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Q: I have a question about genital warts (HPV) and their transmission. Approximately 10 months ago my then boyfriend told me that he had visible genital warts. I have yet to show any signs of these warts. However I do believe that I was the one to transmit them to my boyfriend. During a short separation in June 1998 I had unprotected sex with another partner. I continued to have unprotected sex with my boyfriend after that and in August 1998 he developed the warts. Is it possible that I am a carrier now and will transmit these warts to all future partners? I am now in a new relationship. We have had sex with spemicidal condoms only. I am just concerned that if this relationship develops into marriage, will I transmit the disease to him? Is it even remotely possible that I do not have the disease at all and my ex-boyfriend developed them from his last partner (he last had sex with another partner three years before and I am very confident that he had no other partners but me)?
A: Genital warts are usually sexually transmitted. They are caused by human papilloma viruses.There are various types of these viruses which cause the disease. Over 70 different papilloma viruses have been identified. About 80% of genital warts are caused by human papilloma viruses (HPV) types 6 and 11.On the other hand, HPV types 16 and 18 only account for about 20% of genital warts. However, about 80% of cervical cancers in the United States and England are due to HPV 16 and 18. About 60% of partners who have sexual contact with partners having genital warts develop the disease, usually within about 2 to 3 months. However, the period between infection and the presence of disease can be much longer. Genital warts are among the most common sexually transmitted diseases in the United States. A minimum of about 10 to 20% of sexually active adults are thought to be infected. HPV lesions are difficult to eradicate. No treatment is universally effective, with recurrence rate of about 25% at three months. Clinical diagnosis is possible if lesions are clearly visible. However, lesions of the cervix are difficult to identify clinically. Clinical examination and Papanicolau's smears comprise the current diagnostic standards.Also, application of 5% acetic acid permits the physician to visualize the warts in many cases when looking at the affected area under magnification (colposcopy). Genital warts may be completely asymptomatic, although itching, burning sensation, and pain may also occur. Condoms can protect both the user and sexual partner if used correctly. In your particular case, the above indicates that you could possibly have the disease and transmit it. However, we can, of course, not be sure. It is also possible that your boy friend developed the disease from his last partner. I would, of course, suggest that you visit your gynecologist and ask him/her to carefully evaluate you. Note, however, that, if present, no treatment is in general universally effective. Also, recurrence rate may be 25% at three months. I think that your gynecologist should be able to more definitely evaluate your case once he/she examines you and then suggest how to proceed in your particular case.
Updated: 06/29/99
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