HPV: Human Papilloma Virus
HPV can cause genital warts and lead to cervical cancer. One encounter is all it takes, and generally people who have had 5 sexual partners have been exposed to HPV. The information below has been provided by the IU Health Center.
What is the difference between genital warts and the types of warts that appear on other parts of the body?
All warts are caused by one or another strain of the HPV. Some types of HPV cause genital warts whereas other types cause common skin warts. Genital warts can develop on the cervix, penis, or in the vaginal or rectal area. They look similar to warts that might appear on the hands, feet, or other parts of the body.
Genital warts, like warts on other parts of the body, are dry and painless, firm and rough in texture, and usually grayish or skin color. Warts can be small and difficult to detect, even during a medical examination. Small or flat warts on a man's penis or a woman's cervix are particularly likely to go unnoticed. They may itch slightly or give an irritated feeling.
Untreated, genital warts can grow large and numerous, and perhaps grow together to look like a tiny piece of cauliflower. These growths may block the urethra, rectum or vaginal opening.
Where do genital warts usually develop in women?
Genital wart infection most commonly develops near the opening or on the lips of the vagina and near the anus. Genital warts may also be found inside the vagina or on the cervix. Genial warts often develop in several areas at the same time. Research has found that the cervix is involved in about half of the cases of genital warts in women.
Where do genital warts usually develop in men?
Genital wart infection in men most commonly occurs on the penis, but it may also involve the urethra or bladder. Infection of the urethra may cause bleeding, a discharge, and the need to urinate frequently. Genital warts can also develop on or near the anus, or within the rectum. Infection often occurs in more than one genital area at a time.
How does a person develop HPV?
The strains of HPV which cause genital warts are generally spread through sexual intimacy. Transmission can occur through all forms of sexual contact including vaginal, oral or anal intercourse. There is currently some indication that HPV may be spread also by sharing damp unwashed intimate articles such as washcloths, towels or underwear. While using a condom may reduce the risk of HPV transmission, it cannot prevent transmission. This is because HPV is transmitted from skin to skin, and a condom can't possibly cover the entire genital skin area.
Can a person have a genital wart virus infection and not know it?
Yes. In fact, recent research suggests that many HPV infections may be completely asymptomatic, that is, they never cause recognizable warts. HPV may be only microscopically visible on the cervix. However, such asymptomatic persons probably can infect their sex partners and may develop complications, such as cervical cancer. HPV can often be identified with a Pap smear and other specialized tests.
Does HPV pose serious health risks?
All genital warts can be treated and HPV on the cervix closely followed. The most serious consequence is the possible development of cervical cancer or vulvar in women; penile cancer in men; and anal cancer in either women or men.
There are more than 100 known strains of HPV and only a few of these are strongly linked to the development of these cancers.
Specifically, an abnormal cellular condition known as dysplasia may occur among women with HPV of the cervix. This condition may pose a risk for subsequent development of cervical cancer. Treatment of genital warts will not cure HPV but will lessen the amount of virus present. Untreated genital warts may simply disappear over time. But even if HPV infection seems to resolve itself, there is a risk of recurrence. Diagnosis, treatment if indicated and follow-up are essential. Women with HPV often are advised to have Pap tests done more often than usual and should seek recommendations from their doctors. While all women should perform monthly vulvar self-examination, women with HPV should do so, in particular, due to their slightly increased risk of developing vulvar precancer (VIN) or vulvar cancer. Individuals with HPV should also know that smoking increases their risk for these cancers.
How are genital warts and HPV diagnosed?
A health professional can often diagnose genital warts by simple observation. But the fairly common small or flat warts can pass unnoticed by the provider or patient particularly because genital warts often do not have symptoms of pain or irritation. For many women, the first indication of HPV may be an abnormal Pap smear. For many men, the first clue to HPV infection might be a bump that itches, and unusual discharge or the need to urinate often or with difficulty. Accurate diagnosis might require a colposcopy examination. This is a painless procedure in which a colposcope (a lighted magnifying device) is used to clearly identify the area(s) of infection. This diagnostic method is used for women and sometimes men. One diagnostic difficulty with HPV infection is that genital warts may be confused with other sexually transmitted infections, especially syphilis. Therefore, clinicians may also recommend tests for other STIs, such as chlamydia, gonorrhea, or syphilis. Another reason for several tests is that sexually active people often have more than one STI at a time. In addition, researchers have learned that genital warts might increase the risk of acquiring or transmitting HIV. Therefore it is frequently recommended that an HIV antibody test be done as well.
How are genital warts treated?
There are several treatment methods. The severity of infection, the location of the warts, and other factors will influence the decision about which treatment might be best for a patient.
Genital warts can be chemically burned or frozen with liquid nitrogen or cryosurgery. Although these techniques for freezing the infection are effective, they can cause a temporarily annoying blistering of tissue. Some cases of genital wart infection are treated by applying caustic chemicals to the infected area. More than one application is usually needed. Laser treatment might be recommended for recurrent warts that have been resistant to other treatment methods. Most of these treatments must be repeated several times, sometimes over several months. All methods of treatment have high failure rates. Therefore, reexaminations sometimes are recommended, even after the warts seem to go away. Genital warts cannot be effectively treated with any over-the-counter preparations.
How can someone reduce the risk of acquiring HPV?
HPV infection is highly contagious. The use of safer sex guidelines will reduce the risk of transmission and acquisition. Limit the number of sexual partners, preferably to one monogamous relationship. Discuss STIs with a possible new sexual partner before you embark on an intimate relationship.
If you or your new partner have active genital warts or any other STI avoid intercourse until you have discussed this with a health care provider.
To reduce the risk of recurrence or further spread of HPV infection, the sexual partner(s) of anyone with genital warts should also be examined and treated if necessary. It is best to avoid direct sexual contact during treatment and to use a condom or latex square (dental dam) if contact cannot be avoided.When intercourse is resumed, condoms should be used for safer sex. Though condom use cannot prevent risk of transmission, they can help reduce the risk.
In considering what's best for you, the following resources may be helpful:
National Sexually Transmitted Disease Hotline
1-800-227-8922
Monday - Friday; 8:00 AM - 11:00 PM (Eastern)
American Social Health Assocation/HPV
http://www.ashastd.org/hpv/hpv_overview.cfm
1-800-783-9877
P.O. Box 13827
Research Triangle Park, NC 27709
ASHA issues the following publications that may also be useful:
HPV News (bimonthly newsletter)
A Patient Guide: HPV in Perspective
Managing Herpes: How to Live with a Chronic STD
These publications can be purchased througth the ASHA online store here.
