What is Human Pappillomavirus (HPV)?
Human papillomavirus (HPV) is a viral infection that may appear as growths or warts affecting the skin and mucous membranes, although it can also be present without any visible lesions. It can spread by skin contact or through sexual intercourse. There are various types of HPV and certain infections can lead to cancer - especially an infection of the cervix in women. HPV has also been associated with cancer of the vagina, vulva, anus,, and throat. Vaccines are available to protect against cervical cancer or genital warts.
Symptoms of HPV
An HPV infection may have no symptoms or may present as growths called warts that vary in appearance. Genital warts are usually seen on the vulva in women and may appear as a bump, flat lesion or stemlike growth. In men, genital warts may not be present or may develop on the penis and scrotum. They can cause itching but are not usually painful. Other types of warts include common warts on the hands and fingers, plantar warts on the feet, and flat warts on the face.
About 90% of HPV infections resolve on their own within 2 years. The immune system is usually able to suppress it and prevent warts from forming, but the virus is still present in the body during this time and can infect others.
HPV infections associated with cancer do not usually cause warts. Cervical cancer can develop long after an HPV infection, and early cervical cancer has no symptoms. Therefore, periodic screening for cervical HPV is highly recommended in women.
Causes of HPV
The virus enters the body through a cut or abrasion in the skin following skin contact or sexual activity, which can lead to infections of the genitals and anus, or manifest as oral or upper respiratory lesions. The warts are contagious and can be spread by direct contact with healthy skin or through a contaminated surface. HPV can sometimes pass from a mother to a baby during delivery, leading to warts in the respiratory system (respiratory papillomatosis).
The following factors increase your risk of contracting HPV:
- Interacting with someone who has HPV without taking precautions
- Having a sexual partner with HPV
- Having multiple sexual partners
- Having a weak immune system
- Skin or mucous membrane injury such as with anal intercourse
- Having multiple children
Diagnosis of HPV
Your doctor will review your medical history and examine any warts you have. Certain tests can help detect HPV lesions or HPV-related cancer in the absence of symptoms. These include:
Pap smear: This test involves obtaining a sample of vaginal or cervical tissue cells for examination in the laboratory. It can help detect cancer or precancerous changes in the cells. Pap smears are recommended every three years from the age of 21.
Acetic acid test: Lesions that are less noticeable may be detected by applying an acetic acid (vinegar) solution to them, which turns the infected area white.
DNA test for HPV: This test can detect the presence of DNA belonging to types of HPV that are usually associated with cancer of the cervix.
Treatment of HPV
HPV vaccination is recommended to help prevent cervical cancer or genital warts. These may not be effective after an infection has taken place. Warts may heal on their own, but the virus can remain and cause a recurrence in the same area or even a different location. Certain medications may be prescribed for genital warts. If a strain of HPV commonly associated with cancer is detected on a screening test, your doctor will evaluate the infected tissue on a yearly basis to determine if the cells show any cancerous changes. Women with cervical precancerous changes may be treated by a procedure called a colposcopy in which an instrument is inserted into the cervix to provide a magnified view, to remove all visible precancerous lesions. Various techniques may be used including surgical removal, freezing with nitrogen, or burning with electrical or laser energy. Cancer related to HPV may be treated by surgery, chemotherapy, radiation therapy or a combination of these procedures.