HPV (Human Papilloma Virus)

HPV (Human Papilloma Virus): Overview

There are more than 60 viral strains lumped together under the term Human Papilloma Virus (HPV).  These viruses can cause warts anywhere on the human body.  The HPV types that attack the genital tract are sexually transmitted; HPV is currently the most common sexually transmitted virus in the United States with a 1000% increase in HPV patients between 1987 and 2002.

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Venereal warts (also known as genital warts or condylomata) are the "clinical" form of this infection because they can be easily seen and diagnosed.  Venereal warts look like a fleshy bump of tissue on the labia, clitoris, or around the anus.  The "sub-clinical" version is more common, and resides under the skin and cannot be seen.  The sub-clinical varieties have been linked to cancers of the genital tract so it is important for sexually active women to have yearly Pap tests to detect pre-cancerous changes.

Incidence; Contributing Risk Factors

Because it is a non-reportable disease, the actual number of patients infected with HPV is unknown.  As at the time of writing (2002), it is believed more than 50 million Americans are currently infected with the virus, with the number growing by a million every year.

You are at risk for HPV if you have had sex with more than one partner, or have had sex with a person who has had more than one partner.

Signs and Symptoms

Whether there are symptoms depends on the strain of HPV present.  If there are warts, you will notice a raised, fleshy area.  If left untreated, the wart may disappear or it may grow and merge with other warts to take on a cauliflower-like appearance.  Some people complain of burning or itching and occasionally a wart may bleed if irritated.  You may see warts appear from one to eight months after exposure, or they may appear many months or years later.  It may be difficult or impossible for you to determine when you were exposed.

Diagnosis and Tests

Evidence of a sub-clinical infection may first show up on a Pap test.  Your test may show HPV changes or dysplasia (pre-cancerous cells).  HPV infection on the cervix usually has no symptoms at all.

HPV cannot be grown in a lab and there is no blood test for it.  Diagnosis of warts is usually made visually.  If a suspected wart is flat and difficult to see, your doctor may look at the area with a Colposcope (a binocular-like instrument).  Warts or HPV infection on the cervix is suggested on a Pap test.  Definitive diagnosis is usually made with a colposcopic exam and biopsies.

There is a test available that can identify HPV DNA called the Virapap.  This test will only indicate whether you are shedding the HPV virus when the test is performed; a negative result does not necessarily mean you have not come into contact with the virus.  If your doctor is going to request the HPV test, the cells collected for a Pap smear will be used for the test.

Women can find more useful information here: theHPVtest.com.  They write, "The HPV test Web site offers comprehensive information about HPV, the HPV test and cervical cancer.  In addition, the site provides important information regarding who should be tested for HPV, how to get the HPV test and understand the test results, what insurance covers, and stories from real women who have had experience with cervical cancer and HPV."

Treatment and Prevention

Once you have the virus it will always be present in your body, but it can be controlled.  Visible warts can be treated as they appear so you may have to return to your doctor for repeat treatments.  It is important to note, however, that the majority of HPV infections go away on their own and do not cause any abnormal growths.

There are several compounds on the market for the topical treatment of venereal warts.

By testing for the presence of the virus, the early detection of cervical disease is improved with the consequent saving of lives.  Early detection of HPV is an important part of cervical cancer prevention.  Apart from HPV testing, borderline Pap smears can be more accurately evaluated with PAPNET, an FDA approved computer assisted test which helps the pathologist more accurately interpret the Pap smear slide.

Complications

Studies suggest that HPVs may play a role in cancers of the anus, vulva, vagina and penis, and some cancers of the oropharynx.

Some types of HPVs are referred to as "low-risk" viruses because they rarely develop into cancer; these include HPV-6 and HPV-11.  HPV viruses that can lead to the development of cancer are referred to as "high-risk".  Both high-risk and low-risk HPVs can cause the growth of abnormal cells, but generally only the high-risk types may lead to cancer.  Sexually-transmitted, high-risk HPVs have been linked with cancer in both men and women; they include HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 and 69.  These high-risk HPVs cause growths that are usually flat and nearly invisible when compared with the warts caused by HPV-6 and HPV-11.

On This Page

Human Papilloma Virus:

Conditions that suggest HPV (Human Papilloma Virus):

Symptoms - Reproductive - General

Symptoms - Reproductive - STDs

Tumors, Malignant

Cervical Cancer

HPV confers a very high risk of developing cervical cancer; all cases of cervical cancer are positive for HPV.  Cervical cancer is the first major solid tumor cancer to be identified as being caused by a virus.

Rectal Cancer

Most anal cancers are associated with human papillomavirus (HPV), which causes warts on the anus and genitals, similar to cervical and other cancers of the reproductive system.

Uro-Genital

Vulvodynia / Vestibulitis

Whether there is an association between vestibulitis and HPV infection is still being debated.

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Recommendations for HPV (Human Papilloma Virus):

Lab Tests/Rule-Outs

Bacteria / Pathogen Testing by PCR

A Herpes/Papilloma Virus Panel (Blood and Swab) can test for the presence of Epstein-Barr Virus (EBV), Cytomegalorvirus (CMV), Herpes Simplex Viruses (HSV 1 and HSV 2 combined), Human Herpes Virus-6 (HHV-6) and Human Papilloma Viruses (HPV 6, 11, 16, 18).

Preventive measures against HPV (Human Papilloma Virus):

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