THE WOMEN’S HEALTH GROUP, P.C.

9195 Grant Street, Suite 410, Thornton, CO 80229

Phone: 303-280-2229 (BABY)

300 Exempla Circle, Suite 470, Lafayette, CO 80026

Phone: 303-665-6016

www.whg-pc.com

  Human Papillomavirus (HPV) Infection

Infection with human papillomavirus (HPV) is one of the most common sexually transmitted diseases.  HPV can cause many changes in the genital tract, including genital warts, precancerous cells and even cancer.  It is most commonly found in men and women between the ages of 20 and 40.  It is estimated that 15% of Americans will have the HPV virus at some time.  Today, more and more men and women are being diagnosed with HPV.  This is not only due to an increased presence of the disease, but also to better diagnostic laboratory tests to detect the virus and an improved understanding of how the virus behaves.

What is HPV?

HPV is a family of many viruses that need to infect cells in order to live.  They prefer to invade certain cell types, including the skin of the vulva and anus, the vagina and cervix.  The virus is passed from one individual to another through direct contact, typically through sexual activity.  Once the virus has been passed on, it may be months or even years before the other person shows any signs of infection. 

There are many types of HPV.  Some types tend to infect cells in the genital areas, while others tend to infect cells in other parts of the body.  Some HPV can cause common warts, such as those that appear on fingers and hands.  While unsightly, common warts do not pose any major health risks.

Certain types of HPV that are found in the genital area cause genital warts, also called condyloma.  These growths may appear on the outside or inside of the genital area and can spread to nearby skin or to a sexual partner.  Other subtypes that are found in the vagina and cervix often do not cause visible disease, but can cause precancerous change (which is not visible to the naked eye) and subsequently can cause cancer.  While most HPV infections are not a serious threat to your health, some can increase the risk of getting cancer.  This is why regular check-ups that include Pap tests are so important for women whether or not you have known HPV infection.

What are the symptoms of HPV?

The HPV may appear as growths called warts that appear on, in and around the genitals, rectum, mouth and throat.  They may appear as single isolated lesions but typically are multiple in number.  The virus itself cannot be seen with the naked eye and may not produce any symptoms.  Your doctor may be able to see evidence of HPV infection by applying a dilute solution of acetic acid to the genital skin and then looking for the lesions with a special magnifying instrument (called a colposcope).

How can I reduce my risk of getting HPV?

HPV is most commonly sexually transmitted infection.  Hormonal birth control does NOT protect against HPV.  Condoms may reduce the risk of transmission but does not eliminate the risk completely.  Smoking can strongly influence the behavior of a viral infection, making it worse.  By limiting the number of sexual partners during your lifetime, using condoms and avoiding smoking you may reduce your risk for disease.

Gardasil® is a FDA-approved vaccine which may reduce the risk of HPV infection and HPV-related disease by up to 85%.  It is offered to girls and women from 9 to 26 years of age, and is given as a series of 3 shots over the course of 6 months.  If you already have HPV, the vaccine will not influence the course of that preexisting infection.  Nevertheless, the vaccine may still be offered as a means of trying to reduce the risk of infection with other HPV subtypes.

Why should HPV be treated?

It has been confirmed that HPV can cause a variety of cancers including cervical, vaginal, vulvar, throat and penile cancers.  Approximately 99% of cervical cancers are HPV related.  By detecting and treating significant precancerous change with pap smears and colposcopy exams we may prevent cancer later in life.

How can I get rid of HPV related warts or precancerous change?

Although some signs of infection may go away, treatment may be advised.  There are many ways of treating the changes caused by the virus:

Trichloroacetic acid (TCA), Bichloroacetic acid (BCA) and podophyllin are strong chemicals sometimes painted on genital warts to destroy them.  These drugs may cause some burning and must be used very carefully.  These are applied by your health care provider in the office, and usually require several applications for treatment.

Aldara® is a prescription drug that you can apply to the warts at home.  It may cause mild burning and inflammation, and may take many weeks to get rid of visible warts.  Your doctor should show you how to apply it before you use it at home.

Several office procedures and outpatient surgical techniques are also used to treat warts that are extensive or don't respond to medical treatments.

·         Cryotherapy (cold cautery) destroys warts or cervical lesions by freezing.

·         Laser treatment, in which a high-intensity beam of light is used, may be used to destroy the growths.

·         Electrosurgery (LEEP biopsy) uses an electric current to shave off infected cells with a tiny wire loop.

·         Excisional biopsy (cutting away) may be needed to remove warts or other growths in some cases.

What if my Pap smear is abnormal?

You will be notified if your Pap is abnormal.  Often, this may mean a follow-up Pap will be recommended in a few months.  Many HPV infections are transient and will go away on their own, so if the changes on your Pap are mild we may simply watch carefully with close follow-up.  If the changes are more severe, and therefore have a higher risk to become cancer later in life, we will need to take a look with the microscope (called a colposcope) to take a biopsy and determine exactly how severe the changes are.