Table 2.

What should the dermatologist know about HPV? Key questions and answers

Question	Answer
Does every patient develop genital warts after HPV infection?	Even though HPV infection is very common, very few patients will develop genital warts after infection
How long can HPV infections last?	Up to 90% of HPV infections will clear within 2 years
Is a patient with subclinical infection contagious?	Yes, but we should distinguish between subclinical and latent infections (we know very little about latent infections). subclinical infections do exist and can last for years, but they are probably only contagious when there is viral replication and shedding
Is the patient no longer infectious once genital warts have been treated?	Patients can be infectious even after removal/treatment of genital warts
Is there a rationale for treating subclinical HPV infections?	No, what is important is the lesions, not the infection itself
What should be the advice for patients who have been treated for genital warts, but who may still have subclinical infection?	The important thing to focus on is the lesions; screening for early lesions, and subsequent treatment Although there is no formal recommendation, HPV vaccination is advised among patients with a history of HPV-related lesions
What advice should patients receive for their sexual partners concerning infection?	The important thing to focus on is the lesions; screening for early lesions, and subsequent treatment Although there is no formal recommendation, HPV vaccination is advised among patients with a history of HPV-related lesions
Is there any risk of HPV-related cancer in male patients?	Only patients who do not resolve HPV infections are at a higher risk of HPV persistence and subsequent HPV-related diseases, including pre-cancer and cancer
Do HPV vaccines protect against other HPV genotypes that may cause genital warts?	Yes, they protect against HPV types 6 and 11 that cause 90% of genital warts and recurrent respiratory papillomatosis
Considering the cost of the vaccine, is there enough evidence for vaccination of already infected patients? And for their sexual partners?	The current cost of HPV vaccines in national immunization programs has been reduced threefold Yes, the vaccine will not cure current active infections but will block new infections as well as auto-inoculated virions
Is there a rationale for HPV vaccination in young males?	Yes, very strong, and threefold: 1. To reduce transmission and circulation in the population 2. To protect themselves (male burden is now considerable) 3. For gender equality