Multiple hpv strains-update.

[222tae]

Doctors.
I posted in September about the possibility of multiple, simultaneous hpv infections. I initially had a surgical procedure under anesthesia and other removal procedures as well. Extremely painful both physically and emotionally. As an update, I'm due for my second surgical removal procedures for this awful  and debilitating disease. But now there is clear evidence of a wart on the inside of my lip as well which has been evident for a number of  weeks.
Questions.
Am I just a member of a "lucky" few that exhibit extreme symptoms or is there something more significant at work here? I have not been sexually active for well over a year due solely to the physical and social disgust I now possess. l was in a committed (as far as I know) relationship with a girl for over two years. These symptoms first showed up approximately 6 months after the breakup.
Shall I be more concerned than most being I have "rare" symptoms? Can I expect this to continue for a much longer period than the "normal"  6-9 months  to 2 years most people require to rid the virus?
I'm completely exhausted researching and pursuing multiple specialists to deal with this very, very significant disease adversely affecting my life.
Thank you in advance.....

[Edward W Hook, MD]

I'm glad I could hep and wish you well. EWH

[222tae]

Dr Hook,

Thank you for your response. I hope to one day get some temporary reprieve from this demoralizing condition  though I anticipate this to be a  lengthy battle due to the severity of my symptoms. My overall fitness and exercise regimen is extensive and I consider my health to be very good. I will continue to exhaust all options to ease my physical symptoms, if only temporary. I will post any future successes in hopes that it may help someone else experiencing HPV issues similar to my case.

Thank you again for offering a forum such as this.

[Edward W Hook, MD]

Welcome back to the Forum.  The extent and course of your infection is certainly not the norm.  You have more widespread infection as well as possibly more aggressive infection that the vast majority of persons who acquire HPV which, as Dr. Handsfield has indicated, is just about everyone. Infection with the same HPV type can manifest itself in a variety of ways in different persons.  This is likely due to both variation in the virus as well as person to person variation in how the virus manifests itself.  As you know, HPV is classified into a number (over 100) of different "types" some of which have more of a tendency to cause visible warts (the so-called "low risk” types), and some of which are more strongly associated with cellular abnormalities which can signal increased risk for cancer at the site of infection (the so-called "high risk" types). However, there is much variation in how even the same type of virus becomes manifest in different people. This may be in part due to subtle variation even within different viruses of the same type but is also clearly associated with person to person variation in the immune response to infection.  The immune response to HPV can be modified by immunosuppressive medications such as prednisone or other steroids, by disease processes which modify the immune system (certain cancers, rheumatologic diseases and infections such as HIV), by certain actions (trying to shave warts may spread them for instance) and finally, again, subtle, not well understood person to person genetic variation which, while acknowledged, is not well described.  As to which of these factors are at play in your situation is difficult to say and if subtle variation in the virus your were infected by and/or your own genetically determined response to infection is something that cannot be readily studies at present and is not currently something that can be done clinically.  You are doing the right thing by working diligently with your doctors to address your infection.  My advice is just to keep at it.  

I hope this comment/perspective is helpful in your unusual situation.  EWH