HPV clearing on its own / General clarification

[tboddin]

I've mostly followed Dr Handsfield's commentary, so if he can answer here that'd be most useful, I gues.
Here's my situation: Just under four years ago I went to the doc with what seemed to be a wart. He treated it--not sure with what. (Can't remember, called the doc's office and they didn't keep records back that far.) He didn't stress at the time that wart = HPV and all that, so I didn't think much of it at all. As a result I never tracked exactly when the wart disappeared, which is now bothering me a bit. I know you've said that HPV generally takes X amount of months to 'clear', with or without treatment. Are you counting those months from when the wart first appears? Basically, given that it's been this amount of time since the appearance of the wart, nearly 4 years--even though I don't recall exactly how long it took that wart to disappear--would you count me 'in the clear' and able to proceed as you've told many others to (i.e. no mandatory ethical responsibility to inform future partners of this infection?) Would you say that I'd be 'in the clear' in this sense, for practical purposes, even if I'd never gotten the wart treated? (Since I can't remember what the doc used it makes me a bit nervous--who knows if he was competent, etc.)  It seems from your other answers that in your opinion the loose idea is that 6 months with no warts = a fair reassurance that the virus is cleared, meaning you don't have to run around telling new sex partners that you are harboring HPV. So I'm hoping that, given this wart first appeared nearly 4 years ago..I can put this behind me, not have to 'confess' to this when having sex in the future, etc...even though I can't say with absolute confidence how much time it took that wart to disappear 4 years ago. I’m hoping that since it’s been four years I can be fairly confident I’m good to go, since once that wart did disappear it never came back (and I’m pretty astute about keeping an eye on those parts of my anatomy, to say the least.)

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  Thank you for reading other discussions and attempting to learn the answers there.  In general, it seems you have learned them well -- but you may be looking for more fine-tuned answers than are available.  And it seems you have read some of my bottom-line, take-home messages without adequate attention to the qualifications and uncertainties that I am also careful to mention.

There are no solid data on the duration of HPV, and no definite agreement even on the definitions of "cure", "eradication", or "persistence" of HPV.  What is known with some certainty (but not much precision) is that among women with asymptomatic genital HPV infections, within several months -- typically 6-12 months for low risk HPV types and typically 12-24 months for high risk types like HPV 16 and 18 -- in the large majority of women viral DNA can no longer be detected with available test methods.  There are no data on how long infection persists in patients with overt, visible warts (after the warts themselves are gone); how long HPV persists in men; or whether infection persists even when the available tests become negative.

My 6 month advice to patients with warts is only my rough estimate of the time a person may be infectious for his or her partners after visible warts are gone.  For all I know it's really 3 months or really a year, or maybe more than that.  (However, to my knowledge I have never had a patient who transmitted warts to a partner 6 months after his or her warts had cleared up.  But that doesn't prove it can't happen.)

Are you completely cleared of HPV 4 years after your warts have been gone?  My judgment is probably yes -- but I certainly won't guarantee that.

Finally, the other point you seem to have missed is that catching genital HPV, with or without overt warts, should be viewed as a mostly trivial inconvenience -- in fact, not even an inconvenience in most cases, since most cases are asymptomatic, go away, and never cause disease in either infected persons or their partners.  HPV is an inevitable, normal part of human sexuality; not desirable, of course, but normal (as long as we agree that something that happens to 80% of people is normal).  Women should have the HPV vaccine (and soon men as well, since the US FDA is soon expected to approve Gardasil for males) to reduce the risk of catching the most troublesome types; and women should have pap smears.  Besides those steps, people should more or less forget genital HPV and not worry about it.

Bottom line:  After 4 years, you should assume you are cured, and don't worry about it if that happens to not be the case.  This impersonal virus simply isn't worth the amount of emotional energy you seem to have devoted to it.

Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

Sorry I misinterpreted your comment above; I make the same typo all the time.  But if you don't mind, I'll let my reply stand; the point is valid in general terms.

You continue to miss a main point, which is that individuals have to make their own decision about disclosure to partners.  That should be based on the best available but obviously incomplete scientific facts, which I have given.  I'm not going to say that you should or should not say anything to future partners, and I did not do so in the thread you cite above.  I don't individualize such advice and that reply is just as valid for you as for him.  (If I were in your situation, knowing what I know, I would not feel obligated to tell future partners.  But if I were to form a new committed relationship, I probably would tell her.)

The issue is not treatment.  It is 6 months after warts are gone and have not recurred, whether or not they responded spontaneously or following treatment.

That has to end this thread.  Please try to achieve a mellow, no-worry perspective about HPV and your past wart problem.

[H. Hunter Handsfield, M.D.]

Huh?  I disagree entirely.  Where did you get the idea that women don't get warts or, when they have them, don't experience the same dilemmas?  Actually, women face problems of stigma and concern for their partners' health much more frequently than men, because abnormal pap smears (which are caused almost entirely by HPV) are a lot more common than warts.  And when HPV arises in women, with either warts or abnormal paps, in my experience most are more concerned for their partners' welfare than most men are.

You'll never convince me men face more stigma from warts and HPV than women do.  It's just the opposite.

[KMCS]

A related discussion, HPV w/o warts was started.

