More HPV Questions

[bob41]

Doctor -
I wrote to you a little over a month ago concerning HPV.  It's been about 7 weeks since my last wart has been frozen off and healed and luckily I haven't yet had any reoccurrences.  I have thought of a few more questions in the interim:
1. If the virus does indeed clear my system, does one episode of genital warts make me more likely to get them again if I am exposed to a different strain of HPV in the future ?
2. Can hair grow out of warts ?
3. How reliable the HPV(DNA) test for men ?  Why is it less reliable for men than for women ?
4. Do you see the results you describe often in your practice (i.e. one outbreak, once rid off, no more outbreaks; most (>90% clear the virus)) ?
5. Could I pass the virus (most likely, HPV 6 0r 11 b/c I had 2 little warts) that I have to a girl and she not get any warts ?

As you can see by my questions, I am having a very hard time with this.  I feel like I am disgusting and will never be clean again.   Is there anything you can say to me (and to the rest of the people who feel the same way that I do) to make me feel better ?

Thank you for your time.

[confusedandfedup]

I was diagnosed when I was 35 with high risk HPV right after I was married 4 years ago.

In the meantime I got pregnant and had a colposcopy while pregnant that they were very careful about ( didn't remove much tissue) and the results were mild cervical dysplasia.....I then lost that baby ( miscarriage unrelated) and got pregnant again so my next colpo was also done with a light touch and came back mild cervical dysplasia again.

All this time I was getting abnormal paps with the ASCUS (not sure if that is the right acronym) label....I got another one of these abnormal paps after my son was born so I had another colposcopy. This time I was not pregnant so the doctor really dug in and removed the whole suspicious looking area. The biopsy said mild cervical ( C1) dysplasia again. This was in December 2004 ( just 3 months ago).......

WELL due to other issues from the traumatic forceps delivery of my son, I have to have some major vaginal surgery. I mentioned to my doctor that I have high risk HPV and he told me I should get a hysterectomy. I called my regular gynecologist and asked to be re-tested for HPV just in case it has cleared up because I didn't want to get a hysterectomy for nothing. He refused and said that since I just had cervical dysplasia in December, of course I am still HPV positive.

Last week  I went to a new gynecologist. He gave me a pap smear which came back NORMAL and an HPV test which came back NEGATIVE. I don't understand how I could get a normal pap after just gaving cervical dysplasia just three months ago. Could he have  gotten rid of the offending tissues when he did that aggressive colposcopy? Could I have gotten a false negative on both the pap ( Thinprep) AND the HPV tests?

I would really appreciate your input as I have surgery scheduled for two weeks from today and need to decide on the hysteretomy.

[H. Hunter Handsfield, M.D.]

I'm not sure exactly why, but I can make some reasonable speculation.  The Digene test was designed for the express purpose of diagnosing HPV in cervical (Pap smear) specimens and not intended for use in men; unless things have changed recently, Digene did not seek FDA approval for its use in settings other than pap smears and makes no claim about diagnosis of HPV in men.  I imagine that detecting HPV DNA in samples from dry skin is inherently less sensitive than for the more fragile, moist surface of the cervix.

HHH, MD

[bob41]

Thanks for your reply.  You must be getting sick of writing about HPV, it seems that every other question concerns it.
Anyways, I looked at the "Troubling new studies" thread and didn't find the answers to my question #3. I did not see the answer.  Maybe I should re-phrase my question.  Why is the most accurate test available now (Digene) less reliable in its results for men over women ?  
Thanks for your time.

[H. Hunter Handsfield, M.D.]

See my response to "Troubling New HPV Studies", immediately before your question; it answers some of your continuing concerns.

1) There just aren't good data one way or the other, as to whether persons who get visible warts with one HPV type are more or less likely to do the same with a new infection.

2 ) No

3) See "Troubling new studies"

4) Yes

5) Yes, that's the usual outcome.

Try to get over it.  Feelings of shame and disgust are pretty common among people with genital warts.  Part of that comes from myths and misunderstanding.  But if accurate factual knowledge (my primary goal) doesn't cut it for you, then consider whether a mental health professional might help.

Good luck-- HHH, MD