Human papillomavirus (HPV) is a very common virus that can lead to infections. HPV is spread through sexual contact and most sexually active people will get it at some point in their lives. There are over 100 different types of HPV, with around 40 types that can infect the genital areas. Some types of HPV can cause genital warts while others are linked to cervical cancer and other cancers. HPV is so common that the majority of sexually active adults will get it, though many never have any symptoms. But HPV is a major cause of infections, especially among sexually active individuals.
What is HPV?
HPV stands for human papillomavirus. It is a group of related viruses that infect either the skin or mucous membranes of the body. There are over 200 identified types of HPV, each marked with a number. Different types infect different parts of the body:
– HPV types 1, 2, 3, 10 and others cause common warts on hands and feet
– HPV types 6 and 11 cause 90% of all genital warts
– HPV types 16 and 18 cause 70% of cervical cancers and precancerous cervical lesions
– HPV types 6, 11, 16 and 18 cause 90% of anal and genital warts
– HPV types 16 and 18 also cause cancers of the vulva, vagina, penis, anus, and oropharynx
HPV is transmitted through direct skin-to-skin contact. It can be spread through vaginal, anal, and oral sex. HPV can also be passed from mother to baby during childbirth. Most sexually active people are exposed to HPV at some point. Around 79 million Americans are currently infected with HPV while about 14 million new cases emerge each year.
How HPV Causes Infections
HPV causes infections by invading and multiplying in the epithelial cells of the skin and mucous membranes. There are two categories of HPV based on their effects:
Low-risk HPV
Types 6 and 11 rarely lead to cancer but commonly cause visible genital warts. They account for about 90% of genital warts globally. These warts appear as soft, skin-colored growths in moist areas like the genitals, anus, mouth, and throat. Sometimes they develop into cauliflower-like bumps. Low-risk HPV infections tend to go away on their own but can still remain dormant in the body for years.
High-risk HPV
Types 16 and 18 do not cause noticeable symptoms but can lead to cellular abnormalities that may become cancerous over time. High-risk HPV causes virtually all cases of cervical cancer, 95% of anal cancers, 70% of vaginal and vulvar cancers, more than 60% of penile cancers, and over 70% of oropharyngeal cancers.
HPV infects basal epithelial cells in the skin or mucous membranes. The virus inserts its DNA into the cell’s chromosomes. This induces the cell to produce more viral particles that are released to infect surrounding tissue. In some cases, the cell’s regulatory processes are disrupted, causing abnormal cellular growth that can potentially become cancerous. High-risk HPV can thus trigger formation of precancerous lesions that transform into invasive cervical, anal, penile, vulvar, vaginal or throat cancer.
HPV Transmission and Risk Factors
HPV is mainly passed from person to person through sexual contact. Both penetrative sex and skin-to-skin genital contact can spread HPV. Using condoms reduces but does not eliminate the risk. HPV can also be transmitted from mother to newborn during vaginal childbirth. Less commonly, HPV might spread through open-mouth kissing if warts are present.
Sharing objects like razors or towels does not spread HPV. The virus dies quickly outside the body so transmission requires skin-to-skin contact. A person’s risk of getting HPV increases with:
– Having a weakened immune system
– Having multiple sexual partners, the more partners the greater the risk
– Starting sexual activity at an early age
– Failure to use condoms
– Having sex with high-risk partners like those with multiple partners
– Personal history of sexually transmitted diseases
– Being uncircumcised
HPV is so common that most people get infected within a few years of becoming sexually active. At any time, around 79 million Americans have HPV while about 14 million become newly infected each year. Most don’t even know they have it since HPV often causes no symptoms. Without screening and diagnosis, many HPV infections go undetected.
Signs and Symptoms of HPV
Most people with HPV show zero symptoms as the infection often clears spontaneously. Detectable symptoms usually take months or years after exposure to develop.
