Signs, Symptoms, and Treatment of HPV

HPV is the given name to different versions of the Human Papilloma Virus. HPV has 150 different types, and each sub type is given a number. More commonly called Genital Warts, HPV is one of the most common infections worldwide, and 50% of the people who engage in sexual activities acquire it at some point in their life.

Causes

HPV is a transmissible infection — you can contract the virus if an infected person is in your immediate vicinity. 40 types of HPV are transmitted via sexual contact, such as vaginal, anal, or oral sex with an infected person. It is so common that most sexually active males and females acquire it, even if they only have sexual intercourse with one person. HPV transmits by contact with oral or genital mucus membranes, skin, and body fluids.

Signs and Symptoms

The HPV infection is transmitted very easily because most infected people do not know they have the virus in their system — it can be asymptomatic. HPV is divided into high-risk and low-risk types. The low-risk types — HPV 6 and 11 — produce genital warts, which are tiny bumps on the genital area. The warts can be large or small, single or multiple, and can be red, pink, or flesh-colored. They appear weeks or even months after contact with an infected person.

Complications

The most important complication of HPV is caused by the high-risk subtypes 16 and 18, as both are some of the most common causes of cancer in women. Approximately 70% of all cervical cancers are attributed to HPV 16 and 18. A high percentage of other cancers, such as those of the vulva, vagina, and penis, are also attributed to HPV infection. Cervical cancer is asymptomatic, and presents late; it is difficult to treat. Prominent symptoms include abnormal discharge from the vagina, pelvic pain, pain during sexual intercourse, and vaginal bleeding between menstrual cycles or menopause. Therefore, it is important to get regular screening tests done if a person is susceptible to the HPV infection.

Diagnosis

A good medical history and clinical examination is sufficient for diagnosis. For women, swabs are taken from the cervix as part of a pap smear. A Pap smear detects any abnormal cells in the cervix, which may be precancerous. A Pap sample can also be used to check the DNA of the virus, to detect its subtype. Women whose Pap tests are abnormal are asked to get Pap smears repeated over time, in order to detect the cancer at an early age. Pap smears are combined with HPV DNA Tests for women who are older than 30-years-old. For men, there is no specific test is needed; however, physical examination is sufficient for diagnosis.

Treatment

Genital warts produced by HPV 6 and 11 mostly self-resolve, but may require treatment if they recur over time. Medical treatment involves topically-applied creams. Other treatment options are laser removal, cryotherapy, or surgical excision of the warts. In case of abnormal cellular changes, the first option is to wait and observe — cervical cellular changes usually resolve on its own. If abnormal cells persist, treatment targets removal of cells, which can be done by cryotherapy, or laser of a cone biopsy.

Prevention

As with every infection, the HPV infection can be prevented. HPV vaccines have recently been developed and combined with the Pap smear, which have significantly reduced the prevalence of HPV infection and cervical cancer. HPV vaccines have been approved by the FDA in 2006, and were introduced under the market name Gardasil. It targets the four main types of HP: 6, 11, 16, and 18. They are recommended as routine vaccines for males and females between the ages of 9-years-old and 26-years-old. Yet, vaccination is strictly prohibited in pregnant women.

The vaccine doesn't guarantee complete protection against HPV. A person can be infected by any one of the types of HPV. Sexually active men are encouraged to use latex condoms. Women between the ages of 30-years-old and 65-years-old are encouraged to get Pap smears and a regular follow-up.