How is HPV transmitted?
What are the signs and symptoms of HPV?
How can people protect themselves from HPV?
What are the short and long-term effects of HPV?
Is there a test?
Once I have HPV, do I have it forever?
If I already had HPV, can I get it again?
Is there a cure?
HPVs that infect the genital area are sexually transmitted.
HPV viruses are very common. So much so that more than 75% of women and men will have this type of infection at one point of their life or another, and between 10% and 70% of women and men have HPV at any one time. HPV is most common in young women and men who are in their late teens and early 20s.
HPV can be transmitted through skin-to-skin sexual contact, whether or not there is penetration. It can be transmitted through vaginal or anal intercourse, oral sex and mutual masturbation (genital touching). The vaginal and anal tracts are particularly susceptible to sexually-transmitted HPV and the risk of transmission is greatest during penetration without a condom. This being said, HPV is also found on parts of the body such as the vulva, scrotum and inner thighs which are not covered by a condom. It is thus possible to for partners to transmit HPV even when a condom is used.
What are the signs and symptoms of an HPV infection?
The types of HPV that cause genital warts do not cause cancer. Genital warts (also called Condylomata) may be flat or look like a small cauliflower. They can appear on the vulva, cervix, penis, scrotum, rectum, or thigh area.
The types of HPV that can cause cancer are often a “silent infection”. They have no obvious signs or symptoms, and most people will not even know they are infected. For women, the main concern is infection of the cells of the cervix. These infections can lead to changes in the cervical cells that can be observed under the microscope in a Pap test.
Anyone who has engaged in sexual activity with a partner is at risk of getting HPV.
Practicing safer sex, including condom use, can lower your risk of sexually transmitted infections. Having multiple partners increases your risk of HPV infection.
In young women, most high-risk HPV infections actually present very low risk. Most will not lead to lesions and will clear within a few months. Even mild lesions usually regress within a short time frame without any treatment. That being said, some infections may progress to cancer and it is important that women be screened. All cervical cancers are caused by HPV, i.e., infection with HPV is a necessary cause of cervical cancer. Cancer of the cervix was the most common cancer in Canadian women before Pap test screening, and is still one of the most common cancers among women in some other countries. Fortunately, over 99% of women who have HPV will never get cervical cancer. In a small number of women, HPV will cause changes in cervical cells that can eventually lead to cancer if the virus is not cleared. This process is believed to take 10 or more years.
There are special cases where the risk posed by HPV may be higher. This occurs when a person’s immune system is compromised, for example by co-infection with human immunodeficiency virus (HIV). HPV-related cancers such as cervical and anal cancers are more common in HIV-positive men and women.
A test for HPV is available for women, but usually it is not covered by provincial health care coverage. Women must pay out-of-pocket for this test. It is not generally recommended for women under the age of 30.
On the other hand, the Pap test is freely available and is covered by provincial health care coverage. The main purpose of the Pap test is to find abnormal cell changes caused by HPV that may arise from cervical cancer or before cancer develops. If you are a sexually active woman, talk to your health care provider about screening for cervical cancer and the Pap test. Precancerous cervical cells and lesions detected in a Pap test can be treated and cancer can be prevented.
Most HPV infections in young men and women are transient, lasting no more than one or two years. Usually, the body clears the infection on its own. It is estimated that the infection will persist in only about 1% of women. It is those infections that persist which may lead to cancer. There is some research that suggests that the virus can hide deep in the affected mucosa or skin for several years, below detectable levels. These are called “latent” infections. Having an HPV-positive test followed by an HPV-negative test might mean two different things: that the virus has been completely cleared by the body, or that the level of infection is so small that laboratory tests cannot detect it. Thus, HPV might “reappear” several years after an infection (whether or not it was treated) when the immune system weakens (because of aging, pregnancy, illness, etc.) and then cause lesions. It is unknown what proportion of HPV infections go latent, nor what proportions are truly cleared by the body.
It is possible. There are several types of HPV. Infection with one type will not result in immunity to the other types. Moreover, research has yet to determine whether infection and clearance from one type of HPV provides immunity against subsequent infections from the same HPV type.
There is no cure for HPV infection itself, but there is treatment for the effects of HPV.
Genital warts can be removed by medicated gels or creams, or by surgical methods.
If minor abnormalities in cervical cells are found in a Pap test, women are usually asked to return to their health care provider in six months for repeat screening. If the abnormal cells are more severe, women go to a gynecology clinic where the cells of the cervix can be examined more closely (colposcopy). Lesions can be removed using surgical methods.
Treatment for men with HPV-related lesions other than genital warts varies according to the type and severity of the found lesion. If the lesion is mild, your doctor may choose to wait and see if it clears up on its own. If the lesion is moderate to severe, your doctor will likely refer you to have it surgically removed.