HPV, or Human Papilloma Virus, may well be the STD of the new millennium. The virus has been studied for a relatively short time but already 80 different genotypes have been identified in the US. Approximately 20 to 30 are known to infect the genital area. Even though the viruses are not a reportable disease, it is believed that 75% of reproductive-age adults are infected with one or more types of the virus, with an estimated 5.5 million new cases a year.
The virus was named “Papilloma virus” because they are known to cause warts, or papillomas. The strains of HPV that cause warts on the hands and feet are different from the strains that cause genital warts. Not all the viruses, though, cause warts. Sometimes the virus lives on the skin without showing any symptoms. Many people with HPV are not aware they are infected.
There are strains of HPV that can cause cancers of the vulva or cervix in women, the penis in men or the anus in men and women.
The HPV types that are responsible for genital infections have been divided between “low risk” and “high risk” types, depending upon whether the virus type is associated with genital cancer.
HPV is usually transmitted by sexual contact. The time period between the exposure to the virus and any manifestation of symptoms is unknown. It can be anywhere from several weeks to years making it difficult to know exactly when a person is infected.
Condoms can help avoidance with the virus, but do not prevent it. The only parts of the genitals protected are those covered with latex.
What Are the Symptoms of Human Papilloma Virus?
The HPV types that are associated with genital infection are divided into two types – low risk and high risk, depending upon whether they are associated with genital cancers. Low risk HPV is usually associated with genital warts (also known as condyloma accuminata or venereal warts.) Genital warts are small pink or red bumps on the vulva, vagina, cervix penis shaft, urinary opening or anus. Generally they are painless, but there may be burning or bleeding when irritated. Genital warts tend to occur in clusters. They may grow into a cauliflower-like growth.
High risk HPV has been linked to various cancers in both women and men. Nearly all cases of cervical cancer are caused by a high risk HPV virus. These infections can not be seen with the naked eye.
How Is Human Papilloma Virus Diagnosed?
The diagnosis of genital warts is usually made by a healthcare professional who simply looks at the area. If there is a question the wart may be removed and sent to a pathologist at a lab for diagnosis.
Often HPV infection may first be suspected after an abnormal pap smear. On the basis of the abnormal pap, a colposcopy may be recommended. During this exam, a health care professional will apply acetic acid to the cervix to help identify HPV infection otherwise invisible to the eye. The solution causes “aceto-white patches” which are especially visible with the use of a colposcope. A colposcope is an instrument that looks like binoculars on a stand that is used to inspect the infected area under magnification. A biopsy may be taken to aid in the diagnosis.
There is a test available to detect the HPV DNA. The swab is taken of the vagina or cervix and sent to a laboratory. The test only indicates whether the virus is being shed at the place and during the time the test is performed. A negative test does not necessarily mean exposure to the virus has not taken place. The result of the DNA test indicates whether the viral DNA detected is low risk type or high risk.
What Is the Treatment for Human Papilloma Virus?
As with other viruses, there is no cure for HPV. Genital warts may come and go on their own, or may persist despite aggressive treatment. Treatment of genital warts is easiest when the warts are small and few in numbers.
None of the treatments discussed below will guarantee that the warts won’t return and all treatments cause a local irritation. The goal with treatment of genital warts is to remove visible warts and annoying symptoms.
Treatments that are applied by a health care professional include:
- TCA (trichloracetic acid) is a chemical painted on the surface of the wart to destroy it. The acid may cause some localized burning as it dries. It takes weekly treatments for a number of weeks to get rid of the warts – they should turn white, shrink and disappear.
- Podophyllin is another chemical that can be painted on condyloma. It also causes burning as it dries and should be washed off with soap and water 4 to 6 hours after application.
- Other methods used to treat genital warts are cryotherapy (freezing the warts off) and laser therapy (burning the warts off with a beam of light).There are a few new products that have been introduced that can treat the warts at home:
- Podofilox (Condylox) solution or gel can be applied at home twice a day for 3 days, followed by 4 days of no therapy. This regiment can be repeated up to four times.
- Imiquimod (Aldara) stimulates the immune system to target the warts. The cream is applied three times a week for up to 16 weeks.
How Does Human Papilloma Affect Pregnancy?
Genital warts can cause problems during pregnancy. Sometimes they enlarge, causing difficulty with urination. Warts on the wall of the vagina can cause obstruction with delivery.
There are safe ways to treat genital warts during pregnancy.