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The Facts on Human Papillomavirus (HPV)
The human papillomavirus (HPV) is a group of more than 100 kinds of viruses. These viruses can cause warts, such as genital warts. HPV is the most common sexually transmitted disease in the United States. Also called papillomas, genital warts are noncancerous tumors that may show up in or on the genital tract. There are more than 30 kinds of genital HPVs. To differentiate between the types of HPV, each has a number, such as HPV-16. Some of these have been linked to different kinds of cancer, including cervical, penile, anal, vaginal, vulvar, and oral cancers.
What are the symptoms of HPV?
The most visible symptoms of HPV are genital warts. These can be found on the penis and around the anus in men. In women, they’re found on the vulva, around the anus, inside the vagina, and on the cervix. In some cases, the warts may appear in the mouth area. HPV warts are usually flesh-colored and have a cauliflowerlike appearance. They do not often cause pain but may cause itching. Warts inside the vagina or cervix are not visible and may not cause any symptoms.
How is HPV transmitted?
Although genital HPV can spread through skin-to-skin contact, it is usually transmitted through vaginal, oral, or anal sexual intercourse with a person who has the virus. Because warts may not always be present or visible, it is impossible to tell just by looking if a person has genital HPV. Also, people may not know they have HPV because they may not have symptoms.
How is HPV prevented?
A person who becomes sexually active at a young age or has sex with many partners has a greater risk of getting HPV infection. Having sex with someone who has had many partners in the past can also increase the risk of HPV. That’s why it is important for sexual partners to discuss their sexual history and any sexually transmitted diseases they may have or have had. There is no guaranteed protection against getting genital HPVs for people who are sexually active because skin-to-skin contact with an infected person can spread it. Using condoms during sexual intercourse does not prevent HPV infection, although condoms can prevent other sexually transmitted diseases, such as HIV.
How is HPV diagnosed?
A doctor often diagnoses HPV in men when he or she sees warts on the surface of the penis. A man may also know that he is a carrier of the virus if a female partner is diagnosed with it. It is often more difficult to diagnose HPV in women because it is hard to detect or feel for warts inside the vagina or cervix. It is important for women who are older than 18 or who are sexually active to have a pelvic exam and Pap smear every year. If something abnormal is found in a Pap test, the doctor will probably recommend a colposcopy. This is a test in which the doctor uses a lighted magnifying tool called a colposcope to look at the vagina and cervix. The doctor may also recommend a biopsy, in which he or she removes a small tissue sample. Then a pathologist examines it. These tests can help determine if the person has HPV and what type of HPV infection they have. The HPV test can detect the infection in women. It may be used alone in women who have mild Pap test abnormalities, or in combination with the Pap test for women older than age 30.
How is HPV treated?
There is no cure for HPV. However, the infection sometimes goes away on its own. In other cases, doctors can treat HPV so the warts go away. But the warts may come back, even after treatment. There are several ways to treat genital warts. Doctors can remove warts by freezing them off or by destroying them with intense laser light. They may also remove them through surgery. In addition, there are creams that can be used to destroy the warts. Some of these creams need to be applied by a doctor, while others are safe for use at home. Researchers are looking for more effective ways to treat HPV.
What cancers are linked to HPV infection?
HPV infection is thought to be a major cause of cervical cancer. There are certain types of HPV, including HPV-16, HPV-18, HPV-31 and HPV-45, that increase a woman’s risk of cervical cancer. HPV has been linked to vaginal and vulvar cancers, too. Also, HPV may be linked to anal cancer and to penile cancer in men. It has been linked to oral cancer in both men and women. Some types of HPV are less likely to turn into cancer. These include HPV-6 and HPV-11.
One of the vaccines, Gardasil, was approved by the FDA in 2006 and can protect women from HPV infections. It protects against four types of the HPV virus, including the two viruses that cause 90 percent of genital warts. There is new evidence that Gardasil may also help protect against changes that can lead to vaginal, vulvar, and anal cancers.
Cervarix is the other HPV vaccine in use today. It was approved by the FDA in 2009 and also protects women from HPV infections. It protects against the two types of the HPV virus that cause most cervical cancers.
The HPV vaccines can only be used to prevent HPV infection before an abnormal Pap test develops.
Both vaccines are administered as a series of three injections over a six-month period. For the vaccines to be effective, one of them should be given before girls/women become sexually active or are exposed to HPV. Neither vaccine treats existing HPV infections.
According to the CDC, these vaccines are recommended for 11- and 12-year-old girls. The vaccines also can be given to girls and women ages 13 through 26 who did not get the vaccine when they were younger or who did not complete the vaccination series. Gardasil can also be given to boys and may be started during one of their pre-teen checkups.
Online ResourcesNational Cancer Institute http://www.cancer.gov/cancertopics/factsheet/Risk/HPV
American Cancer Society http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/hpv-vaccine-bivalent