HPV

Human Papillomavirus, or HPV, is the most common sexually transmitted virus infection (STI) in the United States. More than 50% of sexually active people will contract genital HPV at some point in their lives, and some will never know due to the lack of symptoms of HPV. The virus can also impact the health of you or your partner, as it is capable of eventually causing a variety of cancers (like oral, cervical, and penile) if it is never diagnosed.

Genital HPV is a very common virus in men and women. There are more than 40 types of this disease that can infect the genital areas, mouth and throat, and many that are infected with the virus are not even aware that they have a disease as human papilloma virus can be largely asymptomatic.

HPV is usually passed on through genital contact, most often during vaginal and anal sex, but it is also passed through oral sex. However, you do not need to have intercourse to contract the disease; it can be contracted through direct skin-to-skin contact with someone who has the infection. A person can still have human papilloma virus years after he or she had sexual contact with an infected person, regardless of their apparent health, and because there are often no symptoms of HPV, most infected persons do not know they are infected or that they are passing the virus on to their sex partner. It is also possible to get more than one type of HPV.

Can a pregnant woman pass HPV to their baby?

Yes, but it is rare to pass on the infection in this way. A pregnant woman with genital HPV can pass the virus to her baby during delivery. In these cases, the infant can develop Recurrent Respiratory Papillomatosis (RRP); this is a rare condition in which warts can grow in the baby’s throat. In children, it is called juvenile-onset RRP (JORRP). If you are pregnant and have the HPV virus, it is important to talk to your healthcare provider to discuss your pregnancy and diagnosis.

Most people do not show symptoms of HPV. In 90% of the cases, the body’s immune system clears HPV naturally within two years. This, however, is not always the case, and human papilloma virus can remain in the body past two years – which means it can cause:

Genital warts

• Usually appear as a small bump or group of bumps in the genital area
• Can be small or large, raised or flat, or shaped like a cauliflower
• It is rare to have pain, but depending on the size and location of the wart(s), they may be painful, especially with intercourse
• Depending on the size and location, the wart(s) may itch
• Warts can appear within weeks or months after sexual contact with an infected partner—even if the infected partner has no signs or symptoms
• If left untreated, genital warts may go away, remain unchanged or increase in size or number
• The warts will not turn into cancer
• Health care providers can diagnose warts by a visual inspection of the genital area during an office visit
• It is rare to develop warts in the throat (RRP)

Cancers caused by HPV

• In females – Certain types of HPV can linger on a woman’s cervix and cause cell changes. These changes can lead to cervical cancer over time, if left untreated. Less common but serious cancers include: cancer of the vulva, vaginal cancer and/or cancer of the oropharynx (back of throat including base of tongue and tonsils).
• In males – Cancer of the penis, cancer of the anus and cancer of the oropharynx can arise in males with untreated human papilloma virus infections.

How can I lower my chance of getting HPV?

• The HPV vaccine may protect males and females against the four most common types of the disease that can lead to genital warts and cancer. The risks and benefits of the vaccine should be discussed with your healthcare provider.
• Condoms prove effective in combating the transmission of HPV, much like any other STD.

There is no approved test for men or women to check one’s overall “HPV status,” nor to find HPV infection on the genitals or in the mouth or throat.

• For females – The only approved HPV tests are for screening for cervical cancer. In some cases, your health care professional may use a new HPV test that can find out if you have the types of HPV that are linked to cervical cancer. You can prevent cervical cancer by getting regular Pap tests and following up as recommended by your doctor. The Pap test can find cell changes (caused by HPV) on your cervix. This way, you can receive treatment for HPV before it turns into cancer and maintain good health.
• For males – There is no HPV test recommended for men.

There is no treatment for HPV outside of the human papilloma virus vaccine, but there are treatments for the health problems that HPV may cause:

• Visible genital warts – Warts can be removed by the patient with prescribed medications. They can also be treated by a health care provider. Some people choose not to treat warts, but instead wait to see if they disappear on their own, though no one treatment is better than another.
• Cervical cancer – Cervical cancer is most treatable with early diagnosis and treatment. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops.

HPV testing through your healthcare provider is simple and quick to ensure your comfort and peace of mind. If you believe you might have contracted HPV, get tested and get educated about HPV.

If you intend to self-test, note that the HPV tests on the market are only used to help screen women at certain ages and with certain Pap test findings, for cervical cancer and may not properly screen for the disease in all women.

What if I have an abnormal PAP smear?

Because of the link between HPV and cancer, your doctor will most likely perform a Colposcopy, a procedure where the doctor uses a lighted magnifying device to look at your cervix and take a biopsy. This allows further testing to monitor any problems with the health of your cervix. You may need to be examined every three to six months until your doctor determines all the infected tissue is removed or has gone away on its own. If your Doctor feels further treatment for HPV is necessary, one of the following procedures may be performed:

• LEEP – Loop Electrosurgical Excision Procedure – a procedure where a thin, low-voltage electrified wire loop is used to cut out the abnormal tissue. The intent is to remove the abnormal cells and therefore the infection.
• Cryotherapy – The doctor will freeze the abnormal cells with liquid carbon dioxide, which will destroy them. It is not effective if the abnormal cells are high in the cervical canal.
• Cone Biopsy or Conization – Similar to a cervical biopsy, but a larger cone-shaped wedge of tissue is removed from the cervix and examined under a microscope. The tissue is removed with a scalpel, a carbon dioxide laser or a LEEP. The intent is to remove all the affected tissue.

Remember that transmission of human papilloma virus cannot be prevented by washing the genitals, urinating or douching after sex. The existence of an HPV infection, both HPV in women and HPV in men, can have life altering effects on one’s overall health and wellness. If you are sexually active, it is important to take care of yourself by having routine doctor visits to help maintain your health to continue preventing HPV and other STIs/STDs.

CDC HPV Information: http://www.cdc.gov/hpv/parents/whatishpv.html

To get HPV testing help, contact us at any of the San Diego area clinic locations, call us at 619-337-8080, or schedule an appointment.

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