HPV Infection
Genital Human Papillomavirus

HPV Virus

Contents

• What Is HPV?
• How Do I Catch It?
• What Are The Symptoms Of HPV?
• How Is HPV Diagnosed?
• How Is It Treated?
• What Is The HPV Vaccine?
• Can HPV Be Prevented?

Human papillomavirus (HPV) is a virus that spreads from person to person by physical contact. There are more than 100 types of HPV, about 60 cause warts on areas such as the hands or feet. The other 40 or so are transmitted sexually and are drawn to the body's mucous membranes, such as the moist tissue around the genitals and anus. These 40 viruses are known as genital HPV. Genital HPV is the most common sexually transmitted disease (STD). These types of HPV can also infect the throat and mouth (through oral sex). For the remainder of this article will discuss genital HPV only.

Most people who are infected with HPV viruses are unaware because they remain symptom free. However certain strands of the virus can cause genital warts and others are associated with cervical dysplasia (early signs of cancer) and cervical cancer. HPV is nothing to do with genital herpes or HIV (the virus that causes AIDS). While both these viruses are also STDs, they cause different symptoms and health problems.

How Do I Catch It?

HPV is spread by skin to skin contact with an infected person - even if that person has no signs or symptoms. If your genital area comes into contact with an infected person the virus can be transmitted. It can also be passed to your mouth or throat by performing oral sex on an infected person. HPV can infect areas of skin not normally covered by a condom, so condoms (even female condoms which cover more skin area) cannot fully protect you from infection. In rare instances the virus can be passed to a baby during childbirth and that child can develop juvenile-onset recurrent respiratory papillomatosis (JORRP).

What Are The Symptoms Of HPV?

Most people with HPV do not develop any obvious signs or health problems. And, in 90 percent of cases the body's immune system naturally destroys the virus within 2 years of infection. But sometimes, for unknown reasons, the virus does not clear and can cause:
Genital warts: These are small groups of bumps in the genital area that are shaped like cauliflower. Warts have a slow incubation period so they can take up to 6 months after infection to appear. If left untreated they can disappear on their own, or they can remain the same - grow - or multiply. Even if removed, warts tend to recur within 3 months of treatment.
Cervical cancer: Certain types of HPV, namely types 16, 18, 31, 33 and 45, can increase the risk of cervical cancer. 70 percent of cancer of the cervix cases have types 16 and 18 in their cells, and the remaining 30 percent have types 31, 33 and 45. The symptoms of cervical cancer may not be obvious until the disease is well progressed, this is why a regular Pap smear test (a screening process) is important. It can find early stages of the disease (dysplasia, also called cervical intraepithelial neoplasia or CIN) which can be treated before it turns into cancer.
Vaginal cancer: According to the CDC, HPV virus (types 16 and 18 in particular) are responsible for about 40 percent of all vaginal cancer cases. Read, symptoms of vaginal cancer as well as causes of vaginal cancer for more details.
Vulva cancer: HPV virus is appears to play an important role in this relatively uncommon disease - more so in younger woman than in older women. Read about vulva cancer for more details.

American Statistics

• 20 million Americans are currently affected with HPV.
• 6.2 million people become infected each year.
• One study estimated that 33 percent of college women are infected.
• 13,000 cases of cervical cancer are diagnosed every year. HPV is responsible for 95 percent of cases.
• 1,500 women get HPV-related vulvar cancer.
• 500 women who get HPV-related vaginal cancer.
• 2,700 women get HPV-related anal cancer.
• 1,500 women get HPV-related oropharyngeal cancers (throat, tongue or tonsil cancer - however the main cause of these types of cancer is tobacco and alcohol use). Recent shows that HPV-16 can cause oral cancer after the virus is transmitted through oral sex.

Is My Partner Cheating On Me?

You have been in a long-term relationship for years and are suddenly diagnosed with HPV. It is natural to wonder has your partner been unfaithful to you, or will he think you have been unfaithful to him. Finding out you, or your partner has HPV does not necessarily mean anyone has been unfaithful. There is no way of knowing how long the infected person has had the virus - it could be weeks, months or even years.

How Is HPV Diagnosed?

If you suddenly develop genital warts, this is one way a diagnosis may be made. Another way is if you are told your Pap test results are abnormal. The Pap test is the main way that doctors check for precancerous changes of the cervix, and for cervical cancer. If cell changes are detected, your doctor may perform a DNA HPV test to detect if those changes are related to the HPV virus. This test will also tell the doctor what type of HPV you have. The doctor takes a swab of cells from the cervix (just as for the Pap test) and these cells are analyzed in a laboratory. The HPV test is usually only performed on women with abnormal Pap test results, although some doctors perform it as part of the routine Pap test. The HPV test is less likely to be given to you routinely if you are aged under 30 because the HPV virus clears naturally more often in younger women than older women.
If your HPV test is positive your doctor may decide to investigate further. He may order a colposcopy to examine the cervix, vagina and vulva.

How Is It Treated?

There is no cure for HPV, but just because you test positive for the virus does not automatically mean you need treatment. In the vast majority of cases, the body clears the virus naturally by itself. If you have no obvious symptoms but you are diagnosed with one of the high-risk strains of HPV associated with cancer your doctor may recommend closer monitoring in the form of frequent Pap tests. If the virus however has caused abnormal cells changes (dysplasia) that could lead to cancer, he could recommend either a watch and wait policy (sometimes cell changes heal on their own). Or he could recommend a type of cervical cancer treatment - such as conization or laser surgery. The goal of treatment is to remove all the abnormal cells and those remove most of the cells with HPV. See also:
• Vaginal cancer treatment.
• Vulva cancer treatment.

What Is The HPV Vaccine?

It is a vaccination that can protect females (and males) from some of the most common types of HPV that cause cancer. The vaccine is NOT a cure, if you are already infected it will have no effect. It is a preventative medicine only. Two vaccines - Cervarix and Gardasil - are available for girls and women.
Cervarix: Is given to young girls between the ages of 11 and 12 before they become sexually active. It consists of a series of 3 injections given over 6 months. Girls and women between the ages of 13 and 26, who did not get any or all of the shots when they were younger, are also recommended vaccination. It is recommended that you get the same brand of vaccination for all 3 shots. Cervarix protects against strains 16 and 18, which cause the majority of cervical cancers.
Gardasil: A newer vaccination, Gardasil is more comprehensive because it protects against strains 6, 11, 16 and 18, and also gives protection against most strains that cause genital warts. The vaccine is given at the same time at in the same dosage as Cervarix. Both vaccines are considered more effective when given between the ages of 11 and 12.

Can HPV Be Prevented?

1. Get vaccinated, either with Gardasil or Cervarix. If you already have HPV it will not treat or cure the virus. However it will still help protect against other types of HPV (for example cervical cancer HPV viruses are different to those that cause genital warts).
2. Using condoms every time you have sexual intercourse can help reduce your exposure risk. Read about STD prevention for more safer-sex advice.
3. Have regular Pap tests and pelvic examinations. See: Recommended health screenings for women. Even if you have received the HPV vaccine, you will still need to have regular Pap tests because the vaccines do not guard against all types of HPV that cause cervical cancer.
4. If you display any symptoms of STDs, stop having sexual relations immediately and contact your doctor.
5. If you are sexually active with more than one partner read about STD testing and STD clinics. Protect yourself and your partners.

For more advice, see the following:

• Gonorrhea and chlamydia, other common STDs.
• Vaccinations for women: How to protect yourself from diseases.
• Reproductive system disorders: List of common symptoms.

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