Recovery from HPV: Insights on Symptoms and Follow-Up Care

Inquiry about disease-related issues?

Dr.
Hong, I apologize for bothering you.
My brother, who is five years older than me, confided in me two years ago that he had genital warts, but he was too afraid to tell our parents (I was still in high school at the time).
Based on my understanding, he is not likely to engage in unsafe sexual practices, so I was a bit surprised, but later I learned that there are indeed other ways the virus can be transmitted.
Recently, he asked me if not having any recurrence for almost two years means he has recovered.
I am currently in my second year of college, and although I have learned a bit, I have not yet had the opportunity to intern in a hospital for clinical diagnosis.
I could only tell him that the key point is the absence of symptoms, but to determine the viral load, tests would need to be conducted.
Generally, it seems that treatment is based on symptoms, and not having a recurrence over time is considered a good sign.
However, I am concerned that I might not have enough knowledge to advise him correctly.
He has had follow-up appointments twice, and during the last visit, the doctor mentioned that he does not need to return for further follow-up.
However, regarding the tests I mentioned, he said the doctor never brought it up, which I suspect means they may not be necessary and could be out-of-pocket expenses.
He asked me if this means he is cured.
Honestly, I couldn't provide a definitive answer.
I feel that if his immune system is strong, there is a possibility of recovery, or that if he goes a certain period without recurrence, he could be considered healed.
I'm not sure if this understanding is correct.
Lastly, since my brother is asking if there are ways to prevent recurrence, I only know to advise him to eat well and get enough sleep.
Thank you for your response.

BX.Hsu, 10~19 year old female. Ask Date: 2021/03/05

Dr. Hong Yuanbin reply Internal Medicine

The recurrence of genital warts is primarily determined by the presence of any lesions on the surface of the genital area, rather than relying on blood tests.
Based on your description, it seems that your relative has not experienced any further symptoms in the genital area, which is why the physician concluded that there is no recurrence.
They do not need to return for follow-up appointments; instead, they should regularly check for any new lesions or discharge.
It is advisable for your relative to maintain a regular routine and exercise, and to avoid unsafe sexual practices to reduce the risk of recurrence.
Regarding the viral load you mentioned, it primarily pertains to HIV, HBV, and HCV, and not to genital warts.
Thank you for your question.

Reply Date: 2021/03/05

More Info

Understanding recovery from HPV (Human Papillomavirus) can be complex, as it involves various factors including the type of HPV, the individual's immune response, and the presence of any symptoms or lesions. Your brother's situation, where he has not experienced any recurrence of symptoms for nearly two years, is indeed a positive sign, but it does not necessarily mean he is completely free of the virus.

Firstly, it is important to understand that HPV is a common virus, and many people are infected with it at some point in their lives. In most cases, the immune system is capable of clearing the virus without any medical intervention. Studies suggest that approximately 70-90% of HPV infections resolve spontaneously within two years. Therefore, the absence of symptoms or lesions over an extended period, like in your brother's case, can indicate that his immune system has effectively controlled the virus.

However, the absence of symptoms does not guarantee that the virus is completely eradicated from the body. HPV can remain dormant in the system, and while it may not cause any visible symptoms, there is still a possibility of reactivation or transmission. This is why regular follow-up and monitoring are essential, especially for individuals who have had visible manifestations of the virus, such as genital warts (often referred to as "cauliflower-like" growths).

Regarding your brother's question about whether he is "cured," it is a nuanced topic. If he has not had any recurrences and has been symptom-free for a significant period, it is reasonable to consider that he is in a state of remission. However, without specific testing to confirm the absence of the virus, it is difficult to definitively say he is cured. The medical community often emphasizes the importance of follow-up care, especially for those who have had high-risk types of HPV that can lead to more serious conditions, including cervical cancer.

In terms of follow-up care, it is crucial for your brother to maintain regular check-ups with his healthcare provider. While he may not need to return as frequently if he is symptom-free, periodic evaluations can help ensure that any potential issues are caught early. If his healthcare provider has not mentioned further testing, it may be due to the current absence of symptoms, but he should feel empowered to ask about the necessity of follow-up HPV testing or any other relevant screenings.

To reduce the risk of recurrence or new infections, your brother can adopt several healthy lifestyle practices. These include:
1. Boosting Immune Function: A strong immune system can help keep HPV in check. This can be achieved through a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, regular physical activity, adequate sleep, and stress management.

2. Avoiding Risky Behaviors: While your brother may not engage in unsafe sexual practices, it is essential to continue practicing safe sex. Using condoms can significantly reduce the risk of transmitting HPV, although it does not provide complete protection since the virus can be present on skin not covered by a condom.

3. Regular Health Screenings: Encouraging him to keep up with routine health screenings, including Pap smears for women and regular check-ups for men, can help monitor any changes in health status.

4. Vaccination: If he has not already received the HPV vaccine, it may be beneficial. The vaccine can protect against the most common high-risk types of HPV and prevent future infections.

In conclusion, while your brother's lack of symptoms over the past two years is a positive indicator of his health, it is essential to remain vigilant and proactive about follow-up care and healthy lifestyle choices. Encouraging him to maintain open communication with his healthcare provider about his concerns and the need for any further testing will help ensure he stays informed and healthy.

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