Human papiloma infection
Dr. Faozat Aragbaye
Human papilomavirus infection (HPV) is a viral infection that is passed between people through skin-to-skin contact. There are over 100 varieties of HPV, more than 40 of which are passed through sexual contact and can affect the genitals, mouth, or throat.
It is so common that most sexually active people will get some variety of it at some point, even if they have few sexual partners.
Some cases of genital HPV infection may not cause any health problems. However some types of HPV can lead to the development of genital warts and even cancers of the cervix, anus, penis, vagina and throat.
HPV is a virus that is passed skin-to-skin through sexual intercourse or other forms of skin-to-skin contact of the genitals.
While most HPV infections are benign, causing warts on areas of the body including the hands, feet, and genitals, there are certain strains that put a person at a higher risk of developing cancers.
Although most HPV infections resolve themselves, sometimes they can remain dormant and later infect a new or existing sexual partner.
HPV can be transmitted to the infant during birth; this can cause a genital or respiratory system infection.
It is important to note that the strains of HPV that cause warts are different from the group of HPV strains that cause cancer.
Some factors increase the risk of contracting the HPV virus. These include:
- Having a higher number of intimate partners
- Having sex with someone who has had several intimate partners.
- Having a weakened immune system, for example, due to HIV or after having organ transplant
- Having areas of damaged skin
- Having personal contact with warts surfaces where HPV exposure has occurred.
HPV may not cause symptoms at once, but they can appear years later. Some types can lead to warts, while others can cause cancer.
- Warts: Common symptoms of some types of HPV are warts, especially genital warts. Genital warts may appear as a small bump, cluster of bumps, or stem-like protrusions. They commonly affect the vulva in women, or possibly cervix, and penis or scrotum in men. They may also appear around the anus and in the groin. They can range in size and appearance and be large, small, flat, or cauliflower shaped, and may be white or flesh tone.
Other warts associated with HPV include common warts, plantar and flat warts.
- Cancer: Other types of HPV can increase the risk of developing cancer. These cancers include cancer of the cervix, vulva, vagina, penis, anus, and oropharynx, or base of the tongue and tonsils. It may take years or decades for cancer to develop.
If warts or lesions are visible, a diagnosis of HPV can be made during a visual inspection.
Tests to evaluate for HPV or HPV-related cervical cellular changes include:
Pap smear- a test that collects cells from the surface of the cervix or the vagina and reveal any cellular abnormalities that may lead to cancer.
DNA test can be used to evaluate the high-risk types of HPV, and is recommended for women 30 and older in conjunction with a Pap smear.
DNA test for HPV can be used alone without the need for concurrent Pap smear test.
Currently, there is no test available for men to check for HPV, diagnosis is made primarily on visual inspection. In certain situations, if men or women have a history of receptive anal sex, anal Pap test can be done.
Different types of HPV will have different symptoms. HPV viruses can lead to genital warts and cancer.
There is no treatment for the virus, but the symptoms can be treated.
Warts that result from HPV will often resolve without treatment. However, there are medications that can be applied to the skin to remove the wart itself; these include over-the –counter (OTC) salicylic acid for common warts. There are other prescription medications that can be applied by the doctor.
In certain situations, surgical interventions may be necessary and include:
- Laser therapy
- Interferon injection
- Surgical removal
It is important to note that, although warts and cellular changes may be removed or resolved, the virus can remain in the body and can be passed to others.
Cancer- routine Pap tests and other types of screening can provide early diagnosis, if cancer develops. Measures can be taken to treat cancer and prevent it from developing.
Measures that can reduce the risk of contacting HPV include:
- HPV vaccination.
- practicing safe sex.
- practicing abstinence or being in a monogamous sexual relationship.
- not having sex while there are visible genital warts.
Vaccination- HPV vaccination is recommended at the age of 11 to 12 years to reduce the risk of cervical cancer and other cancer developing in future.
Catch up vaccines are recommended for males up to the age of 21 and females up to age 26 who did not receive the vaccination at a younger age.
People between the ages 27 and 45 years who have not had the vaccination in the past are now eligible for vaccination with Gardasil 9.
The vaccine is given in two doses, 6 to 12 months apart.