Spotlight on HPV

There has been a huge spotlight on a disease called the Human Papilloma Virus, or HPV. You see it in commercials for new vaccinations and on the news. But one question seems to remain for many people still. What is HPV?

HPV has been commonly mistaken for an STD, when in fact it is an STI (Sexually Transmitted Infection). More than 100 types of HPV exist and about 30 of them are contracted through sexual contact and are classified as high or low risks. Some types of HPV cause genital warts-single or multiple bumps that appear in the genital areas of men and women including the vagina, cervix, vulva (area outside of the vagina), penis, and rectum. These are considered low risk types. High-risk types of HPV may cause abnormal Pap smear results and could lead to cancers of the cervix, vulva, vagina, anus, or penis. Many people infected with HPV have no symptoms. Some types of HPV cause common skin warts, such as those found on the hands and soles of the feet. These types of HPV do not cause genital warts.

You can easily contract the disease by having multiple partners. Genital warts are very contagious. You can get them during vaginal, anal, or oral sex with an infected partner. You can also get them by skin to skin contact during vaginal, anal, or (rarely) oral sex. About two thirds of people who have sexual contact with another person with genital warts will get infected, usually showing signs in about three months. In women, the warts become visible on the outside and inside of the vagina, on the cervix, or around the anus. In men, genital warts are less common, but they can show up on the tip of the penis, on the shaft of the penis, on the scrotum, or around the anus. Rarely, warts can appear in a person's mouth if they had oral sex with an infected person. However, more than half of women that have HPV have no obvious signs or symptoms. HPV can still be passed on to your partner without any signs or symptoms.

There are no proven methods to test for HPV in men, other than noticing the obvious signs. For women, usually it is discovered in an abnormal Pap smear, a primary tool for cancer screening and finding pre-cancerous changes of the cervix. A health care provider will examine for genital warts by simply looking at them. Another testing method to check for otherwise unseen warts on the skin is for a health care provider to apply vinegar to areas on the body. The vinegar will whiten the areas on the skin that are infected.

There are several ways to treat genital warts. They can go away on their own or sometimes they are residual. A doctor might suggest some of these treatments:
- Imiquimod cream
- 20 percent podophyllin antimitotic solution
- 0.5 percent podofilox solution
- 5 percent 5-fluorouracil cream
- Trichloroacetic acid (TCA)

If you are pregnant, you should not use podophyllin or podofilox because they are absorbed by your skin and may cause birth defects in your baby. In addition, you should not use 5-fluorouracil cream if you are pregnant.

If you have small warts, your health care provider can remove them by one of three methods.

- Freezing (cryosurgery)
- Burning (electrocautery)
- Laser treatment

If you have large warts that have not responded to other treatment, you may have to have surgery to remove them.

Some health care providers inject the antiviral drug alpha interferon directly into warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return.
Although treatments can get rid of the warts, none get rid of the virus. Because the virus is still present in your body, warts often come back after treatment.

Some strains of HPV can cause cervical cancer in women. Another testing procedure besides the Pap smear is called a colposcopy. A colposcopy is ordered when a woman receives an abnormal Pap smear result. The colposcopy allows further testing of any lesions (pre-cancerous cells) in the cervix. A biopsy may be done on these cells. However, most types of HPV do not lead to cervical cancer.

If a person leads a healthy lifestyle and is a non-smoker, their immune system can fight off the virus within 1-2 years. Historically, research studies have not confirmed that male latex condoms prevent transmission of HPV. Recent studies, however, demonstrate that consistent condom use by male partners suggests strong protection against low and high-risk types of HPV infection in women. Unfortunately, many people who don't have symptoms don't know that they can spread the virus to an uninfected partner.

Scientists are doing research on HPV vaccines. These vaccines are made of proteins like the ones found in human papilloma virus. In June 2006, the Food and Drug Administration approved Gardasil; the first vaccine developed to prevent cervical cancer, pre-cancerous genital lesions, and genital warts due to HPV. Gardasil is a vaccine that prevents infection with four HPV types: 6, 11, 16, and 18. Types 6 and 11 are low risk HPV types, associated with 90 percent of genital warts. Types 16 and 18 are high-risk HPV types which together cause 70 percent of the cases of cervical cancer.

Many people are embarrassed to learn that they have an STI like HPV. Little did they know that it is very common for all, and in most cases very treatable.