HPV Transmission/Immunity

[remedy777]

Good day to you Dr.Handsfield

My questions are with regards to the strains of HPV that cause genital warts. I have read in some of your replies that when a couple is sharing the same strain of HPV, there is no need for limited sexual activities and that protection is superfluous. Also I have read in your replies that the virus can be cleared within two years and that re-infection of the same strain is not possible. I hope I have not misquoted you.

I do believe I grasp the concept of immunity, but to the best of my knowledge HPV is cutaneous and mucosal disease specific to certain areas. Wouldn't that conclude that an area free and clear of lesions could still be prone to infection regardless if one already has the virus?

If a couple is infected with the same strain in the same area, (the genitals) couldn't the warts still be transmitted to other areas of the body such as the anus, face and or mouth? For instance, if the male's infection is on his penis and the women's on her vagina, couldn't the warts still be spread to the woman's anus if they engaged in anal sex, even though she already had the virus but not in that area? The same question applies to oral sex. Couldn't the male acquire oral lesions from the woman's vagina and vice versa; the woman acquiring oral lesions from the man's penis. I have read and heard a great deal of conflicting information through out my tireless investigation, however I respect and value your opinion due to your impressive credentials and reasuring nature.

  I hope this isn't a frustrating read. I do understand that you get many eccentric and hypochondriatic questions. Perhaps mine are no exception.

My second question is, if indeed the virus can be completely cleared within approximately two years, how could you not be infected again by the same strain in the future?

Again, I hope these don't strike you as uncouth inquiries. Thank you for your time. I don't know how you do it.

Cheers,

[Edward W Hook, MD]

I suppose one cannot be "sure" that immunity has been built up however if the infection clears, it is because an immune response has developed.  The time course of immunity from natural infection  varies from time to time.  You appear to be looking for absolutes when there are none.  EWH

[remedy777]

Thank you. I'm sorry, I didn't mean to come off as a know it all and I trust your judgement. I guess I didn't understand immunity. My only follow up question is, if the couple has a strain of HPV on the genital regioin, it cannot then be transmitted to the oral regions? How can one be sure an immune response has been built up? How long would it typically take for that to happen? I did read your answer yes, but I'm still unclear.  

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

Your questions are reasonable but betray a modest mis-understanding of immunity.  When persons develop an immune response to a local process to an infection such as a wart, that response may originate locally but is not localized.  The antibodies and immune cells which make up the immune response circulate throughout the body, providing protection from future infections not only at the site of infection but elsewhere throughout the body.  In addition, the cells which produce the antibodies, as well as the immune cells which fight the infection directly are "long lived" and give rise to other cells which carry the same sort of immunological reactivity and providing us with immunological "memory" which protects us from infection going forward.

I hope this brief explanation clarifies things.  EWH