The information you need on HPV

EDITOR’S NOTE: Yash Jani, a senior at Deerfield-Windsor School in Albany, spent part of his summer researching health-related issues that he expects to treat one day as a medical doctor.

Human papillomavirus, or HPV, is a virus that can cause skin warts, genital warts, and some forms of cancer. Human papillomavirus is the most common sexually transmitted infection in the United States with more than 200 variations, which can be subdivided into cutaneous or mucosal categories.

Although most infections are asymptomatic and appear to resolve spontaneously within a few years, prevalence of genital infection with any HPV type was 42.5% among United States adults ages 18 to 59 years during 2013-14. Persistent infection with some HPV types can cause cancer and genital warts. HPV types 16 and 18 account for approximately 66% of cervical cancers in the United States, and approximately 25% of low-grade and 50% of high-grade cervical intraepithelial lesions, or dysplasia.

HPV types 6 and 11 are responsible for approximately 90% of genital warts. Some health effects caused by HPV can be prevented by the HPV vaccines.

Human papillomaviruses

Human papillomaviruses (HPVs) are small, non-enveloped, capsid viruses. HPV is the most common sexually transmitted infection. HPV is a different virus than HIV and HSV (herpes).

— STD.gov.org

Spread of HPV

One can get HPV by having vaginal, anal or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if he or she has had sex with only one person. Persons also can develop symptoms years after having sex with someone who is infected. This makes it hard to know when anyone first became infected.

Health problems related to HPV

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A health care provider can usually diagnose warts by looking at the genital area.

Interactions between HIV and HPV

There is a “bidirectional epidemiologic interaction” between HIV and HPV infections.

HPV (the virus): About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually active will get HPV at some time in their life if they don’t get the HPV vaccine. The prevalence of oropharyngeal human papillomavirus (HPV) is generally lower than that of anogenital HPV infection. In a study of 1,626 men ages 18-70 years (88 percent men who have sex with women only) without a prior history of HPV-associated disease and with a median follow-up of 13 months, 4.4 percent acquired an oropharyngeal infection with any HPV type, and 1.7 percent with an oncogenic HPV type.

Cancer and HPV: HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

Ways to Avoid HPV-related complications

♦ Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups;

♦ CDC recommends 11- to 12-year-olds get two doses of HPV vaccine to protect against cancers caused by HPV;

♦ Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer;

If you are sexually active:

♦ Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;

♦ Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

— Cancer.gov

Ways to detect HPV

♦ In the United States, there are no Food and Drug Administration-approved tests clinically available to detect HPV infection of oropharyngeal, anal or male genital specimens. There are also no FDA-approved serological or blood tests to detect HPV infection.

♦ There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older.

♦ HPV tests are not recommended to screen men, adolescents or women under the age of 30 years.

♦ Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening).

HPV-related disease in females

♦ Cervical cancer

♦ Vulvar and vaginal cancer

HPV-related disease in females and males

♦ Non-genital warts

♦ Genital warts

♦ Anal cancer

♦ Oropharyngeal cancer

♦ Recurrent respiratory papillomatosis

♦ Other cutaneous diseases

♦ Bowen’s disease

♦ Epidermodysplasia

♦ verruciformis

Can HPV be prevented?

Yes. For most people between the ages of 9 to 26, the best way to protect against HPV is to get the HPV vaccine.

The vaccine only works if it is given before a person gets infected with HPV.

This is why doctors suggest getting it at a young age. The vaccine is very good at preventing the types of HPV infection that can cause cervical and vaginal cancer in women. It might lower the risk of other types of cancer, too. The vaccine is also very good at preventing the types of HPV that cause genital warts.

Recommendation for Vaccination per the CDC

♦ All boys and girls ages 11 or 12 years should get vaccinated. They should get two doses.

♦ Catch-up vaccines are recommended for boys and men through age 21 and for girls and women through age 26, if they did not get vaccinated when they were younger.

HPV vaccine is also recommended for the following people, if they did not get vaccinated when they were younger:

♦ Young men who have sex with men, including young men who identify as gay or bisexual or who intend to have sex with men through age 26;

♦ Young adults who are transgender through age 26;

♦ Young adults with certain immunocompromising conditions (including HIV) through age 26.

♦ There is emerging evidence that HPV vaccination can protect against oropharyngeal HPV infection.

Special Photo: Yash Jani