Human papillomavirus (patient information)
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Human papillomavirus |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Human papillomavirus (HPV) is considered the most common sexually transmitted infection in the United States. There are different types of this virus and some are related to the development of serious conditions such as cervical cancer. Although many people disregard its existence, it is very common. It is generally transmitted through genital contact, such as vaginal and anal sex, however, it may seldom be transmitted by skin-to-skin contact. About half the people who have had sex, will be infected by HPV at some point in time. Although infection by this virus may be harmless in some cases, with some patients never developing any symptoms, it is a matter of public concern, since it may lead to the development of certain types of cancer. Despite the absence of a specific treatment to eliminate the viral infection, some health effects caused by certain kinds of HPV may be prevented with vaccination.[1][2]
What are the symptoms of Human papillomavirus?
HPV may lead to a broad spectrum of diseases. If you are infected you may have no signs or symptoms of HPV infection or, you may have increased risk of developing cancer.
There are over 100 different kinds of HPV and not all of them cause health problems. Some types of HPV may cause problems such as genital warts, while others can cause cancer of the cervix, vagina, vulva, or anus. Most of these problems are caused by types 6, 11, 16 or 18.[1]
When cancer develops, it may affect men and women. According to the CDC, HPV may be involved in different types of cancer, with the following incidences:[3]
- Cervical cancer: The most common HPV-associated cancer. Almost all cervical cancers are caused by HPV.
- Vulvar cancer: About 50% are linked to HPV.
- Vaginal cancer: About 65% are linked to HPV.
- Penile cancer: About 35% are linked to HPV.
- Anal cancer: About 95% are linked to HPV.
- Oropharyngeal cancer: About 60% are linked to HPV.
Who is at highest risk?
Any person who has ever had sexual contact with another person may be infected with HPV. The virus may infect both men and women. Among other reasons, the population should be aware of this virus, since people may be infected with it, never developing any symptoms and therefore not knowing that they have higher risk of developing disease. The virus may remain in the individual without carrying out any manifestations for years.[1]
You are more likely to be infected by HPV, if you have:
Diagnosis
Today there is a test to search for the kinds of HPV that may lead to cervical cancer.
The FDA has approved the HPV test to be used for women over 30 years old. It may find HPV even before there are changes to the cervix. However, women who have had the HPV test, will still need to get the Pap test.[1]
When to seek urgent medical care?
Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Medical care should be sought whenever some abnormality is noticed by the patient. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they have developed more serious problems from HPV, such as cancers. Therefore it is important to keep regular check-ups with your physician in order to detect abnormalities in their early stages, so that proper treatment may be started.
Treatment options
Up till today there is still no cure for the HPV itself.
There are, however, treatments for the health problems that HPV can cause, such as genital warts, cervical changes, and cervical cancer.[1]
Where to find medical care for Human papillomavirus?
You may find out more about medical care for HPV [3]
Prevention
The FDA has approved vaccines that prevent certain diseases, including cervical cancer, caused by some types of HPV. Ask your doctor about vaccination and if you should get the HPV vaccine.[1]
In order to lower your chances of being infected by HPV you can:
- Choose not to have sex (abstinence).
- Limit the number of partners you have.
- Choose a partner who has had no or few sex partners. The fewer partners your partner has had, less likely he or she is to being infected with HPV.
To the best of our knowledge, it is not known how much condoms protect against HPV, since areas not covered by the condom can still be exposed to the virus.
What to expect (Outlook/Prognosis)?
Often HPV goes away by itself within two years and does not cause health problems. It is thought that the immune system fights off HPV naturally. It is only when certain types of HPV do not go away over years that it can cause cancer. It is not known why HPV infection resolves in most, but not all cases. Unfortunately, there is no way to know which people will develop cancer or other health problems.[3] Considering that HPV infection may be asymptomatic, some patients may carry the virus and not know that they are infected. Accordingly, the prognosis will depend on the course of the infection, whether it is asymptomatic or it evolves into a cellular abnormality that may lead to cancer. The prognosis will therefore depend on the condition resulting from the cellular abnormalities and how early this is diagnosed, since for instance, a cervical cancer may be cured if diagnosed and operated on early, while if it is only caught late in its course, it may have a fatal outcome.
Possible complications
Infection with HPV may have a broad spectrum of manifestations and complications. These may include:[1]
- Genital warts - There are many treatment choices for genital warts, yet no treatment may be considered better than the other. Some people prefer not to treat warts. Warts can be removed by the patient with medications or treated by a health care provider. However, even after these have been treated, the virus might still be present and may be passed on to others.
If genital warts are not treated they may go away, remain the same, or increase in size or number, yet they will not turn into cancer.
- Cervical cancer - all women should be checked regularly with Pap tests. The Pap test looks for cellular changes, caused by the HPV, and is able to find them at early stages, thereby preventing further changes that could potentially lead to the development of cancer. This also contributes to the diagnosis of cancer in its early stages, so it can be treated before it becomes too serious. It is most treatable when it is diagnosed and treated early. Most women who get routine cervical cancer screenings and follow up as told by their doctors can find problems before cancer even develops.[3]
- Vaginal or vulvar cancer - vaginal cancer is cancer of the vagina (birth canal), while vulvar cancer is cancer of the clitoris, vaginal lips, and opening to the vagina. Both of these kinds of cancer are very rare and not all vaginal or vulvar cancers are caused by HPV.
- Anal cancer - cancer that is formed in the tissues of the anus. The anus is the opening of the rectum (last part of the large intestine) to the outside of the body.