HPV 101: Simple Answers to Basic Questions

HPV stands for Human Papillomavirus. Although we normally speak of the HPV "virus", the plural form "viruses" would be more accurate: There are over 100 types (strains) of this virus. Therefore HPV stands for a group of viruses, the Human Papillomaviruses.

2) Do all types of HPV cause genital warts?

No. Approximately 1/3 of HPV types (over 30 types total) are sexually transmitted and cause genital infections. This is genital HPV, the most common sexually transmitted disease (STD). Other HPV types cause, for example, plantar warts (on the soles of the feet) or warts on the hand, fingers, or face. These types are not genital HPV.

3) Are all types of genital HPV equally dangerous?

No. Genital HPVs are divided into low-risk and high-risk types. The terms "low-risk" and "high-risk" refer to the likelihood of cervical dysplasia (i.e. pre-cancer) and/or cancer. Generally, low-risk HPVs can cause mild Pap test abnormalities and genital warts. High-risk HPVs can cause precancerous cell changes or even cancer.

Five HPV types (6, 11, 42, 43, and 44) are low-risk. Thirteen HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) are high-risk. Of these, low-risk HPV types 6 and 11 are responsible for 90% of genital warts cases, and high-risk types 16 and 18 are responsible for 70% of cervical cancer cases.

Women without infection by high-risk HPV types rarely develop precancerous lesions or cancer of the cervix.

4) If I have high-risk HPV, does it mean I will get cervical cancer?

No. It means you are at higher risk for cervical cancer and you need to be monitored closely with regular Pap tests and/or colposcopies, as your physician advises. The risk factor here is not just the HPV infection, but persistent HPV infection. About 10% of women infected with HPV will develop persistent infections, i.e. infections that will not clear away on their own.

5) Is HPV the only risk factor for cervical cancer?

Absolutely not. Although HPV infection is considered as the most important risk factor, there are several other factors that increase your risk of cervical cancer. These include smoking, multiple sexual partners, diet low in fruits and vegetables, long-term use of oral contraceptives, chlamydia infection, and exposure to DES (diethylstilbestrol, a synthetic form of estrogen) in utero.

6) How is genital HPV transmitted?

By skin-to-skin and genital (vaginal, anal, oral) contact. Using protection (latex condoms) during sex will reduce the risk of transmission, but infection will still be possible through contact of unprotected skin areas.

7) What are the symptoms of genital HPV infection?

In many cases there are no signs or symptoms, which is a reason why this infection is so common: Many people are not aware that they have it, but they are infectious all the same and pass it along to their sexual partners.

Your physician may diagnose HPV infection through visual inspection during the gynecological exam or by a Pap test. A more specific test, the HPV DNA test, detects viral DNA in cervical cells. This test is usually prescribed after an ASCUS (atypical cells) Pap test result. A colposcopic examination and biopsy can also reveal cell changes indicative of HPV infection (e.g. koilocytosis, a cell change that is considered the HPV calling-card).

8) Is there a cure for HPV?

No. There are treatments for conditions caused by HPV, e.g. genital warts (medications, surgical procedures) and dysplasia (surgical procedures: cryosurgery, LEEP, laser treatment, ), but no cure for the HPV infection itself.

9) Isn't the HPV vaccine a cure for the virus?

No. The vaccine (Gardasil �) protects against infection against four HPV types, the low-risk types 6 and 11 and the high-risk types 16 and 18, provided you have not been infected with any of these types. The vaccine has no therapeutic impact on pre-existing infections, i.e. if you have been infected with one of these four types, it will protect you against the other three.

10) Are regular Pap tests necessary?

Absolutely. Early detection remains our most powerful weapon against the effects of HPV infection.