HPV (Human Papilloma Virus)
What is human papillpoma virus (HPV)?
HPV stands for human papilloma virus. It is a very common virus. There are about 100 types of HPV that affect different parts of the body. About 30 types of HPV can affect the genitals — including the vulva, vagina, cervix, penis and scrotum — as well as the rectum and anus. Of those, about 14 types are considered "high risk," for leading to cervical cancer.
Male pelvic anatomy
How common is HPV?
HPV that affects the genitals is very common. Approximately 79 million Americans are currently infected with HPV, with roughly 14 million people becoming newly infected each year. Most men and women — about 80 percent of sexually active people — are infected with HPV at some point in their lives, but most people never know they have the virus.
Can men get HPV?
Yes. In men, genital warts most often appear on the penis, on the scrotum, in or around the anus, or on the groin. For men, HPV infection — including those that can cause cellular changes — cause no symptoms, so diagnosing HPV in men is difficult. The diagnosis of HPV in men is made when external genital warts are seen.
Since there is no treatment for HPV that has no symptoms, most men with the infection are not treated. Sometimes, a healthcare provider can see small warts that might have otherwise gone unnoticed. In general, HPV infection does not place a man at a much higher risk for health problems. However, HPV prevention is still important for men, as the virus has been linked to uncommon cancers such as penile, anal, and head and neck.
How is HPV related to cervical cancer?
Certain strains of HPV can cause changes in the cells of the cervix, a condition called cervical dysplasia. If it is not treated, dysplasia can advance to cervical cancer. HPV is almost always the cause of cervical cancer. However, just because a woman has HPV or cervical dysplasia does not necessarily mean she will get cervical cancer.
Regular Pap tests are the best protection against cervical cancer. The test detects pre-cancerous changes and cervical cancer. Cervical cancer is almost always preventable or cured if pre-cancerous changes are detected and treated early, before cancer develops.
Before age 30, HPV infection is usually transient (gets better on its own). By age 30, finding HPV during Pap screening can help determine how often to be screened. The absence of high-risk HPV types usually means that a woman is at low risk for developing cervical changes related to the risk of cervical cancer. In this case, the period between Pap test screenings is usually five years for most women.
If a woman tests positive for high-risk HPV types, her healthcare provider will perform more frequent Pap tests to check for any cell changes that might be pre-cancerous or that need to be treated .
What is cervical cancer?
Cervical cancer is a condition in which the cells in the lining of the cervix — the narrow, outer end of the uterus — change and grow very fast, producing a grouping of cells called a tumor. This condition usually develops over time. It can affect women of any age, but it is most common in women in their mid-40s. A type of virus, called HPV, is the cause of most cases of cervical cancer.
Symptoms and Causes
How do you get human papilloma virus (HPV)?
Genital HPV is spread through contact with (touching) the skin of someone who has an HPV infection. Contact includes vaginal, anal, and oral sex. Some types of HPV cause genital warts, which are hard, rough lumps that grow on the skin. Anyone who is sexually active can get HPV and genital warts.
In women, genital warts most often appear in the following areas of the body:
- On the vulva (the outer female genital area)
- In or around the vagina
- In or around the anus
- On the groin (where the genital area meets the inner thigh)
- On the cervix
What are the symptoms of HPV?
In many cases, HPV causes no symptoms. When they do occur, the most common symptom is warts in the genital area. Signs of infection can appear weeks, months, or even years after the person has been infected with the virus.
Diagnosis and Tests
How is human papilloma virus (HPV) diagnosed?
There are no blood tests for HPV, but some tests can help your healthcare provider diagnose the infection:
- Pap test: During this test, the healthcare provider removes a sample of cells from the cervix. The cells are then examined under a microscope to look for any changes in the cells, even if the patient does not have genital warts.
- Colposcopy: For this test, a healthcare provider uses an instrument — called a colposcope — that shines a light and enlarges the view of the cervix. A vinegar solution is placed on the cervix. The solution turns abnormal cells that are infected with HPV white, so they can be seen more easily.
- HPV DNA test: This test looks directly for the genetic material (DNA) of the HPV within a sample of cells. The test can detect the type of HPV connected to cervical cancer. The sample used for this test is generally collected at the same time as a Pap test.
Management and Treatment
How is human papilloma virus (HPV) treated?
There is no cure for the virus itself, but many HPV infections go away on their own. In fact, about 70 to 90 percent of cases of HPV infection are cleared from the body by the immune system.
When treatment is needed, the goal is to relieve symptoms by removing any visible warts and abnormal cells in the cervix. Treatments might include:
- Cryosurgery: Freezing the warts off with liquid nitrogen.
- Loop electrosurgical excision procedure (LEEP): Using a special wire loop to remove the abnormal cells.
- Electrocautery: Burning the warts off with an electrical current.
- Laser therapy: Using an intense light to destroy the warts and any abnormal cells.
- Prescription cream: Applying medicated cream directly to the warts. (Do not use over-the-counter wart treatments on the genital area.)
In some cases, no treatment is needed. However, your doctor will closely watch any cell changes during your regular screening appointments.
Only a small number of women infected with HPV will develop cellular changes that need to be treated.
Can human papilloma virus (HPV) be prevented?
Using condoms correctly every time you have sex can help reduce the risk of HPV. You should be aware, however, that condoms do not cover all of the genital skin, so they are not 100 percent effective in protecting against the spread of HPV. A person with genital warts should not have sex until the warts are removed. This might help reduce the risk of spreading HPV.
Here are some other ways of reducing the risk of HPV:
- Women should have regular Pap tests to look for abnormal changes in the cervix that might be pre-cancer.
- Men and women should stop having sexual contact as soon as they know or think they have genital warts, and they should seek treatment immediately.
- Get vaccinated with one of the three available HPV vaccines. Gardasil® and Gardasil9® protect against the development of cervical cancer and genital warts. They are approved for girls and women ages 9 to 26, as well as for boys and men ages 9 to 26 to protect against genital warts. The third vaccine, called Cervarix®, is approved for women only to protect against cervical cancer (does not protect against several of the HPV strains that cause warts).
It is best to get the vaccine before the start of sexual activity. The vaccine consists of a series of three shots, with the second shot coming two months after the first, and the third coming six months after the first. If you already have HPV, the vaccine does not treat or cure, but can still help protect against other types of HPV infections.
Glossary of terms
- Cervical dysplasia: A pre-cancerous condition that occurs when the human papilloma virus (HPV) leads to changes in the cells of the cervix
- Cervix: The tip of the uterus, where the vagina meets the uterus
- Genital warts: Hard, rough lumps that develop on the skin
- Groin: Where the genital area meets the inner thigh
- Vulva: The outer female genital area