Overview
Human Papilloma Virus Infection
A DNA(deoxyribonucleic acid) virus from the Paillomaviridae family causes HPV infection. Most of the infections that are due to HPV do not cause any symptoms. They are self-limiting; and resolve spontaneously in less than 2 years.
Persistent HPV infection can lead to development of either warts or precancerous cells. Precancerous cells are a risk factor for development of cancers of the cervix, penis, vagina, vulva, mouth and throat.
HPV is an infectious virus, and can result in cancer development(malignant growth).
Epidemiology
In the United States of America, almost 37,000 cancer cases reported each year are related to HPV.
9 out of 10 of HPV-positive oropharyngeal cancers are due to HPV type 16.
Risk Factors, Cause and Transmission
Risk factors;
- Having multiple sexual partners
- Weakened immune system
- Personal contact. Touching warts and having skin contact with areas exposed to HPV.
Cause;
HPV infection is caused by HPV virus. This is DNA(deoxyribonucleic acid) virus from the Paillomaviridae family.
Transmission;
- HPV virus is transmitted through contact; sexual contact or regular skin contact.
- Sexually transmitted HPV virus is classified into 2 classes; low-risk and high-risk HPV. Low risk HPVs are responsible for genital warts whereas high-risk HPVs can cause malignancies/ cancers.
- Sharing of cutting and piercing instrument such as needles and syringes with HPV-infected people can transmit the disease to healthy uninfected persons.
- Surgery. Inhalation of viral particles by surgeons during medical procedures such as electrocautery.
Signs & Symptoms
- Genital warts(female and male genital warts). Genital warts are caused by HPV6 and HPV11
- Common warts. These are cased by HPV types 2, 7 and 22.
- Plantar warts. These caused by HPV types 1,2,4 and 63
- Flat warts. These are caused by HPV types 3, 10 and 28.
Warts are non-cancerous growths on the skin caused by HPV. They occur due to rapid cell growth on the outer skin layer.
Tests for Diagnosis
- Patient sexual history, which is captured during history-taking.
- Clinical examination to check for warts, for example genital warts.
- Vinegar solution test. Acetic acid(vinegar) solution, when applied onto HPV-infected areas of the genitals, they turn white.
- DNA test. This checks for HPV varieties as HPV is a DNA virus.
- Pap smear test.
Treatment & Management
Medications;
Medications to eliminate warts include;
- Salicylic acid
- Imiquimod
- Podofilox
- Trichloroacetic acid
Note that mostly, warts can go away even without medications, especially in children.
Removal of warts;
Surgical procedures for wart removal, in case drugs are not working effectively.
Methods of removing warts can include;
- Laser surgery
- Surgical removal
- Cryotherapy
- Electrocautery
Treating HPV in the cervix;
Procedures such as cryotherapy and loop electrosurgical excision repair(LEEP) are used to remove any cervical precancerous lesions
Complications
Most of the HPV-related infections are self-limiting(they resolve independently and are not responsible for any cancers)
High-risk HPV is likely to cause several cancers. Such include;
- Vaginal cancer
- Vulvar cancer
- Oral cancer
- Anal cancer
- Cervical cancer
- Penile cancer
Apart from cancers, oral and upper respiratory lesions can develop as a result of HPV infection.
These lesions can appear on the;
- Tongue
- Soft palate
- Larynx
- Nose
Prevention
- Individuals who are eligible for vaccination should get vaccinated against HPV. This can also act as a preventive measure against cervical cancer.
- Utilize latex condoms during sex. Polyurethane condoms can be used for individuals who are allergic to latex.
- Creation of awareness.