[GullibleFlower]

Can a woman (or any of the people above in the forum) get the Gardisil Shot after they get rid of warts if they have not had another wart appear after 4 years or a certain amount of time to protect themselves if they get a new partner that they do not want to hurt or give warts to either??

Since they invented Gardisil, could they do more research to invent something else to help people?
Could there or would there be a special soap in the shower that keeps stuff from developing down there or could people use a K-Y Jelly you can cover yourself up with while having sex that protects both people from getting any warts or stops them from ever happening??

[GullibleFlower]

Can you get genital warts from someone sneezing and sneezing fluids and their snot fluids being transferred onto your vagina or not and then they touch you there with their fingers or not?  The doctor sneezed all over and then put her gloves on without washing her hands after sneezing from alergies in my examination room during the pap session?

Also, if a guy (or anyone) has warts on his fingers and fingers your vagina while he has warts on them (that you did not see on him),  can you get these type of warts inside your vagina after fore play or not from fingers, too??
If people have a wart on their own fingers and then masturbate themselves, can they give warts to themselves from their own human papiloma virus from their own hands??
Is it true that HPV warts can go away and not come back if you are more careful in the future??

[H. Hunter Handsfield, M.D.]

Forum users cannot and should not attempt to extrapolate specific advice to individual questions to their own situations.  Some answers are tailored to details that may not apply to other persons.  You indeed are splitting hairs and I suggest you simply stop reading everything you can get your hands on about all this.  I do not attempt to assure 100% consistency in all answers simply to keep obsessed users more comfortable!

Please let this go.  This thread is definitely over; I will delete any additional comments.

[tboddin]

Thank you doctor. I realize you're not in the business of making ethical pronouncements--but it does seem at times that you feel that disclosing to new partners after this amount of time would somehow create more hassle than good. This very recent post, for instance:

http://www.medhelp.org/posts/STDs/HPV-transmission--question-about-types/show/1029218

Here you tell this person: "Absoutely you can (and should) refrain from telling future partners."

Again, probably splitting hairs here I'm sure. Apologies for extending the thread; doing my best to be calm about all this.

[tboddin]

I think what I'm questioning is related to your feedback here, which is very clear--and I feel like I'm in somewhat of the same situation as this individual.

http://www.medhelp.org/posts/STDs/How-Long-Should-I-Wait/show/454908

Here you also mention a 6 month duration with or withOUT treatment..

Again, I know there are no 'hard and fast' rules, and I'm not asking for guarantees, just a reasonable way to proceed in sexual life without feeling like a *******.

[tboddin]

I misphrased that entirely--please disregard (or delete). What I meant was: men with visible warts are inconvenienced more than MAN without visible warts who may have other strains of HPV--simply because the latter don't know they've got anything.

One more question and than I'm truly done.

*If you could clarify what I'd asked above: "If you think it's fair to proceed without having that discussion--even though I didn't mark the exact date when the wart disappeared, which may have been 3.5, 3 years ago, etc--than I feel better about the whole (trivial) thing."

Essentially, as with most people, it's a matter of disclosure and angst that I am having. I'm assuming I know what your answer will be from your initial 'bottom line' response. I would just like to know that I can proceed without having this 'conversation' before entering into a sexual relationship with a new partner. The 'obligation' to do so is what is causing me the emotional anguish, despite knowing that HPV is common, trivial in most cases, etc. If you can address that and that alone...I'd definitely feel a bit better.

[tboddin]

Actually, one final follow-up if you don't mind, only because it may be of help to the larger forum:

WHat confuses me about all this--male HPV in general--is that it's only the men with low-risk (wart-causing) HPV who are ever inconvenienced. We "know" about it because we can see it , or show up at the doctor's without a visible wart...yet the strain causing that wart is one of the least concerning HPV strains. Other men--many of them--are walking around with higher risk HPV strains, and no symptoms, or ways of testing if they are HPV-positive...What I gather from most of your feedback is that this is one of the reasons why "confessing" a previous HPV infection after 6+ months is pointless...because the person you would be sleeping with would doubtless otherwise be sleeping with guys who have been/are HPV positive and don't know it, or never had symptoms, etc....And by "confessing" a known HPV infection it's simply creating a stigma, given that most people (i.e. those who don't frequent this forum) don;t know much of anything about HPV...


Would that be somewhat in the ballpark?

[tboddin]

Thank you for your clear & direct help.

I guess the only follow-up I have is...I don't know that it has been four years "since my warts have been gone." That was when I first noticed it, and had the treatment done. (Also, at about the same time, I believe, another doctor diagnosed me with molloscum...so this may all be a moot point, as what the one GP was saying was "a wart" may have been the other thing.)

Your bottom line puts me at ease though. I'd much prefer to simply let this be, and not mention it with future partners (since as you might tell from how I phrased my question, that'd probably initiate an unneeded catastrophe.) If you think it's fair to proceed without having that discussion--even though I didn't mark the exact date when the wart disappeared, which may have been 3.5, 3 years ago, etc--than I feel better about the whole (trivial) thing.

[H. Hunter Handsfield, M.D.]

This information does not change my opinion or advice.

[tboddin]

One addendum: whatever treatment the doctor used was done only once, in the office.

He put some solution on the area that, from what I remember, turned the area a vivid inky color. He did not freeze the warts, nor was I given any oral medication, etc.