Possible signs and symptoms include:
- Genital warts – soft, skin-colored growths in moist areas like genitals, mouth, anus
- Respiratory papillomatosis – wart growths in the airways causing hoarse voice
- Abnormal Pap test results indicating precancerous cervical cell changes
- Cervical cancer symptoms like abnormal vaginal bleeding or discharge, pelvic pain
- Anal cancer signs like anal bleeding, pain, itching or discharge
- Vulvar, vaginal, penile cancer symptoms like genital warts, sores, growths or lesions
- Oropharyngeal cancer symptoms such as persistent sore throat, earaches, mouth sores
But even high-risk HPV types that can lead to cancer generally don’t show any symptoms until actual malignancy develops. There are no early warning signs that indicate one’s HPV infection status. Testing is needed to detect lurking HPV.
HPV Testing
Since most HPV causes no symptoms, specific testing is required to check for infection. There are two main HPV tests:
HPV DNA test – This detects HPV infection by identifying the genetic material or DNA of the virus in cervical cells. It can identify high-risk HPV types 16 and 18 which cause 70% of cervical cancers. The HPV DNA test is often done together with a Pap smear which screens for any abnormal cervical cell changes.
HPV E6/E7 mRNA test – This looks for RNA messengers associated with two HPV genes E6 and E7 that indicate high-risk HPV infection. This test is more specific than the DNA test and can determine if HPV is actively replicating.
An HPV test can be done on its own or combined with a cervical Pap smear. It is recommended for:
– Women above 30 years together with a Pap smear every 5 years
– Follow up testing after treatment of an abnormal Pap smear
– Testing for high-risk sexual partners of HPV positive individuals
– Screening in HIV positive women
There is currently no approved test for HPV in men. But HPV testing may be done if men have certain symptoms like genital warts or abnormal cells on exam. An HPV test result cannot specify how long infection has been present or source of infection. A positive test indicates you have contracted HPV at some point in time.
Is HPV Infection Treatable?
There is no cure or treatment that can eradicate HPV once infected since it remains in cells within the body. But visible HPV symptoms like warts can be removed through minor outpatient treatments. And cellular changes from high-risk HPV can be managed to prevent progression to cancer.
Visible wart treatment options
– Medication – Prescription topical treatments like podofilox, imiquimod, sinecatechins
– Cryotherapy – Freezing warts with liquid nitrogen
– Surgery – Cutting away warts through electrosurgery, laser, excision
– TCA – Chemical burn using trichloroacetic acid to remove warts
Over-the-counter remedies like salicylic acid preparations can also help remove genital warts. Treatment success depends on the size and location of warts. It may take several attempts over weeks or months to fully resolve. Even after visible warts are gone, HPV may remain dormant in the body and warts can recur.
Precancerous cell changes management
For abnormal cell changes in the cervix, anus or other areas that can lead to cancer, treatment options include:
– LEEP – Using an electrical current passing through a thin wire loop to burn off abnormal cells
– Laser ablation – Vaporizing abnormal tissue using a highly focused laser beam
– Conization – Surgically removing a cone-shaped chunk of the cervix containing abnormal cells
– Hysterectomy – Surgical removal of the uterus and cervix
These allow early intervention before cell changes trigger actual cancer. After treatment, regular follow-up testing is needed to check for recurrence. Using condoms and limiting partners can help reduce reinfection risk. HPV vaccines also now exist that can protect against cancer-causing HPV types.
Can HPV Infection Be Prevented?
The two main ways to avoid HPV infection are:
1. HPV vaccination
Three HPV vaccines are currently approved:
– Gardasil 9 protects against high-risk HPV types 16, 18, 31, 33, 45, 52 and 58 as well as low-risk types 6 and 11
– Gardasil protects against types 16, 18, 6 and 11
– Cervarix protects against types 16 and 18
The vaccines are over 99% effective at preventing HPV infection from the vaccine-specific strains. HPV vaccination is recommended for preteens ages 9 to 12 before sexual debut for best protection. Catch-up vaccination is advised for teens and young adults up to age 26. Three doses are given over 6 to 12 months.
