HPV

STI of Human Papillomavirus

Key information about the most common type of sexually transmitted infection

What is Human Papillomavirus?

Human Papillomavirus (HPV) is a class of viruses that can infect both men and women and is often sexually transmitted. While many cases are harmless and will resolve on their own, some strains of HPV can lead to serious complications for women including genital warts and cervical cancer [1,4].

How common is it?

Studies show most people will contract some type of HPV at some point during their lifetime and most of them won’t have any symptoms. In the U.S., approximately 79 million people currently have HPV although in most cases it will be a type that causes zero or mild symptoms [4]. 

Worldwide, about 500 million women are diagnosed with cervical cancer every year including 15,000 in the U.S. Although HPV is not the only cause of cervical cancer, it is the most common one [2].

What causes HPV and what are the risk factors?

There are over 100 documented different strains of HPV, and different  “types” can have different symptoms and effects on the body. Some types of HPV are not exclusively sexually transmitted and may spread through general skin-to-skin contact. The strains that are predominantly sexually transmitted tend to have more serious consequences. For example, HPV16 and HPV18 are responsible for most cases of cervical cancer, and HPV6 and HPV12 can cause genital warts. 

Even though many people do not show any symptoms of the virus, they can still pass it on to others during sex. As with other STIs, risk factors include having multiple sexual partners, unprotected vaginal, anal or oral sex, and/or a weakened immune system. 

What are the symptoms?

Although HPV often does not cause any symptoms, it can lead to other conditions such as cervical cancer or genital warts. Most of the time, the body’s immune response will defeat the infection before warts have a chance to develop. Warts often won’t appear until weeks or months after sexual intercourse with an infected partner, indicating that the immune system was not able to clear the infection. The good news is that wart-causing types of HPV are not typically associated with cervical cancer. 

How is it diagnosed?

HPV is diagnosed by a gynecologist via an abnormal pap smear result or through the occurrence of genital warts. Histological analysis is used to confirm the presence of cancerous or precancerous cells, whilst PCR (polymerase chain reaction) tests can be used to identify if the infection is caused by a high-risk strain. Since an HPV infection may take years to develop into cancer, it’s important to stay up to date with regular preventative screenings like pap-smears [2]. Even though men can be carriers of high-risk HPV, there is currently no approved test available for them.

What are the treatment options?

Since there is no cure for an existing HPV infection, prevention is the best course of “treatment”. The CDC recommends routine HPV vaccinations (Gardasil or Cervarix) for both males and females between the ages of 9 and 45. Although the vaccine does not protect you against every possible type of HPV, it can prevent many of the cancer-causing ones [3]. 

If precancerous lesions are detected during a pap-smear, they can be treated or removed before they develop into cancer. For genital warts, topical prescription medications can be used. In more severe cases, surgical removal or laser therapy might be recommended. 

Can HPV lead to other complications?

As mentioned above, most cervical cancer cases are a result of HPV. Certain strains can also cause anal, vulval, vaginal or penile cancer [4]. 

What can be done to prevent HPV?

The HPV vaccine is the first line of defense according to the CDC. To reduce your chances of getting an STI, practice safe sex by always discussing sexual health with your partner, using barrier protection correctly (such as a condom or dental dam), and getting tested regularly. Other ways to prevent HPV include avoiding anything that disrupts the balance of bacteria within the vaginal microbiome such as douching or using scented tampons, pads, or soaps.

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References

1. Human papillomavirus (HPV) [Internet]. nhs.uk. 2020 [cited 19 September 2020]. Available from: https://www.nhs.uk/conditions/human-papilloma-virus-hpv/

2. HPV test - Mayo Clinic [Internet]. Mayoclinic.org. 2020 [cited 19 September 2020]. Available from: https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355

3. HPV vaccine: Get the facts [Internet]. Mayo Clinic. 2020 [cited 19 September 2020]. Available from: https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292

4. HPV Vaccine [Internet]. Centers for Disease Control and Prevention. 2020 [cited 19 September 2020]. Available from: https://www.cdc.gov/hpv/

Written by Aisha Ommaya, science comms officer with Juno Bio

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