HPV, short for Human Papillomavirus, is a group of over 100 different kinds of viruses, some of which cause warts on the hands and feet and others which cause genital warts and cervical cancer. This health guide is about the sexually transmitted types of HPV. If you are sexually active, or thinking about becoming sexually active, your best protection is to learn the facts about how HPV is spread and how to prevent getting it.
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HPV (Human Papillomavirus) is one of the most common sexually transmitted diseases. There are many different types of HPV and more than 30 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers, such as 6, 11, 16, and 18.
Some sexually transmitted HPV types may cause genital warts. Persistent infection with “high-risk” HPV types—different from the ones that cause skin warts—may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer. However, most infections with these types do not cause disease.
Some types (such as 6 and 11) cause genital warts, others (such as 16 and 18) cause pre-cancerous changes on the cervix that can later lead to cancer of the cervix. In rare cases, the virus can cause other types of cancers to the vulva, vagina, and anus in girls and the anus and penis in guys.
HPV is passed on through genital contact, usually during vaginal and anal sex, as well as during oral sex. People with weakened immune systems, such as those on chemotherapy or people with HIV are more susceptible to HPV infection.
At least 1 in every 2 sexually active young women has had a genital HPV infection. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. HPV is mainly spread by sexual contact. Very rarely, a mother who is infected with the HPV virus can infect her newborn baby during the delivery.
It’s estimated that by the age of 27, most sexually active people have been exposed to some strain of HPV, usually without them knowing, and very rarely do doctors know which strain.
Most people with HPV don’t develop symptoms or further health problems, as in around 90 per cent of cases the body’s immune system has naturally cleared it within two years.
However, certain types of HPV (most commonly strains 6, 11, 16 and 18) can cause genital warts in men and women, while other HPV strains (especially 16, 18 and 39) can cause cellular changes that lead to cancer of the cervix and possibly other less common but serious cancers including:
•cancer of the vagina
•cancer of the penis
•head and neck (tongue, tonsils and throat) cancers
It’s possible to have HPV present years after sexual contact with an infected person, and it’s also possible to be exposed to more than one strain of HPV.
There is currently no easy way to spot which people affected by HPV exposure will go on to develop cancer or other serious health problems.
Very rarely, a pregnant woman can pass HPV to her baby during birth and the child can develop recurrent respiratory papillomatosis – a chronic lung condition where growths block the airways.
*The infected area of your body remains totally normal (called latent or inactive infection). You may never know about it, but you may give the infection to others. Your body then usually clears the infection.
*Bumps, called genital warts, can be seen in your genital area. They almost never lead to cancer.
*Changes in the cells of your cervix can result in an abnormal Pap test. Most of the time, if you are a teenager, your body will clear the HPV and the Pap test will become normal again over several years. However, sometimes the HPV infection persists in your cervix which can lead to cervical cancer. This is why your doctor will want to see you for follow-up visits if you have had an abnormal Pap test.
*You had sexual contact at an early age.
*Either you or your sexual partners have had many different sexual partners at any time.
*You or any of your sexual partners have had a history of sexually transmitted diseases.
*Any of your sexual partners did not wear a condom.
HPV and cancer risks:
We don’t fully understand the way in which HPV affects cells. Both high-risk and low-risk strains of HPV can cause the growth of abnormal cells, but only the high-risk types of HPV appear to lead to cancer.
Several types of cancer (up to five per cent worldwide), while linked to other risk factors, are now also associated with HPV exposure:
•cervical cancer (the most common HPV-associated cancer)
•vulval and vaginal cancer (40 to 70 per cent linked to HPV)
•penile cancer (possibly 40 per cent linked)
•anal cancer (around 85 per cent linked)
•cancers of the head and neck (although most are linked to tobacco and alcohol use, it’s now thought about 25 per cent of mouth and 35 per cent of throat cancers may be linked to HPV exposure (in particular HPV strain 16)
Sometimes it’s hard to know if you have HPV. Although genital warts are usually seen on, around, or inside your vagina or anus, they may be small and hard to see. And you may not have any symptoms such as pain or bleeding.
In March 2003, the U.S. Food and Drug Administration (FDA) approved a test manufactured by Qiagen, which is a “hybrid-capture” test, as the primary screening tool for detecting HPV cervical infection as an adjunct to Pap testing. The test may be performed during a routine Pap smear. It can detect the DNA of the 18 HPV types that most commonly affect the cervix and distinguish between “low” and “high-risk” HPV types, but it cannot determine the specific HPV types.
According to the National Cancer Institute, “testing samples of cervical cells is an effective way to identify high-risk types of HPV that may be present. The FDA has approved an HPV test as a follow-up for women who have an ambiguous Pap test and, for women over the age of 30, for general cervical cancer screening. This HPV test can identify at least 13 of the high-risk types of HPV associated with the development of cervical cancer. The test can detect high-risk types of HPV even before there are any conclusive visible changes to the cervical cells.”
The recent outcomes in the identification of molecular pathways involved in cervical cancer provide helpful information about novel bio- or oncogenic markers that allow monitoring of these essential molecular events in cytological smears, histological or cytological specimens. These bio- or onco- markers are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. E6 and E7 mRNA detection PreTect HPV-Proofer, (HPV OncoTect) or p16 cell-cycle protein levels are examples of these new molecular markers. According to published results these markers, which are highly sensitive and specific, allow to identify cells going through malignant transformation.
Although it is possible to test for HPV DNA in other kinds of infections, there are no FDA-approved tests for general screening in the United States or tests approved by the Canadian government, since the testing is inconclusive and considered medically unnecessary.
