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Avatar universal

Strange anal wart type

Hi Doctor --

I've got what I think is a pretty unusual case and I'm looking for some guidance.

I'm a straight male with no history of any anal sexual exposure. I was recently diagnosed with an anal wart (nothing on my genitals), which obviously shocked me.  The doctor agreed it was an odd presentation so he did a biopsy to confirm.

The lab confirmed it was a wart during biopsy but apparently felt something looked odd so they did subtype testing as well. They narrowed it down to one of the "common wart types," either type 1, 2 or 4, I believe. They didn't proceed with further specification after determining it was NOT 6, 11, 16 or 18.

I understand this is very odd to have something besides type 6 or 11 causing an anogenital wart.  

I have the following questions:

1. Is there any reason to believe types 1, 2 or 4 will clear faster or slower than the typical genital strains?

2. Does this have any implications for likelihood of tranmission? Since types 1, 2 and 4 don't "like" the anogenital area, does this suggest I'm less likely to transmit this to a sexual partner?

3. Having had the wart removed, is there any benefit to proceeding with immiquimod use to help speed up my body's immune response to clear the virus? My doctor said it might help but didn't seem to think it was that important.

4. In general, do you have any advice on how I should treat this differently than a typical genital wart?

Thanks.
3 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.  I'll try to help.

First and perhaps most important, your situation is not all that unusual or atypical.  Anal warts are less frequent in straight men than in gay men and women, but they are by no means uncommon.  Some but not all are associated with genital warrs.

I have no familiarity with anal warts being cased by HPV-1 and related strains; my standard response to similar questions on this forum is that anal warts are almost always caused by the sexually transmitted genital HPV types.  On the other hand, if specific testing indeed was done and showed one of the non-sexually transmitted common HPV types, I suppose that test result is reliable.  But I have no experience with it and cannot comment further.  To your specific questions:

1) I have no knowledge of clearance rates for anal warts based on HPV type.  I doubt it has been studied, but your doctor may be able to answer better than I can.  Sorry.

2) It is reasonable to assume that sexual transmission would be less likely given the HPV type documented.  But this too probably has not been studied and I cannot give you a definitive answer.

3) I see no need for imiquimod once the wart has been surgically removed.  The manufacturer of imiquimod has done a superb job of skirting FDA regulations and fostering the implication that treatment with their product might reduce the frequency of wart/HPV recurrence compared with other therapies, despite complete absence of data, and without FDA approval to promote such a benefit.  The mechanism of action of imiquimod suggests a possibility of reduced recurrence rate, but the clinical experience in fact shows no difference compared with other treatments.  But a lot of doctors have succumbed to the implications -- although it sounds like yours has not bought in.  Good for him.

4) No, I have no other advice, except to follow your doctor's recommendations.

Sorry I can't be more helpful.  Best wishes--  HHH, MD
Avatar universal
Thanks -- Is it safe to assume (as it is with types 6 and 11) that if warts do not re-appear in 6 months to a year that my immune system has cleared it?
239123 tn?1267651214
MEDICAL PROFESSIONAL
Again, I have no experience and haven't had an occasion to study up on non-genital-type HPV infections.  For genital infections, the 6 month estimate is only that -- an educated guess, no guarantee that it would not take longer.  In any case, I see no reason why it would be different for HPV types 1-4.
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