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HPV remain infectious? Can you get it in the absence of lesions?
Oct 30, 2002

My wife and I participate in an open, active, sexual lifestyle...primarily, "safe-sex" with other couples. We are concerned about the prevelence of HPV and its ease of transmission even with proper condom usage (hands, toys, etc.) Given how common HPV infection it possible for someone who once had HPV warts, but had them treated/removed to remain infectious? What are the risks of 'going down' on a person that may have HPV? If a male has no visible lesions, does he remain infectious or are the infections really only tied to the lesions themselves? We understand that there are absolutes that can eliminate the risk of transmission, but given our lifestyle we're most interested in understanding effective methods of mitigating and managing these risks. Your help is greatly appreciated.

Response from Dr. Dezube

Human papillomavirus (HPV, also known as the wart virus) loves to infect the skins cells (squamous cell) around the genital area. It is transmitted by skin contact from an infected person to an uninfected person. This is in contrast to the HIV virus, which needs more exchange of fluids to be transmitted.

Once a person is infected by HPV, many scenarios are possible

-- some patients become truly cured of their infection (this typically happens in young college woman)

-- some develop warts and or cancer (this is called clinical disease)

-- some maintain the HPV with no evidence of clinical disease (this is called sub-clinical infection; you can find the HPV by sophisticated testing, yet there are neither warts nor signs of cancer)

So to answer your question, YES, if a male has no visible lesions, he may remain infectious. Lesions make it more likely that a permission will transmit HPV, but indeed the absence of lesions does not guarantee HPV-free sex. Also HPV can be transmitted despite the use of condoms.

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