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All about anal warts-- Treatment for internal anogenital warts; what happens to people infected with the wart virus?
Oct 9, 2002

what is the treatment for internal anogenital warts? I heard there was a pill, is that true? If anal intercourse was performed with a person with internal warts would the suseptible top pass it along to others?

Response from Dr. Dezube

Anal warts, both internal and external, are caused by the human papillomavirus (HPV, also known as the wart virus). Given that it is a viral infection, it can be readily spread from an infected bottom to a susceptible top. Once a person gets infected with the HPV virus, many different scenarios can happen. Some folks get HPV and develop immunity to it (i.e. they are cured of their infection); other folks become carriers without disease (i.e. they harbor the virus and can infect others, yet they don't have warts); others develop warts; and yet others develop anal cancer from this virus. When compared to folks who are HIV negative, HIV positive patients tend to get more aggressive strains of HPV and to get less frequently a protective immune response to HPV (ie. HIV'ers are less likely to be cured of the HPV disease).

As for treatment for internal warts, I am not aware of any pill. How I wish that this was so! Treatment for internal wart typically requires surgery-- a combination of cutting and burning (e.g. with a laser). Internal warts are harder to take care of than external ones since there is no good way to apply topical treatments to internal warts. For external warts, treatment can be as simple as the application of Aldara cream, which is a medicine approved for the treatment of this condition.

On one final note, given that you are infected with HPV, it would be good to have high resolution anoscopy or at least an anal PAP smear. The anoscopy and anal PAP smear are means by which your medical providers can check you for early signs of anal cancer. High resolution anoscopy is not available in all places. During this latter procedure, a provider looks up you with a special microscope and looks at the cell surface inside the anal canal. S/he can then biopsy anything that looks suspicious.

You are doing the right thing by having your internal anal warts dealt with?


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