of proof is not proof of absence.)

HHH, MD

[H. Hunter Handsfield, M.D.]

Good point; thanks for raising it.  Of course, the general problem is that there are no regulations or requirements for website content; as you well know, anyone can post anything and it's buyer beware for all content on all websites.  It is the viewer's responsibility to assess and judge the reliability of the source.  That said, HPV is a special case, and for purposes of my reply I'm assuming that the websites with conflicting information are well-meaning and in some cases may be run by experts.

There are two main reasons for the discrepancies about duration of HPV infection.  First, HPV knowledge is evolving rapidly and until a few years ago most experts indeed thought it likely that most infections persist indefinitely.  Some online resources continue to say this, either because the website managers haven't caught up to the latest research (or don't understand it) or because they simply haven't gotten around to updating the posted information.

Second, a certain amount of scientific uncertainty remains.  What can be said with certainty is that the most sensitive tests available--tests that detect HPV DNA in genital tissues--become negative within 6-12 months in over 90% of infected persons.  We also know that once the test becomes negative, the person is immune to catching the same HPV type again, which is further evidenced that the infection was truly eradicated by the immune system.  However, it remains possible that HPV DNA (or maybe even intact virus particles) persists in small amounts, too small for detection by the available tests.  Whether this happens at all, or in what proportion of infected persons, cannot be known with certainty with available technology.  But if infection persists, it almost certainly is in amounts to small to be transmitted to another person and probably will never re-grow to cause warts or precancerous growth.

Bottom line:  Although HPV can persist, in most persons the most infections are controlled by the immune system and most experts believe they are truly cured.  For "quick and dirty" responses by clinicians like me, the evidence is good enough to say "cure" and to reassure our patients accordingly.  But some doubt remains and interested persons should keep their antennas up for futurAlso, there are exceptions; infection surely persis

Thanks for your kind comments about the forum. Happy New Year--  HHH, MD

[Sarah_C]

I'm certainly not a doctor, but after I had had seven years of clear pap tests after a HPV infection, my doctor told me I could consider myself "cured" and (after all other STD tests came back negative) move to a fluid-bound relationship with my partner.

[monkeyflower]

I've also read that your body will resolve the infection over time, from *very* reliable sources (Dr. Handsfield, www.cdc.gov/std, www.ashastd.org). But in any case, if it makes you feel any better, the strain that produces warts just produces warts. Pretty easily treated, certainly nothing life threatening. And since HPV is spread through skin-to-skin contact, even if you're using condoms, chances are she's already been exposed to at least one strain of HPV anyway, whether from you or from other partners.

I tend to think that the problems with most STDs are a result of our society's issues with sex (if you caught HPV or herpes from someone sneezing on you, I'm sure they would be treated like the potentially mildly annoying skin disease they really are). Educate yourself as much as possible, take appropriate precautions, and enjoy your sexuality :-)