Human Papillomavirus or HPV is a virus that affects humans.

It affects the skin in a cell type called Keratinocytes and also affects the mucous membrane.

There are many different subtypes of HPV virus.

Over 120 types have been identified.

HPV is the most sexually transmitted disease in the world

Many types do not cause problems or symptoms.

Certain types can cause cervical cancer, genital warts, and more.

Often this virus is transmitted through sexual activity.

Recently, vaccinations against HPV have been approved.

Gardasil and Cervarix are the names of the vaccinations, which can prevent certain types of HPV including 16 and 18 which cause 70% of cervical cancers.

 

Symptoms/Types of HPV:

  • Types 2,7 –   Common warts
  • Types 1,2,4,63 –   Plantar warts
  • Types 3,8, 10, –   Flat warts
  • Types 6,11,42,44, and others –   Anogenital warts
  • Types 6,16, 18, 31, 53, 58 and others   – Anal lesions
  • Types 16, 18, 31, 45  –   High risk for Genital Cancers
  • Types 33, 35, 39, 51, 52, 56, 58, 59 – Other high risks for Genital Cancers
  • Types 26, 53, 66, 68, 73, 82 –  Probably High risk for Cancer

 

Types of Cancers from HPV

Overall

  • Almost 575,000 new cases of cancer each year are from HPV infections – Worldwide
  • This accounts for more than 5% of all cancers
  • Most new cancers from HPV were found in developing world areas

HPV Cancers

1.)  Cervical Cancer
2.)  Anal Cancer

  • It is being considered if an Anal pap smear should be a screen process in some populations.

3.)  Vaginal Cancer
4.)  Penile Cancer
5.)  Vulvar Cancer
6.)  HPV positive throat Cancer

  •   Previously, the number 1 cause [in the US] of throat cancer was tobacco.
  •   It is believed that HPV will overtake as the largest cause agent.

7.)  Head and Neck Cancer

 

Other HPV related Conditions

1.)  Skin warts

  • HPV can cause warts (verrucae)
  • These are non-cancerous growths on the skin
  • They appear as small bumps, skin growths, blemish, protuberance or lump on the skin.
  • Often found on hands, feet, genital areas, rectal area, or other areas.

Several different types:

1.)  Common Warts

  • Cauliflower like surface that rises above the skin

2.)  Plantar Warts

  • Often on soles of feet
  • Grows inward
  • Often causes pain when walking

3.)  Flat Warts

  • Commonly found on arms, face, and forehead
  • Seen in children and teens

4.) Genital Warts

  • Also called Condylomata acuminate or Venereal warts
  • HPV types 6 and 11 account for approximately 90% of case.
  • Not everyone who comes into contact with these types will develop the genital warts.
  • The virus may be transmitted without obvious symptoms of an infection

 

Mechanism of Transmitting the Virus

1.)  Prenatal

  • Transmission of HPV from mother to child is rare.

2.)  Genital infections

  • Sexual Activity
  • This is the main transmission route
  • Condoms do not completely protect transmission because skin contact, pelvic region, inner thighs and other skin areas.

3.)   Shared objects

4.)   Finger to Genital Contact

5.)   Oral Sexual Activity

6.)   Other

Diagnosis

  • Cervical testing through pap smear is essential.
  • A few lab tests are available when skin samples are given
  • Identification of HPV type with regards to genital warts is not done routinely.

Prevention

Options for prevention include:

  • Abstinence
  • Condoms
  • Vaccinations
  • Microbicides

 

Vaccines

Gardasil – marketed by Merck

Cervarix marketed by GlaxoSmithKline

  • Both protect against HPV types 16 and 18
  • Not recommended for older women
  • Recommended primarily for women not yet exposed to HPV
  • Delivered in 3 shots over six months
  • In most countries, only approved for women
  • Approval for men is increasing in importance.

Condoms

  • The risk is reduced for HPV
  • This is a lesser degree of protection compared to other sexually transmitted diseases.
  • Female Condoms provided somewhat improved protecton

Microbicides

  • Some studies shows that some chemicals may help block HPV
  • Must be applied to genitals just prior to sexual contact
  • Some sexual lubricants may have agents that may help as well.
  • Carrageenan is the gelling agent occasionally used.

Treatment

  • No specific treatment against HPV itself
  • Treatment is often related to area affected.
  • Warts, Cancer, and other problems are treated according to management required.
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