Sexually Transmitted Diseases

Human Papillomavirus (HPV) – Learn The Risks, Available Treatments & HPV Prevention Steps

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HPV is among the most common sexually transmitted diseases (std’s) worldwide. Many types of HPV have been identified, with some leading to cancer and others to skin lesions (e.g. an0-genital warts).

Fortunately, two vaccines are now available to help prevent infection with some types of HPV and offer protection against HPV types that are responsible for 70% of cervical cancers.

Papillomavirus Background

The different types of HPV can lead to different health outcomes.  Some types can infect areas as the hands and feet while other types target the ano-genital area, and are transmitted during vaginal, oral or anal sex or during intimate skin to skin contact with someone who is infected.  It is possible to be infected by more than one  HPV at a time.

It is estimated that as many as 75% of sexually active men and women will have at least one HPV infection in their lifetime but many people with healthy immune systems will eventually clear the infection from their bodies.  Of those infected, only a small proportion will potentially gone on to develop cancer.

A cure for HPV infections does not exsist but many symptoms (e.g. warts) are treatable.  Although some infections persist with recurring symptoms, practicing safer sex by using condoms and reducing the number of partners you have can help reduce your chances of getting an HPV infection or another STD.

There is no precise way to determine in which people HPV infections will persist and lead to cancer but for women, routine Pap testing is an important screening tool for cervical cancer and allows early stage treatment with complete cure.

There is no equivalent of Pap testing in males.  Penile cancer is rare in occurs in less than 1% of all male cancers.  Ano-genital warts are more frequent.

Symptoms of HPV

Ano-genital warts (also called condylomata) are one symptom of HPV infection.  They may look like a small cauliflower or may be flat.  Many people with HPV will have no obvious signs of infection because the warts may be inside your body or of on the skin, too small to be see.

In women, warts may appear on the vulva, thigh, anus, rectum or in the vagina or urethra with the cervix being a common HPV site.  During pregnancy, the number and size of warts can increase, but usually decrease after delivery.

With  an active infection, the cells appear normal under a microscope during a Pap test and the woman may never know she was infected. With an active infection, the cervical cells undergo a change.  An active infection can follow one of two courses:

  • The abnormal cells become normal again and the infection is inactive or cleared from your body by your immune system.  However, it is possible that an inactive infection can become active again, for reasons that aren’t clearly understood.
  • The abnormal cells slowly progress to cervical cancer.

In men, the warts may appear on the penis, scrotum, thigh, anus, rectum or in the urethra.

How To Test For Infection

HPV testing is available but access varies across the country and is not part of a woman’s regular check-up or Pap test.

If not covered by your insurance, you may have to pay for HPV testing but where recommended and available, Pap tests are currently used to decide if a woman is at risk of developing pre-cancerous changes in the cervix thereby allowing these changes to be treated or closely followed and reduce the chances of developing cancer.

In men, HPV testing is currently under study but once the malignat lesion has developed, complete surgical removal is the only treatment.

The Health Risks of HPV

HPV causes almost all cervical cancers but is also linked to cancer of the throat, oral cavity, penis, anus, vagina or vulva.  More research is needed to define the extent of these linkages.

Ano-genital warts, although rarely associated with cancer, are still a significant burden for those affected often leading to physical, emotional or social problems.  They can be effectively treated by applying prescribed medication either in the doctor’s office or by you at home.

Other medical treatments include cyrotherapy (cold), an electric current, a laser or surgical removal of the warts but these methods do not always eliminate HPV infection.  Even with treatment, warts can recur.

HPV does not appear to affect a woman’s ability to become pregnant but it’s effect on the baby is uncertain.  Although considered rare, the baby may be at risk of getting an HPV infection in the throat.  A  C-section delivery is not routinely recommended, unless there is a significant obstruction or other risks.

Protecting Against HPV through Immunization

There are two popular vaccines to prevent infections from the most common types of HPV, Gardisil (for females and males) and Cervarix (for females only).  Both vaccines appear to be very effective in preventing HPV infection and changes in the cells of the cervix related to these types of HPV.

Studies have found that both Gardasil and Cervarix to be safe.  Other than a brief soreness at the injection site, participants reported few side effects.  Because vaccines contain only particles from part of the virus, infection from the vaccine is not possible.

Also, the vaccines do not contain any preservative or antibiotics, including thimerosal or mercury.  It is important to note that Cervaix contains a special new additive (ASO4) which studies have also been shown to be safe.

If you are infected with one of the HPV types in the vaccine, you will still be protected against the other type of HPV not indicated in the authorization.  It is important that vaccinated girls and women continue to have regular Pap tests and practice safe sex.

Neither vaccine has an impact on an exsisting infection or consequences of infection (e.g. ano-genital warts and cancerous or pre-cancerous changes) that you may already have.

Minimizing Your Risk Of Contracting HPV

These measures can help protect you against HPV and its consequences.

  • Anyone who has had sex is at risk for HPV.  Since not all  infections have symptoms or noticeable symptoms, you often cannot tell if you are infected.
  • If you are a woman, see your doctor regularly for a Pap test and/or a HPV DNA test, where recommended and available – even if you have been vaccinated for HPV.
  • Learn about STD’s including their sign, symptoms, consequences and methods of transmission.  Learn about safer sex methods and use them consistently.
  • Make informed decisions about your sexual health.  Talk to your partner(s) about their STD status and the use of protection.  Remember that the previous sexual behaviors of your partner are also a risk to you, especially if they had had multiple partners.
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