What is HPV?

Human papillomavirus (HPV) is a virus.  In infects the skin and the lining of the mouth, cervix, vagina, urethra and anus.  There are more than 100 types of HPV.  About 40 of them cause genital infections.

How common is HPV?

More than 6 million Americans get a genital HPV infection every year. Twenty million are currently infected.  In fact, most sexually active Americans have been infected at some time.

How do you get HPV?

You get HPV from contact with an infected person’s genitals or body fluids.  Usually you get it through sex.  You can also get it through oral sex or genital touching.

What are symptoms?

Most people with HPV infection have no symptoms.  Only a small percentage of people with HPV have genital warts.

How can you find out if you have HPV?

Most  people who are infected with HPV have no obvious signs of infection.  Most women find out they have been infected when their Pap test result comes back “abnormal”.   Most men do not have symptoms and do not know they are infected.

How can it be treated?

Low-risk types of HPV can cause genital warts.  High-risk types can cause cancer.  Genital warts can usually be treated in a doctor’s office.  This treatment cause the warts to decrease in size or disappear, infection may still be present and can be passed on.  Warts sometimes come back even after treatment.

Most high-risk HPV infections go away on their own.  Infections that don’t go away can cause cancer. If caught early, cancer usually can be treated with surgery, chemotherapy or radiation.

What are the complications of HPV infection?

Long-lasting HPV infections can cause cervical, penile, anal, vaginal, vulvar, and oral cancers.  Almost all cases of cervical cancers are caused by HPV. Every year in the United States about 10,000 women get cervical cancer and about 3,7000 women die. Early stages of cervical cancer can be detected by Pap tests.

Can you prevent HPV?

Yes.  HPV can be prevented.  Avoid all sexual activity if you are single or be faithful to one uninfected partner for life.  This is the only way to avoid the risk of an infection.

There are also a number of ways to reduce your risk for an HPV infection.

• The fewer people you have sex  with, the lower your risk.
• Correct and consistent condom use can reduce (but not eliminate) your risk.  Consistent condom use (100%) during vaginal sex reduces your risk for HPV by 50% or less. To date, there is no evidence that condoms reduce your chance of getting HPV during oral or anal sex.
• HPV vaccine is available and is recommended for young women.  However, vaccination does not protect against all types of HPV that cause cancer and warts.  How long it works is unknown.

Women should get regular Pap tests to detect cancer in its earliest stages.  Waiting to have sex until you are in a faithful, lifelong relationship (such as marriage) is the only certain way to avoid being infected sexually.

 

References:

1  Sanders GC, Taira AV. Cost-effectiveness of a potential vaccine for human papillomavirus. Emerg Infect Dis. 2003;9(1):37-48.  Available at:  http://www.cdc.gov/ncidod/EID/vol9no1/02-0168.htm.  Accessed December 26, 2006.

2  Cates W Jr. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States.  Sex Transm Dis. 1999;26(suppl 4):S2-S7.

3  Koutsky LA, Kiviat NB, Genital human papillomavirus.  In:  Holmes KK, Mardh PA, Sparling PF, et al., eds.  Sex Transm Dis 3rd ed. New York, NY:  McGraw Hill, Co. 1999;347-359.

4 Edwards S, Carne C. Oral sex and the transmission of viral STIs.  Sex Transm Inf. 1998;74:6-10

5  Syrjanen S. PL7 Oral viral infections that could be transmitted oro-genitally.  Oral Dis. 2006;12 Suppl 1:2.

6  Sonnex C, Strauss S, Gray JJ.  Detection of human papillomavirus  DNA on the fingers of patients with genital warts.  Sex Transm Infect. 1999;75:317-319.

7  Ho GY, Bierman R, Beardsley  L. Chang CJ, Burk RD.  Natural history of cervicovaginal papillomavirus infection in young women.  N Engl J Med.  1998;338:423-428.

8  Moscicki AB.  Impact of HPV infection in adolescent populations.  J Adolesc Health. 2005;37(6Suppl):S3-9.

9 Dillner J, von Krough G. Horenblas S, Meijer CJ.  Etiology of squamous cell carcinoma of the penis.  Scand J Urol Nephrol Suppl. 2000;205:189-93.

