Human Papillomavirus & Condylomata Acuminata: HPV & Genital Warts

According to the National Institute of Allergies & Infectious Diseases, Human Papillomavirus is among the most common causes of sexually transmitted infections in the world.(1) In the United States, it is estimated that there are more cases of genital human papillomavirus infections than any other sexually transmitted diseases; indeed, according to the Centers for Disease Control, approximately 20 million people are currently infected and at least 50% of sexually active men and women acquire a genital HPV infection at some point in their lives. The CDC estimates that by age 50, at least 80% of women will have acquired a genital HPV infection, and about 6.2 million Americans get a new genital HPV infection each year.(2)

There are more than 100 different strains of HPV, as it is commonly referred to, most of which are harmless. However, an estimated 30 types of HPV are spread through sexual contact; some of which can cause genital warts.(3) Also called condylomata acuminata or venereal warts, genital warts typically appear in "clusters" of bumps. The warts can appear either as raised or flat and range in size from small to large. Common locations for the warts in women include the vulva, cervix, and inside and surrounding the vagina and anus. Genital warts typically appear on the scrotum or penis in men who are affected. The warts are highly contagious and can easily be spread during vaginal or anal sex with an infected partner. Rarely, genital warts also can develop in the mouth or throat after having oral sex with an infected partner. Genital HPV infections often do not have any symptoms; however, even without obvious symptoms, HPV can still be spread from partner to partner.

Warts are usually diagnosed, even in absence of symptoms, by sight. Gynecologists can confirm the diagnosis in suspected cases by applying acetic acid (vinegar) to the infected areas, causing the areas to whiten and making the warts more visible. Abnormal Pap Smears can also result in the presence of a cervical HPV infection.

There is no cure for HPV. There are, however, treatments for the warts, including topical agents such as Imiquimod, Podophyllin Antimitotic solution, Podofilox, Fluorouracil cream and Trichloroacetic acid. Genital warts can also be removed surgically through cryosurgery, which freezes them, electrocautery, which burns them, or laser. As there is no cure for human papillomavirus, the warts may come back even after definitive treatment.

HPV is more than just an STD. Some forms of the virus can actually can cause cancers of the cervix, vulva, anus, and penis.(4) Genital warts can also cause problems during pregnancy, ranging from vaginal obstruction to the development of warts in the throat of the infant (laryngeal papillomatosis).(5) Early diagnosis and intervention in a patient with genital warts are crucial for successful treatment.

According to the University of Iowa Department of Obstetrics & Gynecology, there are three ways to decrease exposure to HPV and other sexually transmitted diseases: use of condoms, which can lower the risks of exposure; monogamous relationships; and complete abstinence.(6) The University is currently conducting important research towards a possible vaccine through their study on HPV types 6, 11, 16, and 18. For more information or to participate, please see http://obgyn.uihc.uiowa.edu/FutureII.htm.

References:

1, 3, 4, 5 - "Human Papillomavirus and Genital Warts." NIAID Fact Sheet. Online, http://www.niaid.nih.gov/factsheets/stdhpv.htm
2 - "Genital HPV Infection." Center for Disease Control & Prevention Fact Sheet. Online, http://www.cdc.gov/std/HPV/STDFact-HPV.htm.
6 - "Human Papilloma Virus." University of Iowa Department of Obstetrics & Gynecology Fact Sheet. Online, http://obgyn.uihc.uiowa.edu/Patinfo/Adhealth/hpv.htm