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Avatar universal

risk of passing on hpv and telling future partners

Doctor,
I am a 27 year old hetero male diagnosed with genital warts during a long term relationship about 2 1/2 years ago. The first outbreak was about 5 or 6 individual small warts around the pubic area and base of penis. Warts were treated with freezing but a few more occured a couple months later and were treated again. About 6 weeks ago (2 years since the last outbreak) 2 very small warts appeared and were removed with freezing. Having the warts reoccuring 2 years later has been very distressing, my questions are:

1. I was under the impression hpv cleared the system usually within a year. Is this re-occurence abnormal considering I have not had a new sexual partner since the first outbreak and (casual smoking aside) am in great physical health- diet, exercise, etc ??

2. My doctor told me I was no longer contagious after the scabs from the freezing fell off (about a month ago now) and I did not have to mention this to future partners. Is this accurate, or is there a suggested time frame of being symptom free before mentioning this to future partners is no longer necessary?

3. I have recently become involved (not sexually yet) with a 23 y/o woman from AUS, where most girls of that age have been vaccinated. Is the vaccine typically affective against my type of hpv that causes warts?

Basically, I am terrified to have this discussion with future partners as I'm sure most women will run for the hills after I tell them I have hpv/warts and would rather not bring it up if it is unecessary. However, if I am a legitimate risk of passing it on I would feel ethically (and perhaps legally) obligated to tell them. Is it necessary for me to tell a soon to be sexual partner of my history with warts?

I can appreciate that advising on future outbreaks and risk of transmission is speculative at best, but I would like your insight on how to approach this issue with future partners, as I am concerned with informing them if I'm actually a risk.

Thank you
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
The answer to your second question reallly is dependent on whether or not the lesions that were treated were warts or not.  As you know, I have my doubts for the reasons mentioned but I did not see them.  The safest and most conservative approach would be tell your partners that you MAY have had warts and that they were treated.  EWH .
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Avatar universal
Thank you for your prompt response.
To answer your question, no the diagnosis was not verified intially or the recent reoccurence. In fact the first GP at my clinic did not think they were warts in the initial instance. However, a couple months later a second doctor believed them to be warts and treated them. If I have any further symptoms my next stop will be a dermatologist, thank you.

Just to clarify, assuming this second reoccurence actually is warts, I should not have any sexual contact without informing my partner until it has been 3 months of the freezing treatment. Or am I being overly cautious, considering the re-occurence may not even be a result of HPV?

Thanks for your advice
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to our Forum.  I'll address your questions below but before I do, a comment or two.  Was the diagnosis of warts verified by a dermatologist?  I don't mean to challenge your doctor but warts in the pubic hair area are quite unusual, as is recurrence after a period of years.  Rather than recurrence after more than 3-6 months, in our experience, folks have either been mistaken about the warts (there are many things which can mimic warts) or have been reinfected.  Now on to your questions:

1.  See above, this is unusual, and if they have recurred in the same place after such a long time, I would worry that this are not warts but some other dermatological process.  Sometimes the diagnosis can be difficult an there are many other dermatologic processes which can mimic warts.  

2.  Most therapy for warts/HPV such as freezing, laser, etc. is destructive in nature.  Thus once healing occurs (i.e. the scabs fall off), the person is no longer infectious, as long as the therapy has been successful.  In about 20% of persons however the initial treatment is not completely successful and the warts recur.  For this reason we ask our patients to wait for about three months following therapy before they assume they are no longer infectious,  If the treatment failed, it is typically apparent within 3 months of treatment.

3.  There are two types of HPV vaccine.  The one manufactured by Merck prevents 4 types if infections including the two that cause over 95% of visible warts.  The vaccine from Glaxo Smith Kline targets only two HPV types an these are not the ones that cause warts.  Not sure which vaccine she received.  If it was the Merck vaccine her risk for getting warts, if that is what you have, is very, very low.

4.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  Because the infection is so very common we feel that notification of all partners is neither realistic (most people with HPV do not know they have it) or practical.  It appears that you have had at least some conversation with your GF since you found out that she has been vaccinated- this is a goo start.

Hope these comments help.  EWH
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