HPV: Concerns About Recurrence and Transmission to Your Baby

Cauliflower issue

Hello, doctor.
I had genital warts in 2009, which were treated successfully, but they recurred in 2012 and were treated again.
It has been three years since then, and I would like to know if there are still viruses in my body after being cured.
I have heard that the body can automatically clear the virus within two years, but I have also heard that even if symptoms are gone, the virus can still hide in the body.
I am very worried; since it has been three years since my last treatment, can I consider myself cured? However, I am puzzled as to why I had a recurrence after three years.
I am certain it was not a reinfection because I have been very careful with hygiene, and my partner is also consistent.
Is it possible for genital warts to recur after such a long time?
I have also given birth via cesarean section, and during my pregnancy, I did not experience any recurrence of warts.
People say that immunity is lower during pregnancy, yet I did not have any issues.
Does this mean I am cured? I am very concerned that there might still be a virus in my body that could accidentally infect my baby.
The other day, after taking a shower, I cleaned my baby's mouth.
I washed my hands with soap before doing so, but I am still worried that the action could transmit the virus to my baby.
I washed my intimate area while showering, and I fear that I might have contaminated my hands and then transferred it to my baby's mouth, even though I washed my hands afterward.
I currently have no lesions, but I am still very anxious.
I usually clean my baby during the day, but that day I noticed a thick coating on his tongue, and after my shower, I immediately cleaned it.
Now I regret it and am very worried that I might have infected him.
I have been thinking about this issue for days and can't sleep.
It is really distressing.
If there was a virus on my hands, would washing them remove it? Ever since I contracted this disease, I have felt very dirty, and even after all this time, I still feel like it is an incurable condition.
I am becoming quite depressed, and now that I have a baby, I am even more worried about whether I might transmit anything to him.
Please help me clarify these concerns.
Thank you very much.

Xiao Zhen, 20~29 year old female. Ask Date: 2015/08/19

Dr. Li Yilun reply Urology

Human papillomavirus (HPV) is a small DNA virus (diameter 55 nm) that biologically belongs to the Papovavirus family.
There are over a hundred known genotypes of HPV, with more than thirty types capable of infecting the skin and mucous membranes of human genital organs, leading to various diseases.
For example, the commonly seen sexually transmitted infection known as "genital warts," colloquially referred to as "cauliflower," is caused by HPV genotypes 6 and 11.
HPV exhibits a high degree of host specificity, primarily infecting human skin and mucous membranes.
Under normal circumstances, the nuclei of human skin and mucosal cells are uniform in size; however, when infected by HPV, the nuclei become enlarged and vary in size, leading to cellular dysplasia and precancerous changes.
Recent epidemiological studies have clearly demonstrated a strong correlation between HPV and the development of cervical cancer.
Therefore, having a method to test whether women are infected with HPV could significantly aid in the prevention and treatment of cervical cancer.

Additionally, the cervical cancer vaccine mentioned in the news is actually a preventive vaccine against HPV.
If this vaccine can be successfully developed and administered to girls before puberty, it would enable them to produce HPV antibodies before reaching reproductive age, thereby preventing HPV infection after puberty.
This could lead to a substantial reduction in the prevalence of cervical cancer, representing a significant advancement for women's health.

HPV is primarily transmitted through "sexual contact" (hands, mouth, genitals) or through "blood and bodily fluids." However, in very rare cases, it can also be transmitted during childbirth or through other means.
According to statistics, the average prevalence of HPV infection among women in Taiwan is 9%.
The prevalence rates for different age groups are as follows: 6.6% for ages 20-30, 7.5% for 30-40, 7.3% for 40-50, 9.2% for 50-60, and 14.8% for those over 70, indicating an increase with age.
In Taiwan, the most common HPV genotype is type 52, followed by type 16 and then type 58.
However, when comparing cases of invasive cervical cancer, type 16 is the most prevalent, followed by type 58, while type 52 is rarely seen.

Genital warts may not always present visible symptoms in women; the virus can remain latent within cells, making it impossible to completely rule out the possibility of transmission.
While the likelihood of transmission may be low, given that HPV is sexually transmitted, it is possible that partners may have already infected each other before detection or treatment, complicating the identification of the source of infection.
Women who wish to understand their current HPV status or have other questions about the virus should consult their obstetrician-gynecologist.
Currently, there are also HPV vaccines available that can provide protection for children.

Reply Date: 2015/08/19

More Info

Understanding HPV and its implications for both your health and your baby's health can be quite complex, especially given the emotional weight of your concerns. Let’s break down your questions and provide some clarity on the subject.

Firstly, it’s important to understand that HPV (Human Papillomavirus) is a very common virus, with many different strains. Some strains are considered high-risk and can lead to cancers, while others may cause benign conditions like warts (also known as condyloma or "菜花"). You mentioned that you had warts in the past and have been treated for them. After treatment, many individuals experience a resolution of symptoms, but the virus can remain dormant in the body.
Research indicates that the immune system can clear HPV in about 70-90% of cases within two years. However, even if the virus is not actively causing symptoms, it can sometimes remain in a latent state, which means it is not detectable but could potentially reactivate under certain conditions, such as a weakened immune system. This could explain why you experienced a recurrence three years after your initial treatment. It’s also possible that the recurrence was due to a different strain of HPV, as the virus can be transmitted between partners.

Regarding your concerns about transmission to your baby, HPV is primarily transmitted through intimate skin-to-skin contact, particularly during sexual activity. The likelihood of transmitting HPV to your baby during childbirth is low, especially if you had a cesarean section (C-section). While there is a theoretical risk of transmission during vaginal delivery, studies suggest that the risk is minimal, and many babies born to mothers with HPV do not develop any related health issues.

In terms of your hygiene practices, washing your hands thoroughly after cleaning yourself and before touching your baby is a good practice. The virus does not survive long on surfaces and is unlikely to be transmitted through casual contact like handwashing, especially if you have already cleaned your hands. However, it’s always wise to maintain good hygiene to minimize any potential risk.

Your anxiety about the possibility of transmitting HPV to your baby is understandable, but it’s important to remember that the virus is not spread through casual contact, such as kissing or sharing utensils. The primary mode of transmission is through sexual activity. Therefore, your daily interactions with your baby, including cleaning their mouth, do not pose a significant risk of HPV transmission.

If you are still feeling anxious about your health and the potential for HPV recurrence or transmission, consider discussing your concerns with a healthcare provider. They can offer reassurance, conduct any necessary tests, and provide guidance on monitoring your health moving forward. Regular check-ups and screenings are essential for managing HPV and ensuring your overall well-being.

In summary, while HPV can be a source of concern, especially regarding its potential impact on your health and that of your baby, the risk of transmission during normal caregiving activities is very low. Maintaining good hygiene practices and staying informed about your health can help alleviate some of your worries. If you continue to feel anxious, seeking support from a healthcare professional can provide you with the reassurance and information you need.

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