10  Daling JR, Madeleine MM, Johnson LG, et al. Penile cancer: importance of circumcision, human papillomavirus and smoking in situ and invasive disease.  Int J. Cancer. 2005;116(4):606-16.

11 Poletti PA, Halfon A, Marti MC. Papillomavirus and anal carcinoma.  Int J Colorectal Dis. 1998;13:108-111.

12  Daling JR, Madeneine MM, Johnson LG, et al.  Human papillomavirus, smoking and sexual practices in the etiology of anal cancer.  Cancer. 2004;101(2):270-80.

13  Daling JR. Madeleine MM, Schwartz SM, et al.  A population-based study of squamous cell vaginal cancer:  HPV and cofactors.  Gynecol Oncol. 2002:84(2):263-70.

14  Casolati E, Agarossi A, Valieri M, Ferrazzi E.  Vulvar neoplasia in HIV positive women:  A review.  Med Wieku Rozwoj. 2003 Oct-Dec;7(4 Pt 1):487-93.

15  Rosenquist K. Risk factors in oral and oropharyngeal squamous  cell carcinoma:  A population-based case control study in southern Sweden, Swed Dent J Suppl. 2005;179:1-66.

16  Bosch FX, Manos MM, Munoz N. et al., for the International Biological Study on Cervical Cancer (IBSCC) Study Group.  Prevalence of human papillomavirus in cervical cancer:  A worldwide perspective.  J National Cancer Inst.  1995;87:796-802.

17  Walboomers  JM, Jacobs MV, Manos MM, et al.  Human papillomavirus is a necessary cause of invasive cervical cancer worldwide.  J Pathol. 1999;189:12-19.

18  World Health Organization.  Report of consultation on human papillomavirus vaccines.  Geneva, Switzerland:  World Health Organization.  April 2005.  Available at:  http//www.who.int/vaccine_research/documents/816%20%20HPV%20meeting.pdf.  Accessed November 16, 2006.

19  American Cancer Society. Cervical cancer overview.  How many women get cancer of the cervix?  Available at:  http://cancer.org/docroot/CRI/2_2_1X_how_many_women_get_cancer_of_the_cervix_8.asp?siteerea=Accessed November 17, 2006.

20  Kurman RJ, Henson DE, Herbst  AL, Noller KL, Schiffman MH, for the 1992 National Cancer Institute Workshop.  Interim guidelines for management of abnormal cervical cytology. JAMA. 1994;271:1866-1869.

21  Ault KA.  Epidemiology and natural history of human papillomavirus infections in the female genital tract.  Infect Dis Obstet Gynecol.  2006:14(1):40470.

22  Vaccarella S, Franceschi S, Herrero R, et al.  Sexual behavior, condom use, and human papillomavirus:  pooled analysis of the IARC human papillomavirus prevalence surveys.  Cancer Epidemiol Biomarkers Prev. 2006;15(2):326-33.

23  National Institute of Allergy and Infectious Diseases, National Institutes of Health.  Workshop Summary:  Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention.  2001.  Available at:  http://www.niaid.nih.gov/dmid/stds/condomreport.pdf.  Accessed on December 28, 2005.

24  Manhart LE, Koutsky LA.  Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia?  A meta-analysis.  Sex Transm Dis. 2002;29(11):725-735.

25  Winer RL, Hughes  JP, Feng Q, et al.  Condom use and the risk of genital human papillomavirus infection in young women.  N Engl J Med.  2006;354(25):2645-2654.

26  Centers of Disease Control and Prevention (CDC).  STD-prevention counseling practices and human papillomavirus  opinions among clinicians with adolescent patients – United States, 2004 MMWR Morb Mortal Wkly Rep. 2006;55(41):1118-20.

27  Mao C, Koutsky LA, Ault KA, et al.  Efficacy of human papillomavirus 16 vaccine to prevent cervical intraepithelial neoplasia:  A randomized controlled trial.  Obstet Gynecol. 2006;107(1):18-27.

 Contents excerpted from the pamphlet “The Facts About HPV (Human Papillomavirus” ISBN 1-933902-10-8, Copyright 2007. Excerpted with permission. All rights reserved. www.medinstitute.org