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HPV

What is HPV?

Human Papillomavirus (HPV) is the name of a group of over 100 viruses. Over forty of these viruses can affect the genital area. They can also affect the mouth and throat. Some strains of this virus cause visible warts or growths to appear in the genital area (Genital Warts), some strains are asymptomatic, and some strains may increase risk of certain cancers, including cervical, vulvar, vaginal, penile, anal, and oropharyngeal (throat) cancers.

How common is HPV?

It is estimated that approximately 20 million people in the United States are currently infected with HPV, and another 6 million become infected each year. Moreover, 50-80% of Americans will be infected with HPV at some point in their lives. In most people, HPV infection will go away on its own within 2 years.

How do people get HPV?

HPV is transmitted through genital contact, most often via vaginal or anal sex, but also during oral sex or close genital skin-to-skin contact. Many HPV infections do not cause warts or have no symptoms, so a person can be unaware that they have the infection and spread it to others during sexual activity. Rarely, a pregnant woman who has genital warts around the time of delivery can pass HPV to her baby during a vaginal delivery, and the baby could develop warts in their throat.

What are the signs and symptoms of HPV?

Most people who have HPV will have no symptoms at all. Other people get visible warts that appear as soft, moist, or pink. They can be raised or flat, and can appear as individual warts or multiple cauliflower-like growths. They can be located on the vulva, in or around the vagina or anus, on the cervix, on the penis or scrotum, on the groin or thigh, or occasionally in the throat. The warts usually appear within 6-12 months, but possibly up to years, after genital contact with an infected person. Another sign of HPV infection can be pre-cancerous changes to the cervix, vulva, anus, penis, tongue, tonsils, and throat.

How do I find out if I have HPV?

There are a few ways to check for an HPV infection.

  • Checking for genital warts is done by a health care clinician by inspecting the genital area with a special light and/or magnifying instrument.
  • The Pap test (Pap smear) can detect cervical disease caused by HPV. A woman should begin to get Pap tests at age 21. If the Pap test comes back as “abnormal” or “positive”, further testing, which may include an HPV test, could be required.
  • There is an HPV test that detects high-risk types of HPV that can lead to cervical cancer. The test process is the same as a Pap test — cell samples are taken from the cervix and sent to a lab for analysis.

Pap and HPV Tests — the Differences

  What it Finds How it Works
Pap Test abnormal cell changes A lab professional looks at a sample of cervical cells through a microscope.
HPV Test the virus that causes the abnormal cell changes A computerized system checks a sample of cervical cells for HPV.
  • The HPV test is included with the Pap test for women over the age of 30 because having an HPV infection is less common in women over 30 and is more likely to lead to cervical cancer. The HPV test is not recommended routinely for women under the age of 30 because HPV infection is very common in this age group and usually goes away on its own.
  • The HPV test is currently not used for men.

How is HPV treated?

If a person has visible genital warts, they can be removed by medications that a doctor prescribes or by treatments performed by a health care provider. If cervical disease is detected by the Pap test, further testing will determine what, if any, treatment should be followed. In many people HPV infections (with or without symptoms) will resolve without treatment, depending on how effective the immune system is at clearing the infection.

How can I reduce my risk of getting HPV?

Two vaccines that prevent certain strains of HPV are currently available in the U.S.

A vaccine (Gardasil) that can prevent 4 types of genital HPV is available for females and males between the ages of 11-26. It is a 3 injection series that has been shown to be very effective at preventing 2 types of HPV that can lead to cervical cancer and 2 types of HPV that can lead to genital warts.

Another vaccine (Cervarix) can prevent 2 types of HPV that can lead to cervical cancer. It is a 3 injection series and is very effective at preventing two types of HPV that are associated with cervical cancer. This vaccine is currently recommended for females ages 11-26.

Both vaccines are most effective if given before a person becomes sexually active (because there has been no exposure to genital HPV strains before sexual activity begins). After a person has been sexually active, the vaccine can still be effective against any of the strains of HPV in the vaccine that a person has not already acquired, but it will not protect against a type that a person already has. There is currently no test available to determine if a person has any or all of the types of HPV that the vaccines cover.

The only way to completely eliminate risk of HPV infection is to refrain from any genital contact with another individual.

For those who choose to be sexually active, a long-term mutually monogamous relationship with an uninfected partner is likely to prevent HPV infection, but it can be difficult to determine whether a partner who has been sexually active in the past is infected or not.

HPV infection can occur in both male and female genital areas that are covered by a condom and can occur in areas that are not covered by a condom. Condoms do reduce the risk of HPV transmission if the infected area is covered. Studies have shown that condom use is associated with a lower rate of cervical cancer, which is an HPV associated disease.

Resources

http://www.cdc.gov/hpv