Human Papilloma Virus

When many think of Human Papilloma Virus (HPV),the first thing that comes to mind now a days is the alarming link between HPV infection and the development of cervical cancer.
What is even more scary, is that both men and women can be carriers of this virus and not ever know it. But, what is less commonly known is that there are symptomatic manifestations of HPV infection as well.

There are different types of HPV. HPV types are often referred to as “low-risk” (wart-causing) or “high-risk” (cancer-causing), based on whether they put a person at risk for cancer. In 90% of cases, the body’s immune system clears the HPV infection naturally within two years. This is true of both high-risk and low-risk types. For example, HPV type 1 causes plantar warts. HPV type 6 causes anogenital warts and HPV type 16 infection can produce abnormal cervical cell changes, a process called Dysplasia. These dysplastic cells can then progress to becoming cervical cancer.



The clinical manifestations of HPV infection depend on the location of the lesion and the type of the virus.

• Common warts usually occur on the hands as flesh colored to brown lesions that are raised above the skin (exophytic) and are thicker than skin in texture (hyperkeratotic).
  

• Plantar warts may be quite painful. They look a bit like calluses, but have thrombosed capillaries underneath

• Flat warts (verruca plana) are most common among children and occur on the face, neck, chest and flexor surfaces of the forearms and legs.
  

• Anogenital warts usually appear as small bumps or groups of bumps, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. Warts may appear within weeks or months after sexual contact with an infected person. Or, they may not appear at all. If left untreated, genital warts may go away, remain unchanged, or increase in size or number.They will not turn into cancer.

-Genital HPV is contracted through genital contact, most often during genital and anal sex. A person can have HPV even if its been years since he or she has had sex. Most infected people do not realize that they are infected or that they are passing the virus to a sex partner.
- Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during vaginal delivery. In these cases, the child may develop warts in the throat or voice box- a condition called Recurrent Respiratory Papillomatosis (RRP)


-There are no symptoms for cervical cancer until it's reached its later stages, so it is very important that all women from age 21 or no later than one year after their first sexual intercourse, should have yearly PAP smears so that any abnormal cells can be identified and further examined for any existence of HPV.

-Other less common HPV-related cancers, such as cancers of the vulva, vagina, anus and penis, also may not have signs or symptoms until they are advanced.

-An HPV DNA test, which can find high-risk HPV on a woman’s cervix, may also be used with a Pap test in certain cases. The HPV test can help healthcare professionals decide if more tests or treatment are needed.

• There is a vaccine available called Gardasil, which protects against HPV types 6,11,16 and 18. It is administered in three doses and is a recommended vaccination for females 11-12 years of age; catch-up vaccination is recommended for females 13-26 years of age. It is best to have received the vaccine before becoming sexually active so that there is optimal chance of preventing acquiring genital warts and cervical and vaginal cancers.

(I am not personally endorsing Gardasil, just presenting all that is available. It is a personal choice that parents have to make for their young girls)

-Even women who got the vaccine when they were younger need regular cervical cancer screening because the vaccine does not protect against all cervical cancers.There is currently no vaccine licensed to prevent HPV-related diseases in males.

While it can be difficult to prevent coming into contact with all of the types of HPV, genital HPV and all of its consequences can be easily averted by abstinence from sex, always using barrier methods such as condoms, and being honest about you and your partner's sexual history. Keep in mind though, that apart from abstinence, there is no method with 100% guarantee that you won't become symptomatically infected, or a carrier of the virus. This is because a condom only covers the penis, leaving other parts of the genitalia that can carry the virus, and unless men have had a genital wart episode, they may never know that they are infected.