HPV-What You Should Know   

HPV-What You Should Know

Human papillomavirus infections are among the most common and can cause a host of health problems.

The human papillomavirus (HPV) is the most common cause of sexually transmitted diseases, with more than 40 HPV types capable of infecting the male and female genital areas, as well as the mouth and throat.

Typically, HPV is passed through genital contact, ie, vaginal, anal and oral sex, as well as genital-to-genital contact.

The prevalence of HPV is high in women below 35 years, which is when they are more sexually active. About 20 million Americans are currently infected with HPV, while another six million will become newly-infected every year. HPV is so common that at least 50% of sexually-active men and women will be infected at some point in their lives.

In addition, the myriad types of HPV means there is a high risk of many people being infected. The different types of HPV have various and unique transmission and persistence characteristics.

Despite the alarming rate of infection, most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body's immune clears HPV naturally within two years. However, there are certain HPV types that can cause genital warts in both males and females (HPV types 6 and 11 contribute up to 90% of these benign warts) and cancers (HPV types 16 and 18 are responsible for more than 70% of cervical cancers). Certain groups are at higher risk for some HPV related health problems, eg, gay and bisexual men, and people with weak immune systems (such as those with HIV/AIDS).

Because HPV infections can persist for years in the body after a person last had sexual contact with an infected person, most infected people do not realise they are carrying the virus and thus, can pass it on to their partners.

Signs & symptoms of HPV-related problems
The most common HPV cancer is cervical cancer. As it does not show symptoms until the disease is quite advanced, it is important for women to undergo regular screening for cervical cancer. Other HPV-related cancers that also may not show signs or symptoms until they are advanced and hard to treat include cancer of the vulva, vagina, penis, anus, head and neck (tongue, tonsils and throat). It should also be noted that the HPV types that cause genital warts are not the same as those that can cause cancer.

Genital warts
These appear as a small group of bumps in the genital area. The shape and size varies - they can be small or large, raised or flat, or shaped like a cauliflower warts can appear within weeks or months after sexual contact with an infected person (even if the infected person has no signs of genital warts).
If left untreated, genital warts may go away, remain unchanged or increase in size or number. Genital warts do not progress to cancer.

Recurrent respiratory papillomatosis (RRP)
This condition causes warts to grow in the throat, sometimes blocking the airways and causing a hoarse voice or trouble breathing. The condition is very rare and is estimated to occur in less than 2,000 children annually in the US.

How HPV causes genital warts and cancer
Normal cells can become abnormal on HPV-infected skin. Most of the time, you cannot see or feel these cellular changes. If the body is unable to fight off HPV, genital warts or cancer may develop. However, while genital warts appear within weeks or months after contracting HPV, cancer often takes years to develop.

Preventing HPV
There are several ways to lower your risk of HPV infection. These include:
1. Vaccination
There are vaccines available to protect males and females against some of the most common types of HPV. They are given in three shots and it is important to get all three to obtain the best protection. The vaccines are most effective when given before a person's first sexual contact, when he or she could be exposed to HPV. There are two types of HPV vaccines - one is a bivalent vaccine that protects against HPV types 16 and 18, whilst the other is a quadrivalent vaccine that protects against HPV types 6, 11, 16 and 18. While both vaccines protect against cervical cancer, only the quadrivalent vaccine has additional protection, ie, it also protects against genital warts. The quadrivalent vaccine is also available for males and protects them against most genital warts.

2. Condoms
To be most effective against STDs, condoms should be used during every sexual act, from start to finish. However, while they may lower the risk of developing HPV-related diseases, HPV infection can occur in areas that are not covered by a condom.

3. Being in a faithful relationship with one partner
Limiting your number of sex partners and choosing one with no or few prior sex partners lowers your chance of HPV infection. However, even people with a lifetime-long sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected.

Treating HPV related diseases
Although there is no treatment for the virus, there are treatments for the diseases that HPV can cause:

Visible genital warts can be removed by the patient using topical medications or by surgery. Some patients opt not to treat warts, but to see if they disappear on their own. No one treatment is better than another.

Cervical cancer is most treatable when diagnosed and treated early. However, women who get routine
Pap tests and follow-ups (as needed) can identify problems before cancer develops. Prevention of cancer is always better than treatment.

Other HPV-related cancers Similar to cervical cancer, these cancers are more treatable when diagnosed and treated early.

RRP This condition can be treated with surgery or medicines. It can sometimes take many treatments or surgeries over a period of years.

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