HPV: Managing Condyloma and Safe Sexual Practices

Cauliflower (Condylomata Acuminata)

Dear Dr.
Chuang,
In mid-February, I discovered condylomata acuminata on the inner labia and vaginal opening.
The HPV pap smear result was positive for type 6.
I underwent treatment with "Wartec" for four cycles and have been consistently returning for follow-up since the end of March, with no symptoms present.
After the absence of symptoms, I resumed sexual activity (using condoms), and the doctor mentioned that the infection rate is extremely low at this time.
However, my boyfriend recently found a single wart-like growth at the base of his penis near the groin, which was diagnosed and treated with electrosurgery, and he is still continuing follow-up visits.

I have the following questions:
1.
How long should I continue to wash my underwear by hand (until there are no symptoms or how long after that) before I can use the washing machine?
2.
After the absence of symptoms, should I continue using "Aldara" or other topical treatments, or just monitor for any recurrence of symptoms?
3.
Does "cured" mean the absence of symptoms or the absence of transmissibility? When is the appropriate time for a repeat HPV pap smear?
4.
When is it safe to say there is no transmissibility, and when can we engage in safe sexual practices or even consider pregnancy?
5.
Since we are both monogamous partners, are there any additional precautions we should take to avoid reinfection and recurrence?
Thank you very much for your assistance.

Fanrao Hua, 20~29 year old female. Ask Date: 2008/06/21

Dr. Zhuang Zhijian reply Obstetrics and Gynecology

Hello, thank you for your inquiry.
I would like to address your question and provide the following suggestions: The treatment and follow-up for condyloma (warts) typically last about a year, during which there is approximately a 50% chance of recurrence.
This can be attributed to various factors, including reinfection.
Generally, after treatment, regular follow-up is necessary to monitor for any re-emergence of lesions, allowing for timely intervention if needed.
There is no need for special precautions regarding clothing or ongoing treatment, and it is safe to become pregnant.
The most important aspect is to maintain regular follow-up.
Wishing you peace and happiness!

Reply Date: 2008/06/21

More Info

Understanding HPV, particularly in the context of condyloma (genital warts), is crucial for managing your health and maintaining safe sexual practices. Human Papillomavirus (HPV) is a common sexually transmitted infection, with certain strains leading to the development of genital warts, while others can cause various cancers. Here’s a comprehensive response to your questions based on current medical knowledge.

1. Washing Underwear: It is advisable to wash your underwear separately for at least a few weeks after the last visible signs of warts. This is to minimize any potential risk of viral transmission through contaminated fabrics. Once you have been symptom-free for a significant period (generally 2-3 months), you can consider using the washing machine again, but it’s still wise to maintain good hygiene practices.

2. Use of Topical Treatments: After the resolution of visible warts, continued use of topical treatments like Aldara (imiquimod) is generally not necessary unless advised by your healthcare provider. Monitoring for any signs of recurrence is essential. If no new warts appear after a few months, you may not need further treatment. However, regular follow-ups with your healthcare provider are important to ensure that any new developments are addressed promptly.

3. Understanding Cure and Transmission: The term "cure" in the context of HPV can be misleading. While the visible signs (warts) may resolve, the virus can remain dormant in the body. A person is considered to have no active infection when there are no visible signs and no detectable virus through testing. HPV testing can be done during routine Pap smears, typically every 3-5 years depending on your age and health history.

4. When is it Safe to Engage in Sexual Activity?: Engaging in sexual activity is generally considered safe when both partners are symptom-free and have not had any new warts for at least 2-3 months. However, it’s important to note that HPV can still be present even in the absence of symptoms. Using condoms can significantly reduce the risk of transmission, but they do not provide complete protection since HPV can infect areas not covered by the condom. If you are considering pregnancy, it’s advisable to discuss this with your healthcare provider to ensure that both partners are in good health.

5. Preventing Re-infection and Cross-infection: Since both you and your partner are monogamous, the risk of cross-infection is lower, but it’s still important to maintain good hygiene. Avoid sharing personal items like towels or razors, and ensure that both partners are aware of their health status. Regular check-ups and open communication about any new symptoms are crucial. Vaccination against HPV can also help reduce the risk of future infections, even if you have already been infected with one strain.

In summary, managing HPV and condyloma involves a combination of good hygiene practices, regular medical check-ups, and open communication with your partner. While the risk of transmission decreases significantly when both partners are symptom-free, it’s important to remain vigilant and proactive about your sexual health. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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