INCUBATION PERIOD

hpv-kling2ALAN KLING, M.D

Dr. Kling is a recognized expert in the field of HPV treatment, Dr. Kling has lectured on HPV at Columbia, Cornell, Mount Sinai, NYU, Yale and many other medical centers, as well as at numerous national meetings. He is up-to-date on the latest advances in the diagnosis and treatment of HPV. Dr. Kling is the recognized go-to-person for HPV-related diagnoses in the metropolitan NYC area.
Dr. Kling’s private practice offices are located on the Upper East Side in Manhattan and in Park Slope, Brooklyn. The offices are comfortable, stylish, elegantly decorated and impeccably clean. You can feel reassured that your consultation and treatment will be performed by an accomplished, experienced, and well-respected board-certified physician.

Q: If I have the high risk strains of HPV, does that mean that I will eventually get cancer?
A:
Everybody who has the high risk strains does not develop cancerous or precancerous growths. Only a small percentage of high risk HPV strains actually progress into cancers. Most do not.

Q: Are all abnormal Pap tests due to high risk strains?
A:
An abnormal Pap smear is not necessarily caused by high risk strains. Many Pap smears go back to normal on their own and usually do not require immediate treatment. The doctor may obtain a new Pap smear several weeks or months later in order to evaluate whether abnormalities are still present. Treatment may be necessary if an abnormality in the Pap test persists over time.

Q: Why is the term HPV so frequently associated with cancer?
A:
There has been an increased awareness of HPV over the last several years and much discussion concerning it’ s association with cancerous and precancerous conditions. A very large number of people have HPV, and a small percentage of even a large number of people still results in a high number, and this generates concern.

Q: What are the most worrisome types of infection?
A:
The infections which are of greatest concern are those that continue to persist over time and do not resolve. These infections need to be carefully monitored because they have been associated with an increased chance of evolving into cancerous or precancerous growths.

Q: How long does it take for an HPV infection to turn into a cancer?
A:
It can take several decades between the time the person is first was exposed to the infection and the time that it takes for a cancer to develop. The most common age range in which women are diagnosed to have cervical cancer, for example, is when they are 35-50 years old. This indicates that these women most likely contracted the infection when they were young adults or even during their teenage years.

Q: Are there any other factors that influence whether a person will develop a cancer, and how severe it may be?
A:
Women or men who are immunocompromised are at increased risk of developing infections, which tend to require more treatments and be associated with a greater number of recurrences. People who are immunocompromised and have high risk strains of HPV are also more likely to develop more aggressive cancers.

Q: Can genital warts in women or men who are immmunocompromised be treated as easily as they are in those who are not?
A:
Genital warts in women or men who are immunocompromised are associated with a greater number of growths, more extensive involvement, more frequent recurrences, and a more aggressive natural history. Nonetheless, with proper treatment and monitoring, these infections can be managed and contained.

Q: What can I do in order to make sure that I can minimize the chance of giving an HPV infection to my current or future partners?
A:
You need to go to your physician so that you can be properly evaluated. Early diagnosis and treatment are important. Like many things in life, the most important thing is just showing up.

Q: How long do the low risk strains like 6/11 that cause genital warts last before they go away on their own?
A:
Low risk strains like 6/11 have an average duration of approximately 6 months in men.

Q: How long do the high risk strains like 16/18 that can cause HPV-related cancers last before they go away?
A:
High-risk strains like HPV16/18 have an average duration of 12 months in men. This means that 50% of men are positive for the high risk strains of HPV for one year or more before and if they resolve. Their partners are a t risk of contracting the infection during this time. The decision must be made ASAP whether to treat and/or to use condoms in order to minimize the chances of the spread of the infection on the person who is already infected as well as to minimize the chances of them spreading their current or future partner(s).

Q: Do all HPV infections eventually go away on their own?
A:
No, all HPV infections do not eventually go away on their own. If they do and until they do go away, the person continues to be contagious and anybody they come into sexual contact with is at risk from the infection. The person who has the genital warts can infect their partner(s) as long as the infection is active.

Q: How does a genital wart infection in one person spread to additional areas on them?
A:
The person who has the genital warts can continue to spread the infection from the localized confined area(s) originally infected to the normal uninfected tissue surrounding the warts, which can result in an even more extensive infection. Treatment will be even more challenging and the infection even more contagiou if the infection spreads to new locations.

Q: How would I know if my infection is going to go away on it’s own?
A:
You cannot accurately predict whether an infection will or will not go away on it’ s own. You have to consider yourself contagious during this time if you decide to wait it out and take precautions with your current and future partners in order to minimize the chance of infecting them.

Q: Any guidelines as to which infections will stay away?
A:
More extensive infections which involve a greater number of growths over a large surface area are more likely to recur and less likely to spontaneously resolve. HPV infections in a man who is uncircumcised tend to be more persistent and associated with higher recurrence rates after treatment. Growths which contain the high risk HPV infections are also more likely to persist.

Q: How accurately can I tell on my own whether I have an infection in my genital area?
A:
You should see your doctor and have them monitor your progress. Many HPV infections are difficult to detect with the naked eye. Physicians are able to examine the area carefully with magnifiers, are able to get closer to the areas that need to be examined than you are and also have more experience differentiating the normal from the not normal. In addition, there are areas that are out of your sight line which you cannot see.

Q: Is everything OK if my doctor cannot detect any growths?
A:
Many people with HPV infections don’ t have readily apparent signs or symptoms of infection may nonetheless be asymptomatically shedding the virus which can still cause an infection in their partner(s). There are various tests that can accurately evaluate the presence of infection. You need to discuss this at length with your doctor.

Q: What is the amount of time that it takes between the initial exposure to a contact that was infected and until I will be able to see the genital warts?
A:
The median time for HPV infection to grow into a genital wart is 3-6 months. This is called the incubation period. The incubation period ranges from 1-8 months and many cases are visible within several months.

Q: What are the screening methods for HPV available for women?
A:
There are a number of different screening tests available for women which will result in the early detection and if necessary treatment of HPV infections. These screening tests include Pap smears and HPV DNA tests. Cancers and/or infections can be detected early and a treatment plan can be initiated before the infection has the change to further progress.

Q: How long does the average HPV infection last?
A:
The average HPV infection lasts at least 6 months. HPV infections containing the high risk strains last approximately 12 months.

Q: Can HPV infections go away on their own without being treated?
A:
HPV infection are frequently transient and can resolve on their own without being treated.

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