Image courtesy of: University of Maryland. Human Papillomavirus (HPV) Vaccine Information. 2009. < http://www.health.umd.edu/hpv>
Drs. Sylvester, Youngren, Lo and Sansobrino
Presentation by Megan Blomeyer, St. George’s University School of Medicine, MS-IV
HPV, or Human Papillomavirus, is the most common sexually transmitted disease. It is estimated that about 79 million Americans are currently infected with HPV with nearly 14 million people becoming newly infected each year. HPV is so common that it is estimated 3 out of every 4 sexually active individuals will contract HPV in their lifetime.
HPV is a virus that is spread from person to person via sexual contact. This contact can be through vaginal or anal intercourse, mouth to genital contact or any skin-to-skin contact. Sexual intercourse is not necessary for transmission. There are over 40 subtypes of HPV that may affect the genital as well as oral and throat areas. People may not realize they have HPV and may unknowingly pass it from person to person.
Some individuals develop symptoms related to the HPV virus while others clear the infection before any consequences occur. At this time, which individuals will develop symptoms after HPV exposure and which will not is unknown. Additionally, symptoms of HPV may develop years after exposure to the virus without any warning; therefore, protecting yourself and others is of utmost importance.
Health issues related to HPV
1) Genital warts– HPV types 6 and 11 are the most common types that cause genital warts. These are “low risk” types that are the least likely to cause cancer. The lesions caused by these types present as small bumps or groups of bumps in the genital region that may be flat or raised, small or large, or cauliflower in shape.
Image courtesy of: University of Wisconsin Madison.
Approximately 360,000 people per year are affected with genital warts. The diagnosis of genital warts is made by your doctor. These warts may be treated with medications or surgical removal. Although, in some cases, the warts may go away on their own, untreated warts may also grow in size or number so proper treatment is necessary.
2) Cervical cancer– Approximately 10, 300 women each year are diagnosed with cervical cancer. HPV types 16 and 18 are most commonly related to cervical cancer. HPV can enter the thin layer of cells that covers the cervix, which is an opening on the uterus (see image below). Once these cells are infected, they may be damaged and begin to grow differently. These abnormal cells may progress to precancerous lesions that may further evolve into cancer.
Image courtesy of: University of Wisconsin Madison.
Symptoms develop very late in the course of cancer development so screening for cervical cancer with a PAP Smear is vital. Testing for HPV itself is also conducted in women over 30 years of age. Information on proper screening protocols can be found in the PowerPoint presentation titled “What You Should Know About Cervical Cancer,” which is available on the Women First Health Center blog page.
Cervical cancer is better treated in the early stages or even better at a precancerous stage which is another reason that screening is so important. Treatment of precancerous areas includes removal through surgery or other techniques, while treatment of cancer may also include surgery with or without radiation and/or chemotherapy.
3) Other cancers–HPV has been linked to vaginal, vulvar, penile, anal and oropharyngeal (back of the throat) cancer. Treatment for these cancers is dependent on the severity as well as location and may also involve surgical removal, chemotherapy, radiation or other medications.
4) Respiratory papillomatosis-Mothers with genital warts present on the genital area during birth can be problematic for a newborn. These lesions can cause recurrent respiratory papillomatosis or warts in the throat area that can cause breathing difficulties. This can also develop in the adult leading to a hoarse voice or trouble breathing. Treatment involves medications with or without surgery.
The only way to prevent HPV infection is through abstinence, but other measures may reduce your risk.
1- HPV vaccine– It is estimated that approximately 21,000 cases of cancer related to HPV can be prevented with the HPV vaccine. Today, the HPV vaccine is recommended for both males and females between 11 and 12 years of age. It is given in a three shot series over six months. Obtaining the HPV vaccine before the first sexual encounter is important as the HPV vaccine does not treat previous HPV infection.
2- Condom use– Condom use during sexual intercourse may prevent development of HPV as well as HPV related infections such as genital warts and cervical cancer. HPV can be spread to areas of the skin where the condom does not cover; therefore, condoms are not 100% effective. Even so, using a condom during sexual intercourse every time from start to finish may help lower your risk.
3- Safe sexual practices– Being with one partner who has had few or no other sexual partners and limiting the number of sexual partners you have may reduce your risk of developing HPV. This being said, you may contract HPV by being with one partner one time, as its prevalence is so high. Again, the only way to prevent contraction of HPV is through abstinence from sexual intercourse.
HPV infections are the most commonly sexually transmitted disease. HPV is the only sexually transmitted disease directly related with cancer development. Proper preventative measures and screening techniques can reduce your risk of developing cancer from human papillomavirus. Protecting yourself and others from HPV infection and its consequences is vital. If you have any questions about HPV or issues related the HPV vaccine, please contact your health care provider.
American College of Obstetrics and Gynecology. Human Papillomavirus
Infection. January 2013. Accessed online 12 February 2014. < http://www.acog.org/Resources_And_Publications/Patient_Education_Pamphlets/Files/Human_Papillomavirus_Infection>.
Centers for Disease Control and Prevention. Genital HPV-Fact Sheet. 25 July 2013.
Accessed 11 February 2014. < http://www.cdc.gov/std/HPV/STDFact-HPV.htm#a5>.
Centers for Disease Control and Prevention. What is HPV? 5 February 2014.
Assessed 11 February 2014. < http://www.cdc.gov/hpv/whatishpv.html>.