How worrying is HPV?

Table of Contents

What is HPV?

HPV stands for human papillomavirus. It is a very common virus that can infect both males and females. There are over 100 different types of HPV, with around 40 types that can infect the genital areas. Genital HPV is spread through skin-to-skin sexual contact and is very contagious.

Most sexually active people will get HPV at some point in their lives. Around 79 million Americans are currently infected with HPV, and about 14 million more become newly infected each year. HPV is so common that the CDC estimates that nearly all men and women will get at least one type of HPV at some point in their lives.

Some key facts about HPV:

HPV is primarily spread through vaginal, anal, or oral sex with someone who has the virus.
It is possible to develop symptoms years after first becoming infected.

In most cases, the body naturally clears the virus within 1-2 years.
HPV can persist and lead to health complications in some cases.
Using condoms reduces, but does not eliminate, the risk of catching or spreading HPV.

The HPV vaccine protects against the types most likely to cause cancer and genital warts.

Symptoms of HPV

In most cases, HPV does not cause any symptoms at all. When symptoms do occur, they may show up weeks, months, or even years after a person first becomes infected. Potential symptoms include:

Genital warts – soft, flesh-colored growths in the genital area that can vary in size and shape.

Abnormal cells – unusual cells found during a Pap test, indicating precancerous changes.
Cervical cancer – Uncontrolled, abnormal cell growth in the cervix that can invade nearby tissue.
Vaginal cancer – Cancer in the vaginal walls, usually along the surface cells lining the vagina.

Vulvar cancer – Cancer of the vulva, which includes the inner and outer lips of the vagina, the clitoris, and the vaginal opening.
Anal cancer – Cancer in the anus, where stool leaves the body.
Oropharyngeal cancer – Cancer in the throat, tonsils, or base of the tongue.

However, it’s important to note that most people with HPV never develop any of these symptoms or health issues.

Risks and Complications of HPV

There are two categories of HPV that determine the virus’s risks and potential complications:

Low-risk HPV types – Types 6 and 11 are considered low risk and rarely lead to cancer. However, they are responsible for about 90% of genital warts cases. Genital warts rarely cause health complications but can cause discomfort.

High-risk HPV types – Types 16 and 18 are high-risk. They are responsible for most HPV cancers, including 70% of cervical cancers. They can also cause cellular changes that may lead to genital, anal, head, and neck cancers.

Other high-risk types include 31, 33, 45, 52, and 58. Together with 16 and 18, these types cause about 80% of cervical cancers and the majority of other HPV-related cancers.

While HPV is very common, cancers caused by HPV are rarer. The American Cancer Society estimates there will be:

14,480 new cases of cervical cancer
13,170 new cases of oropharyngeal cancer
8,300 new cases of anal cancer

3,170 new cases of vaginal cancer
2,570 new cases of vulvar cancer

Most of these cancers can be prevented with vaccination, Pap tests to screen for cervical cancer, and safe sex practices.

Who is most at risk for HPV?

Any sexually active person can get HPV, but certain behaviors and characteristics increase risk:

Having unprotected vaginal, anal, or oral sex
Having multiple sex partners

Having sex at an early age (before 16)
Having a partner who has had multiple sex partners
Smoking cigarettes

Having a weakened immune system
Long term birth control use (more than 5 years)

Factors that increase the risk of HPV leading to health complications include:

Infection with a high-risk HPV type
Persistent infection (not clearing the virus naturally)
Older age

Smoking
HIV or other conditions that impair immunity

Who should get tested for HPV?

There are no FDA-approved HPV tests that check for all high-risk types. Instead, screening focuses on testing for cellular changes caused by HPV that may lead to cancer.

Cervical cancer screening – All women ages 21-65 should get regular Pap tests. Pap tests check for abnormal cervical cells that may indicate precancerous changes. HPV testing may also be done in conjunction with Pap tests for women 30 and over.

Anal cancer screening – Some experts recommend anal Pap tests for HIV-positive men and women, men who have sex with men (MSM), and women with history of abnormal cervical Pap tests.

Oropharyngeal cancer screening – There are no routine screening tests available for oropharyngeal cancer, which affects the throat.

Genital wart screening – There are no approved HPV tests to screen for genital warts. But visible warts can be diagnosed during an exam.

Routine cancer screening is important, even for people who have been vaccinated against HPV. The vaccine protects against the types most likely to cause cancer, but not all high-risk types.

Can HPV be cured?

There is currently no treatment that can cure an HPV infection. However, most of the time the body naturally clears the virus within 1-2 years.

When HPV does not clear and high-risk types persist, it can lead to cellular changes and potential cancer. Cervical precancerous lesions can be removed through procedures such as LEEP or cryotherapy. Cell changes must be monitored and treated early before they progress to cervical cancer.

Genital warts can be removed through prescription medications, cryotherapy, or minor surgery. They may return after treatment, but often eventually clear.

Cancers caused by HPV are treated through surgery, chemotherapy, radiation, or a combination of these. Treatment is often more successful when cancer is caught early through screening.

While HPV itself cannot be cured, the cell changes and cancers it causes can be monitored and treated effectively in most cases. The outlook is good when precancerous changes and early stage cancers are detected and removed.

Is HPV preventable with vaccines?

Yes, vaccines provide effective prevention against certain HPV strains. There are currently three FDA-approved HPV vaccines:

Gardasil – Approved for males and females ages 9-45. Protects against types 6, 11, 16 and 18.

Gardasil 9 – Approved for males and females ages 9-45. Protects against the same four types as Gardasil, plus five additional cancer-causing types (31, 33, 45, 52 and 58).
Cervarix – Approved for females ages 9-45. Protects against HPV types 16 and 18.