Genital warts are the only visible sign of low-risk genital HPV, and can be identified with a visual check. These visible growths, however, are the result of non-carcinogenic HPV types. 5% acetic acid (vinegar) is used to identify both warts and squamous intraepithelial neoplasia (SIL) lesions with limited success by causing abnormal tissue to appear white, but most doctors have found this technique helpful only in moist areas, such as the female genital tract. At this time, HPV test for males are only used in research.
There is currently no specific treatment for HPV infection. However, the viral infection, more often than not, clears by itself. According to the Centers for Disease Control and Prevention, the body’s immune system clears HPV naturally within two years for 90% of cases. However, experts do not agree on whether the virus is completely eliminated or reduced to undetectable levels, and it is difficult to know when it is contagious.
Health management is based on prevention, by advising condom use and vaccination.
There is treatment for some of the diseases that HPV can cause, including:
•Genital warts, which can be cauterised or treated chemically.
•Abnormal cervical cells, which can be removed by various techniques.
Treatments for genital warts range from acid medicines, to creams, to laser therapy. The treatment will remove visible warts and unwanted symptoms such as itchiness. The type of treatment your doctor recommends will depend on the number, location and size of the warts and the cost and side effects of the different treatments. It’s important to talk with your health care provider about treatment choices and what type of follow-up you will need. Tell your health care provider if you think you are pregnant so that the right therapy is chosen.
Do NOT use over-the-counter “wart medicine” on genital warts. (These medicines are not meant for the very sensitive skin around your genital area).
Condoms offer some protection against genital infection, but any exposed skin can transmit the virus. In short, condoms are not 100% effective in preventing HPV. Genital HPV infection is the most frequent sexually transmitted disease in the world.
Two vaccines are available to prevent infection by some HPV types: Gardasil, marketed by Merck, and Cervarix, marketed by GlaxoSmithKline. Both protect against initial infection with HPV types 16 and 18, which cause most of the HPV associated cancer cases. Gardasil also protects against HPV types 6 and 11, which cause 90% of genital warts.
The vaccines provide little benefit to women who have already been infected with HPV types 16 and 18—which includes most sexually active females. For this reason the vaccine is recommended primarily for those women who have not yet been exposed to HPV during sex. The World Health Organization position paper on HPV vaccination clearly outlines appropriate, cost-effective strategies for using HPV vaccine in public sector programs.
Both vaccines are delivered in three shots over six months. In most countries they are approved only for female use, but are approved for male use in countries like USA and UK. The vaccine does not have any therapeutic effect on existing HPV infections or cervical lesions.
Women should continue to seek cervical screening, such as Pap smear testing, even after receiving the vaccine. Cervical cancer screening recommendations have not changed for females who receive HPV vaccine. Without continued screening, the number of cervical cancers preventable by vaccination alone is less than the number of cervical cancers prevented by regular screening alone.
Both men and women are carriers of HPV. Possible benefits and efficacy of vaccinating men are being studied. According to a study by Harvard University Medical School, to vaccinate boys may not be cost effective, especially if a widespread vaccination of girls continues.
No efficacy trials for children under 15 have been performed. Duration of vaccine efficacy is not yet answered by rigorous methodologic trials. Cervarix efficacy is proven for 7.4 years with published data through 6.4 years while Gardasil efficacy is proven for 5 years. Age of vaccination is less important than the duration of efficacy.
The Centers for Disease Control and Prevention says that male “condom use may reduce the risk for genital human papillomavirus (HPV) infection” but provides a lesser degree of protection compared with other sexual transmitted diseases “because HPV also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom.”
Studies have suggested that regular condom use can effectively limit the ongoing persistence and spread of HPV to additional genital sites in individuals who are already infected. Thus, condom use reduces the risk that already infected individuals will progress to cervical cancer or develop genital warts.
Ongoing research has suggested that several inexpensive chemicals might serve to block HPV transmission if applied to the genitals prior to sexual contact. These candidate agents, known as topical microbicides, are currently undergoing clinical efficacy testing. A recent study indicates that some sexual lubricant brands that use a gelling agent called carrageenan prevent papillomavirus infection in animal model systems. Clinical trial results announced at the 2010 International Papillomavirus Conference indicate that a carrageenan-based personal lubricant called Carraguard is effective for preventing HPV infection in women. The results suggest that use of carrageenan-based personal lubricant products, such as Divine No 9, Bioglide and Oceanus Carrageenan may likewise be effective for preventing HPV infection.
A review of scientific studies in healthy subjects has found carcinogenic HPV in 3.5% of the studies subjects and HPV16 in 1.3%. Men have higher prevalence of oral HPV than women.
Oral HPV infection is associated with HPV-positive oropharyngeal cancer. Odds of oral HPV infection increases with the number of recent oral sex partners or open-mouthed kissing partners. Nonsexual oral infection through salivary or cross transmission is also plausible
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
- Should boys be vaccinated against the human papilloma virus (HPV)? (guardian.co.uk)
- How is an HPV cancer screening performed? (zocdoc.com)
- HPV: Symptoms & Treatment in At Risk Men (connectwithwellness.wordpress.com)
- Does HPV cause genital warts? (zocdoc.com)
- How do genital warts and molluscum differ? (zocdoc.com)
- Advice on Human Papilloma Virus Vaccine (drppanda.wordpress.com)
- Do I need a pain medicine injection before my first PAP smear? (zocdoc.com)
- Study shows the HPV vaccine Gardasil doesn’t increase disease activity in SLE patients (medicalxpress.com)
- How do you choose the best vaccination against cervical cancer? (guardian.co.uk)
- Cancer does not define me, but how I live and fight with cancer DOES define me.” (applesaucedelight.wordpress.com)