Overview and Facts
The human papillomavirus, most commonly known as HPV, is a group of common viruses that can cause warts and lesions on the genitals, hands or feet. With over 100 types of HPV, different types of the virus affect different parts of the body. Most of these types are completely harmless and many who are infected with HPV don’t even know it. But, close to 30 types of HPV can increase the risk of cancer, particularly cervical cancer. Some HPVs are transmitted sexually, and genital HPV is the most common sexually transmitted infection.
Over 20 million Americans are infected with HPV. One out of every two people, including men and women, will be infected with HPV at some point in their lives. HPVs are classified as low-risk and high-risk. Low-risk HPV causes things like genital warts; high-risk HPV can cause cervical, vaginal or vulvar cancer in women and cancer of the anus and penis in men.
Signs and Symptoms
HPV causes normal cells to turn abnormal in the areas of the infection. For some people, HPV produces no symptoms. In fact, in 90% of HPV cases the immune system rids the body of HPV on its own within two years. But in other cases, HPV produces genital warts or cancer.
HPV signs and symptoms:
- Genital warts. These appear as different size and shape bumps near the genital area. Warts can appear in as little as a few weeks after sexual contact with someone infected, or as much as a few months.
- Common warts. These are warts that appear on hands or fingers.
- Cervical cancer. Cervical cancer does not have symptoms in the early stages. However, screening tests can be done to detect early signs of cervical cancer. When signs are detected early, they can be treated before it advances into cancer.
- Other cancers. Similar to cervical cancer, other cancers such as vagina, vulva, penis and anus cancer don’t have visible symptoms until they are much more advanced.
Causes and Diagnosis
HPV is passed from person to person through sexual contact, most often during vaginal and anal sex. It can be passed even if the infected person does not show any symptoms. In addition, a person can have HPV even if it has been many years since the sexual contact with an infected person. Since many cases of HPV don’t yield symptoms, people may never know they have it and may be unknowingly passing it on to other people.
Though anyone can get HPV through sexual contact, some people are a higher risk, including gay and bisexual men and people with weak immune systems.
Since so many HPV cases do not produce symptoms, it is important for women to have regular pap smears, as a pap test is the best way to detect HPV. The American College of Obstetricians and Gynecologists recommend that starting at age 21, a woman get annual pap tests. Once a woman reaches 30, it is ok to get a pap test every three years if tests are normal for three consecutive years.
If a pap test indicates atypical squamous cells of undetermined significance (ACUS), it is considered to be abnormal. Based on this result, a doctor may recommend the HPV test, which is a DNA test that looks for the presence of human papillomavirus in cervical cells. This HPV test is currently only available to women – there is no test to detect the virus in men.
Tests and Treatment Options
While there is no cure for HPV, often times it doesn’t produce any symptoms and usually clears on its own without any health problems. This happens in most cases, and it usually happens within two years of the infection. However, if HPV treatment is required, there are different options available. HPV treatment doesn’t treat the actual virus but rather treats the diseases HPV causes, such as warts or cervical cancer.
When a woman tests positive for HPV, the first step her doctor may recommend might be to just closely monitor the virus. Meaning, a woman may need to have more frequent pap tests so her cervical cells can be analyzed and high-risk HPV can be detected. A doctor could also perform a colposcopy, a device that magnifies the cervix, vulva and vagina for a closer inspection.
When HPV does cause abnormal changes in the cells that could lead to cervical cancer, a doctor may recommend a procedure that removes all the abnormal cells. The following are different types of tests:
- Loop Electrosurgical Excision Procedure. Also called a LEEP, the cells are removed with an harmless electrical current.
- Cryotherapy. Cells are frozen with liquid nitrogen.
- Conization. Abnormal cells are removed in a biopsy-type procedure.
If HPV causes genital warts to appear, there are different wart-removal options available. Just like HPV itself, sometimes genital warts can go away without treatment so it is best to avoid aggressive treatment when warts are still emerging. Some wart-removal techniques include:
- Prescription creams. These either work by destroying the wart tissue or enhancing the immune system so that it can fight off the wart itself.
- Cryotherapy. Warts are frozen off with liquid nitrogen.
- Surgery. Warts are removed with a tool such as a scalpel.
- Electrocautery. Warts are burned off.
Helpful Tips and Home Remedies
With HPV having such a high prevalence, it is important to take steps to protect oneself. Using condoms during sexual intercourse can lower the chances of getting HPV; however, they don’t fully protect because HPV can infect an area not covered by a condom.
There are vaccines that both men and women can get to lower the chances of getting HPV. The vaccines are given in three shots, and for the highest level of protection it is recommended to get all three shots. For women, Cervarix and Gardasil are the two vaccines that protect against different types of HPV and related diseases. These vaccines can be given to girls as young as 9 years old.
For men, Gardasil can be given to protect against genital warts. It can be given as young as age 9 and up to age 26.
Other ways to reduce the chances of getting HPV include limiting the number of sexual partners or being intimate only with people who have had few partners of their own. The only 100% accurate way to avoid HPV is abstinence, or avoiding sexual activity altogether.