Hey guys/gals,

32 yr old male, recently diagnosed with HPV-16 after visiting a derm and having a biopsy performed on a small subsurface/flat cluster of brown/purple discolored area about the size of a dime or so. Honestly, it looked more like bruising than warts (i.e. normal raised surfaces) but based on research it seemed very feasible and with diagnosis certainly genital warts. I had them for probably nearly 9 months before going to get them checked out, and it's been over a year now.

Anyway, he prescribed Aldara, which I used for around 5 weeks before returning to him for a checkup...at which point he felt it was getting better and recommended stopping treatment. After a week I could see they still remained, but the derm requested we wait the a total of 6 weeks before having a follow-up so he can verify.

Upon the 6 week check-up he felt they were better than they were before but could still see the discoloration and performed another biopsy.

I got the results in after the second biopsy and the HPV cells still exist. They did not check the type this time, but given the same location and the fact they didn't go away entirely and return I suspect it's the same type 16.

Rather than continuing Aldara, the derm wanted to numb and scrape the area to remove the warts. I was apprehensive due to fear of scarring and not knowing a ton about it and questioned why not continue with Aldara first but he felt it was quicker and better to remove the warts given they are due to a high risk HPV strain. He also felt the scraping would be minimal depth and would not be likely to result in any kind of scarring. So I went ahead with that two weeks ago to remove 80-90% of what was there, and will be following up with the doctor next week. I really hope there is no scarring, but I guess that is the least of what I should be concerned with.

On the flip side, and I've seen it here before...but are derms just ridiculous non-chalant about GW? Mine keeps saying how common it is, it's not a big deal, don't get worked up over it...I mean it's like a rush job every time I go in there...just bang it out and go on to the next appointment. Meanwhile, I'm stressing out in a cold sweat trying to grasp it all, what it means, what kind of timeframe I can expect before it's all "over"...he just seems very dismissive about it all...maybe he sees it 100 times a day and I'm just another case, no big deal. Well to me it feels like a big deal...perhaps it's just poor bedside manner by the derm...I don't know, but it doesn't make it any more comfortable or comforting.

I had all kinds of questions regarding getting surgery vs other alternatives, but didn't get any response on other forums and just found this one yesterday.
I also had questions around HPV-16 being a cause of GW, based on what I read it seemed very uncommon (usually GWs are attribute to other strains) but I found a study last night that stated two things.

1) HPV-16 can result in GW in exactly the type (flat/subsurface) that I experience(d).
2) HPV-16 is one of the most difficult for the body's immune system to supress as it has shown signs of not reacting to the immune system or otherwise taking longer.

I don't know the results yet, or what will come of it all...but I do know it has taken an immense emotional toll on me.
I do have a set of questions, I hope someone here can help clarify...

Once you have a given HPV strain, and your body's immune system surpresses it, they say your body will "remember" that strain and it rarely will resurface. I know from reading posts on here that is not always the case, but if you are fortunate to have that happen whereas no symptoms appears...you are assuming your body has developed an immunity to that particular strain, correct?

On the same token, does that mean you cannot pass that strain on any longer? i.e. if your body is immune to it, has your body eliminated it entirely or just pushed that strain to a dormant state indefinitely (assuming it is indeed supressed) yet it still can be transmitted to others that have not developed an immunity to that strain?

As far as future relationships, how do any of you even begin to start down that path...especially when intimacy is so utterly important (at least to me)?

It seems like such a conflicting disposition...you can "date", go out a few times, avoid any sexual contact that would otherwise be a potential problem...but at some point you have to tell the person (I know there are different schools of thought on this, but unless I went a LONG time without a partner and no symptoms, I would have to tell them)...and hope they understand. As if there isn't enough stress in trying to find a significant other.

Anyway, just wanted to

Hello and thanks for your post.

1) HPV-16 can result in GW in exactly the type (flat/subsurface) that I experience.

Right, HPV-16 can result in "flat" warts, as they're often called.

2) HPV-16 is one of the most difficult for the body's immune system to supress as it has shown signs of not reacting to the immune system or otherwise taking longer.

There is research that shows HPV-16 tends to hang around a bit longer than some other types. To my best memory, this research is primarily done with women and cervical infections, specifically, but of course there may be a parallel with men. The tendency for HPV-16 to be more persistent is relative, though, as most type 16 infections are still cleared by the immune system.

Once you have a given HPV strain, and your body's immune system surpresses it, they say your body will "remember" that strain and it rarely will resurface. I know from reading posts on here that is not always the case, but if you are fortunate to have that happen whereas no symptoms appears...you are assuming your body has developed an immunity to that particular strain, correct?

This process you describe in an inexact science and can vary from case to case. In very broad terms, though, the immune system does clear almost all cases of HPV (usually in 6-24 months) and, while recurrences aren't rare, they tend to happen in the first few months after treatment. Long-term issues are uncommon and, when they do happen, are observed more often in people who have a major illness or become immune suppressed (HIV+, organ transplant, etc.).

On the same token, does that mean you cannot pass that strain on any longer? i.e. if your body is immune to it, has your body eliminated it entirely or just pushed that strain to a dormant state indefinitely (assuming it is indeed supressed) yet it still can be transmitted to others that have not developed an immunity to that strain?

This is the million dollar question. No one can really say "Yes, you no longer have to think about this after X amount of time." Most experts would say you're aren't likely to be able to transmit the virus to new partners forever, and the risks likely decline after - take your pick- months/a year or so of being clear. There is no way to prove this or to say "ok, NOW your risk of transmission is 30%, and in another six months it's 10%," and so on.

I, somewhat pitifully, attempted to address this in the thread at
viewtopic.php?t=394. Check it out if you have time.

Hope this helps. Please post again sometime.

Best,
Fredo

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I've had HPV for about eight years now and I know what you mean about doctors and other people acting like it is no big deal. But to the people that have it, it is. I was in a long term relationship for about six year and he totally accepted it and we had unprotected sex and he never showed any signs of HPV. But that relationship has ended and I'm trying to find someone new and it's hard. I have a girlfriend who has herpes and HPV and she tells me not to even tell new guys. She says it's no big deal and most people either have HPV and don't know it or are exposed to it at some point in their life. But I just couldn't live with myself if I had sex with someone and didn't tell them. I had one wart and it went away with treatment and I have had normal pap smears for the last two years.

Be honest with women and tell them. It is extremely difficult to talk about the first couple of times but don't give up on trying to find someone who will accept you as you are. It is possible. I'm 47 and you are much younger than me and this seems to be a young people's disease so it may be a little easier for you. There are plenty of dating sites online for people with STD's.

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I would always err on the side of caution. It is important not to be selfish when it comes to any kind of STI, and remember that although it may be difficult, the most respect you can show to your partner is to inform and protect. One doctor I went to told me the following rule of thumb he gives to patients with any kind of HPV. Wait for about seven years since you have seen the infection at all and that is the best indicator you are good to go. Patience is going to be very important. Having HPV myself, I am planning on using max protection pretty much forever at this point.

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