The vaccines offer nearly 100% protection against precancerous cervical lesions and genital warts when given prior to HPV exposure. The CDC recommends routine vaccination at age 11-12 for both boys and girls, but it may be given as early as age 9. Catch-up vaccination is recommended until age 26 for females and age 21 for males who were not previously vaccinated.

The vaccine is most effective when given before any exposure to HPV. But it can still provide protection against new HPV infections in those who were previously infected with one or more types covered by the vaccine.

Table 1: HPV Vaccine Coverage and Recommendations

Vaccine	Recommended Ages	HPV Types Covered
Gardasil	9-45 (females), 9-26 (males)	6, 11, 16, 18
Gardasil 9	9-45 (both males and females)	6, 11, 16, 18, 31, 33, 45, 52, 58
Cervarix	9-45 (females only)	16, 18

What about pregnancy and HPV?

HPV can be passed from a mother to a baby during pregnancy or delivery, though this is rare. When it occurs, it does not appear to cause HPV-related health problems.

More commonly, a pregnant woman may develop genital warts or abnormal Pap results caused by HPV. In this case:

Genital warts can be safely treated and removed during pregnancy.
Abnormal cell changes in the cervix are monitored until after delivery. Further testing, monitoring, or treatment occurs after delivery.

Pregnancy does not appear to cause HPV to flare up or worsen. However, pregnancy may make warts grow faster due to hormonal changes.

Women with HPV should discuss their concerns and options for screening and treatment with their healthcare provider. Monitoring and managing HPV-related health issues reduces the risk of complications.

Should sexual partners be notified about HPV?

According to the CDC, there is no clear health benefit to informing partners about an HPV infection when no warts or health problems are present. Since the virus is extremely common and rarely causes health issues, disclosure is unlikely to change the course or outcome.

However, notifying partners about an active HPV infection can be important when:

Genital warts are present – This allows the partner to monitor for potential symptoms.
There are signs of cellular changes or early cancer – This allows the partner to get screened as appropriate.
The partner is at high risk for HPV complications due to a weakened immune system.

A female partner is pregnant – HPV can very rarely be passed to a baby during delivery.

Ideally, partners should have open, honest communication and make notifications decisions together. Those in long-term, monogamous relationships must weigh the risks differently than those with multiple partners. Overall, while there are limited health benefits to notifying partners about asymptomatic HPV, transparency is best.

Should you get the HPV vaccine while pregnant?

No, the HPV vaccine is not recommended for pregnant women. While there are no serious safety concerns, the potential risks of vaccination during pregnancy have not been studied enough.

The CDC and most health authorities recommend pregnant women wait to complete the HPV vaccine series until after pregnancy. However, getting vaccinated while pregnant is unlikely to have negative effects.

Those who become pregnant before completing the 2- or 3-dose vaccine series should finish the remaining doses after pregnancy. It is safe to receive the HPV vaccine while breastfeeding.

Pregnant women who realize too late that they are unvaccinated have a few options:

Get the first HPV vaccine dose during pregnancy, then wait until after giving birth to finish the series.
Wait until after giving birth to begin and complete the vaccine series.
Delay vaccination until after currently breastfeeding.

Discussing vaccination timing with a healthcare provider is advisable for those who are pregnant or hoping to become pregnant in the near future.

Does HPV go away? Can you clear an HPV infection?

In most people, an HPV infection will go away on its own. According to the CDC, about 90% of HPV infections will clear within two years. However, there are a few possibilities:

HPV never clears – In approximately 10% of people, the HPV infection does not clear naturally and persists.

HPV clears then returns – After successful natural clearance of HPV, it’s possible to become re-infected from a new partner. This new infection with the same type can cause recurrent signs of HPV.
One type clears but others remain – If multiple types of HPV were contracted, some may clear while other types remain.

It’s difficult to know if HPV has cleared for certain, since there is no approved test for men or routine HPV screening for women under 30. Signs that HPV may have cleared include:

Genital warts disappearing after treatment and not returning.
Normal Pap test results after a previous abnormality.
Normal anal Pap test results (for those who had abnormal results).

Over time, the immune system will clear most HPV infections. But there isn’t a quick fix, so monitoring and safe sex are important. Using condoms may lower the risk of contracting new HPV infections before any current infection clears.

Can men get rid of HPV?

Unfortunately, there is no cure or direct treatment for HPV infections in men. Like with women, most HPV infections in men will clear up through the body’s natural immune response within 1 to 2 years.

However, some key points about managing HPV in men:

Using condoms may lower the risk of spreading HPV to partners during this time.
Most health complications from HPV occur in women, but men can develop cancers, genital warts, and rare penile lesions.
Genital warts can be removed through topical medications, cryotherapy, laser treatment, or surgery.

HPV-related cancers in men are treated with chemotherapy, radiation, or surgery.
The Gardasil vaccine protects men against cancer-causing HPV types and genital warts.

Men with weakened immune systems are at higher risk for persistent HPV and complications. Overall, most men clear HPV naturally within two years. But condoms, vaccination, and monitoring for abnormalities are important.

Conclusion

While HPV is very common, most infections do not lead to cancer or cause significant health problems. However, persistent high-risk HPV infection is a major risk factor for several types of cancer.

The emotional impact of an HPV diagnosis can be significant, but it helps to know the facts. There are effective prevention options and good screening tests available. Most cases of cervical precancer and cancer are preventable through vaccination, safe sex practices, and regular screening/monitoring.

For most people, HPV will clear within 1-2 years. During this time, using condoms may help prevent transmission. Stopping smoking, eating healthy, exercising, and finding appropriate ways to manage stress and anxiety can help support the body’s natural immune response.

Although HPV cannot be cured once contracted, the outlook is good for clearing the virus naturally. Persistent infection can be monitored and managed through regular screening, vaccination, healthy living, and safe sex practices.