2. Safe sexual practices
Using condoms correctly every time one has sex can reduce HPV transmission though not fully prevent it. Limiting one’s number of sexual partners also decreases HPV exposure. Getting regularly tested for HPV allows early detection and treatment. But HPV is difficult to avoid completely as skin-to-skin genital contact can spread infection.
HPV Infection: Conclusion
HPV or human papillomavirus is a group of over 200 related viruses, with certain high-risk types being a major cause of infections. HPV is sexually transmitted through vaginal, anal, and oral sex. Most sexually active people get infected at some point. HPV is very common – about 79 million Americans currently have it.
In many cases, HPV causes no symptoms and clears up on its own. But some types can lead to visible genital warts while high-risk HPV is responsible for multiple cancers including of the cervix, anus, genitals, and throat. HPV causes infections by inserting its DNA into skin and mucous membrane cells, inducing abnormal cellular growths.
You cannot tell if someone has HPV just by looking at them. Testing is needed to identify lurking HPV. HPV has no cure but visible warts can be removed and precancerous cell changes managed. HPV vaccines now exist that protect against the cancer-causing strains. Using condoms and limiting sexual partners helps reduce HPV exposure. But HPV is hard to avoid completely and is a major cause of sexually transmitted infections.
Frequently Asked Questions
Q: How common is HPV?
A: HPV is extremely common. About 79 million Americans currently have HPV while 14 million become newly infected each year. Over 80% of sexually active people contract HPV at some point.
Q: Can men get HPV?
A: Yes, HPV affects both men and women. The viruses spread through skin-to-skin sexual contact. Around 45% of men have some type of genital HPV.
Q: Is HPV always sexually transmitted?
A: HPV is primarily passed through vaginal, oral and anal sex. But it can also spread from mother to newborn during childbirth. Non-sexual spread is less common.
Q: Can HPV be prevented?
A: Getting vaccinated against HPV prior to sexual debut provides the best protection. Using condoms reduces the risk of HPV transmission. Limiting one’s number of sexual partners also helps.
Q: Does HPV go away?
A: Many HPV infections resolve spontaneously within 1-2 years. But HPV can linger dormant in the body for decades. High-risk HPV is unlikely to self-clear and can progress to cancer.
Q: What cancers are caused by HPV?
A: High-risk HPV types 16 and 18 cause nearly all cervical cancers. They also cause most anal, oropharyngeal, vulvar, vaginal, and penile cancers. Overall HPV causes 5% of cancers worldwide.
Q: How can you test for HPV?
A: HPV DNA tests look for the virus’s genetic material in cervical cells. HPV E6/E7 mRNA tests check for indicators of active high-risk HPV infection. Genital warts may also be biopsied.
Q: Can HPV be cured?
A: There is no cure for HPV. The virus remains in the body lifelong once contracted. But visible warts can be removed and abnormal cell changes managed to prevent cancer.
Key Takeaways
- HPV is the most common sexually transmitted infection with 79 million cases in the U.S. currently.
- HPV spreads through vaginal, anal, and oral sex. Skin-to-skin genital contact can transmit it.
- Most people have no symptoms but HPV causes genital warts and cellular changes that lead to various cancers.
- High-risk HPV types 16 and 18 are responsible for 70% of cervical cancers and over 90% of anal cancers.
- Pap smears and HPV testing allow early detection of infections and precancerous changes.
- There is no cure but warts can be removed and abnormal cells managed before becoming cancer.
- HPV vaccines provide effective protection against cancer-causing virus types.
HPV is ubiquitous among the sexually active population but most infections are harmless. However, high-risk strains can trigger cellular transformations that result in multiple types of cancers. Safe sexual practices and vaccination are essential to reduce HPV transmission and its potentially serious consequences. While HPV often causes no symptoms, it remains a major source of sexually transmitted infections.