Warts and Children

[guy1207]

Dr.

I have a couple of questions regarding HPV transmission.  I had genital warts but have been outbreak free for about 8 months now.  I have been having regular sex with my girlfriend for about 6 months and she has shown no signs of warts, do you think risk of transmission is relatively nill?  Is it OK to now have sex without condoms?

The other part of my questions has to do with her getting pregnant.  I know the warts and HPV do not affect fertility, but I'm just so nervous that if she does eventually get the warts that they will be passed on to one of our children.  Now I know they can be passed on, but is it to the childs genitals or just the throat?  I read that they are working on a vaccine for unborn babies who have infected mothers, is this true, how long until it comes out?  Even if she were asymptomatic, could she still pass it to the child?  Do most people have healthy children?  One more question, sorry.  Do woman who have a history of warts always get them again when they are pregnant?  Please ease some of these fears.  Thank you so much for all you do.  So many other websites out there paint such a dark picture for warts and pregnancy.

[marymagdalane]

Just FYI to curious people who are expecting, You can transmit the virus to your unborn daughters, my daughter had a terrible case at the age of 3. she still remembers it and it is horrifying to her, I still don't have the heart to tell her what happened she will be 17 should I?

[Englishman]

Thanks.

[H. Hunter Handsfield, M.D.]

In the premier research looking at HPV and condoms, in college sexually students who kept careful diaries of all sexual events and condom use, those who reporeted 100% condom use had a 70% lower risk of catching HIV than those who reported zero use.  From 55% to 99% condom use, the risk of HPV was reduced by half.  Below 55% condom use there was no effect.  Those results indicate that condoms are better than nothing.  But in the real world, 100% proper use is rare.  You are correct that it is not certain that  guy1207's partner might not yet have been infected, even if he was.

HHH, MD

[Englishman]

Doc, you say:

"But it's too late to worry about it anyway; since you were having sex with her for several months, she probably has already been infected. There is no point in taking precautions now."

However, it is implied by Guy1207 that he has been wearing condoms (since he asks if he no longer needs to use them). If condoms are effective against genital wart transmission (as a new study suggests) then why do you think that his girlfriend is already infected?

I can understand that the chances of Guy1207 being contagious are so low that condoms are not needed but I am interested in where you draw the line on condom effectiveness.

[H. Hunter Handsfield, M.D.]

The vaccine is recommended for every sexually active woman age 26 or less.  But no, it won't have any benefit for prior HPV infections.

[guy1207]

So,

You say that is a reduced risk of transmitting it, but she has been exposed.  Could the vaccine still be helpful for her because she might not have been infected by me??  If it is passed to the baby, does it infect the genitals?  Is it extremely rare for the baby to get the virus passed during birth?

[H. Hunter Handsfield, M.D.]

All I can do is repeat that most experts believe it is likely that HPV transmission risk declines to zero (or close to it) several months after warts go away. But that's only an estimate, and only an average.  Some people probalby remain infectious for a couple years or more.  The odds are in your favor, but that's the best anybody can say.  But it's too late to worry about it anyway; since you were having sex with her for several months, she probably has already been infected.  There is no point in taking precautions now.

Asymptomatic wart virus infections are not commonly transmitted to babies during delivery; that probably happens mostly when pregnant women have overt warts.  No, women with past warts do not necessarily get recurrences during pregnancy; most do not.  The new HPV vaccine is not recommended in pregnancy and I am unaware of the rumor you have heard about a vaccine specifically designed to protect infants--but I suppose it is possible.

Bottom line:  You are over-worried about this issue. Mellow out and let it go.   Stop looking on websites for bad news.  If or when your partner becomes pregnant, her ObG should be told of her past possible exposure so s/he can be on the lookout for problems. Truly that's all that is needed.  In the meantime, if she isn't planning to conceive right away, she should talk to her health care provider about getting the HPV vaccine.

Good luck--  HHH, MD