The commonest sexually transmitted infection is human papillomavirus. Most sexually active men and women who are at some point during their lifetime exposed to the virus.
The virus is common in the United States and roughly 14 million newly diagnosed cases of human papillomavirus (HPV) are reported annually.
There are various forms of HPV. Some may cause genital warts and others may cause other types of cancer. In the U.S., about 19,400 women and 12,100 men are affected each year by HPV-derived cancers. Vaccines can prevent infection.
We will explain in this article what HPV is, how it is passed between people, any symptoms that might occur, and information about treatment, vaccines, and prevention.
Fast facts on HPV
Here are a few key points regarding human papillomavirus. The main article provides more specifics and supporting information.
- Most sexually active men and women will contract the HPV virus at some point during their lifetime.
- HPV can be spread through oral, vaginal, or anal sex.
- It can result in genital warts and some types of cancer.
- Sometimes, HPV can be transmitted during birth to an infant causing genital or respiratory system infections.
- There is no cure for HPV but safe and effective vaccinations are recommended at the age of 11 to 12 years.
Treatment
Different HPV forms may present different symptoms. HPV viruses can cause cancer and genital warts.
There is no virus cure but it can treat the symptoms.
Protection is via the HPV vaccine.
warts
Warts resulting from HPV often resolve untreated.
There are, however, medications that can be applied to the skin to remove the wart itself; these include salicylic acid over- the-counter (OTC) for common warts.
Prescribed medicines include:
- Podophyllin (chemical applied by a doctor)
- Imiquimod (Aldara, Zyclara)
- Podofilox (Condylox)
- Trichloroacetic acid (chemical applied by a doctor)
Surgical interventions may be necessary in certain situations and may include:
- Cryotherapy: Liquid nitrogen is used to freeze the abnormal areas.
- Electrocautery: The abnormal areas are burned with electric current.
- Laser therapy: Unwanted tissue is removed by a light beam.
- Interferon injection: Due to the high risk of side effects and costs this is seldom used.
- Surgical cancellation
Depending on the type and location of the wart being treated it is important to talk to a doctor about which treatment is best.
It is also important to note that although there may be removal or resolution of warts and cellular changes, the virus can remain in the body and can be passed on to others. Removal of the virus from the body is not treated.
Cancer
Routine Pap tests and other screening types, if cancer develops, can provide an early diagnosis. Measures can be taken for treating and preventing any cancer from developing.
Symptoms
HPV may not cause symptoms at the same time but it may occur years later. Some types may cause warts, whilst others may cause cancer.
Warts
Some forms of HPV are common symptoms of warts, especially genital warts.
Genital warts can appear as small bumps, clusters of bumps, or protrusions similar to stems. In women, or possibly the cervix, they commonly affect the vulva and in men, the penis or scrotum. They can also show up around the anus and in the groin.
They can vary in size and appearance and have the shape of large, small, flat or cauliflower, and may be white or fleshy.
Other HPV related warts include common warts, plantar, and flat warts.
Common warts-raw, raised bumps located most commonly on hands, fingers and elbows.
Plantar warts-described on the feet as rough, grainy growths; most often, they occur on the feet’s heels or balls.
Flat warts-generally affect children, adolescents and young adults; they occur as flat-topped, slightly elevated lesions which are darker than normal skin color and are most commonly found on the face, neck or scratched areas.
Cancer
Certain HPV types can increase the risk of developing cancer. Such cancers include cervical cancer, vulva, vagina, penis, prostate, and oropharynx, or tongue base and tonsils. Cancer can take years or decades to grow.
Causes
HPV is a virus that is transmitted skin-to-skin via sexual intercourse or other types of genital contact between skin and skin.
While most HPV infections are benign, causing warts in areas of the body including the hands, feet, and genitals, there are certain strains that put a person at a greater risk of developing certain types of cancers.
HPV can infect anyone who is sexually active; people who are infected are often asymptomatic, meaning they do not show any symptoms of the virus.
Although most HPV infections resolve themselves, they can sometimes remain dormant and subsequently infect a new or existing sexual partner.
HPV may be transferred to the baby at birth; this may cause an infection of the genital or respiratory system.
It’s important to note that the HPV strains that cause warts vary from the community of cancer-causing HPV strains.
Risk factors
Some factors increase the risk of contracting the HPV virus.
These include:
- having a higher number of intimate partners
- having sex with someone who has had several intimate partners
- having a weakened immune system, for example, due to HIV or after having an organ transplant
- having areas of damaged skin.
- having personal contact with warts or surfaces where HPV exposure has occurred
Diagnosis
When warts or lesions are apparent, during a visual inspection, a doctor may usually make a diagnosis of HPV. Additional tests may however be needed to confirm HPV’s existence.
When should I get tested for HPV?
Tests to determine changes in the cervical cells associated with HPV or HPV include a Pap smear, a DNA test and the use of acetic acid (vinegar).
A Pap smear is a test that gathers cells from the cervix or vagina surface and will reveal any cellular abnormalities that can lead to cancer.
Using a DNA test will evaluate for high-risk HPV types and is recommended in conjunction with a Pap smear for women aged 30 and older.
There is also a HPV DNA test, which can be used on its own without the need for concurrent Pap testing beginning at age 25.
Sometimes it may be necessary to get a biopsy of any abnormal areas.
There is currently no test available for men to screen for HPV; diagnosis is made primarily through visual inspection. In some situations, if males or females have a history of receptive anal sex, it may be advisable to talk to a doctor about the possibility of an anal Pap smear.
Prevention
Measures that can reduce the risk of contracting HPV include:
- having the HPV vaccine
- practicing safe sex
- practicing abstinence or being in a monogamous sexual relationship
- not having sex while there are visible genital warts
Common warts are difficult to prevent. If there is a wart, people should avoid finding it or bite the finger nails. With plantar warts it is best to wear shoes or sandals in public areas such as pools and locker rooms.
Vaccination
The Centers for Disease Control and Prevention (CDC) is recommending vaccination between the ages of 11 and 12 to reduce the risk of future development of cervical and other cancers.
The vaccine is administered in two doses, 6 to 12 months apart.
Catch-up vaccines are recommended for men up to 21 years of age, and for women up to 26 years of age who have not received the vaccination at a younger age. Gay and bisexual men are encouraged to get the vaccination up to 26 years of age.
Individuals aged 27 to 45 who have not had the vaccination in the past are now eligible for Gardasil 9 vaccination.
The United States Food and Drug Administration (FDA) changed the guidelines for this age group in 2018 as researchers had observed that the vaccination had a positive impact on associated diseases, particularly cervical cancer.
Three HPV vaccines currently on the market: Gardasil, Cervarix and Gardasil 9. Talk to your doctor about whether vaccination is appropriate.