Genital Warts

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Dr. Christopher Tzermias

Dermatologist – Venereologist

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Modes of Transmission

Genital warts (Condylomata acuminata) are transmitted through sexual contacts. The risk is the same for both heterosexual and homosexual persons.

Learn more about the treatment of genital warts here

The liberisation of sexual behaviour, the different and various types of sexual contacts, as well as the great movement of human populations increase the chances of genital warts’ transmission.

The minimum viral load required to cause the infection is unknown.

The possibility of transmission from one partner to the other varies; below the corresponding categorisation is presented, n order of probability:

  • sexual contact, vaginal or anal, without a condom,
  • sexual contact, vaginal or anal, with condom,
  • sexual contact without penetration, like between women,
  • oral sexual contact
  • overly-rigorous rubbing of the genital and the perigenital areas with the genitals, contaminated objects (sex toys) or contaminated fingers
  • transmission of laryngeal papillomatosis or genital warts to the neonate from the mother, who had genital warts during pregnancy

The status of the lesions from HPV-caused genital warts can be distinguished in three categories:

  • Clinical lesions (visible to the naked eye)
  • Sub-clinical lesions (which are visible only through magnifying lenses and not to the naked eye)
  • Latent lesions (not giving any visible sign; they can be detected through a PCR assay in tissue samples)

The balance between the organism’s defence system and the viral load contributes in the progression of latent lesions to sub-clinical lesions and then to clinical lesions.

It is not clear whether the extent of disease transmission is greater in clinical as compared to sub-clinical and latent lesions.

When clinical and sub-clinical lesions are present, the organism’s defence system may manage to cause a regression of the lesions, make them stable and non-expanding. However, this may not be possible for the organism, so they will become bigger, expand and proliferate.

It is not clear which is the most likely outcome and, of course, it depends both on the viral load and on all those factors affecting the organism’s defence system.

When referring to the permanent presence of genital warts in an organism, the term “permanent” refers to the permanent presence of inflammation rather than to the actually permanent presence of the virus.