Human Papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the world. It affects both men and women and has a significant impact on public health due to its association with several types of cancer.
What is HPV?
HPV is a group of more than 200 related viruses. Some types of HPV can cause warts on different parts of the body, while others can lead to anogenital and oropharyngeal cancers. HPV is classified into two main categories:
Low-risk HPV: These types can cause genital and anal warts. The most common low-risk strains are HPV-6 and HPV-11.
High-risk HPV: These types can cause cancers. The most common high-risk strains are HPV-16 and HPV-18, which are responsible for most cervical cancers, as well as other types of genital and throat cancers.
HPV transmission
HPV is primarily transmitted through sexual contact, including vaginal, anal, and oral sex. The infection can also be transmitted through skin-to-skin contact in the genital area. It is important to note that HPV can be transmitted even when the infected person does not have visible symptoms.
Risk factor's
Some factors that increase the risk of contracting HPV include:
Number of Sexual Partners: Having multiple sexual partners increases the chances of exposure to the virus.
Age : HPV infections are most common in adolescents and young adults.
Weakened Immune System: People with weakened immune systems, such as those with HIV/AIDS, are at increased risk of contracting HPV.
Skin Damage: Areas of skin that are damaged or traumatized may be more susceptible to HPV infection.
HPV symptoms
Most HPV infections are asymptomatic and go away on their own without causing health problems. However, when symptoms do occur, they may include:
Genital warts
Genital warts appear as small bumps or groups of bumps in the genital and anal area. They can be flat or have a cauliflower appearance. Genital warts are caused by low-risk types of HPV.
HPV Associated Cancers
High-risk HPV can cause several types of cancer, including:
Cervical Cancer: It is the most common type of cancer associated with HPV. Early signs may include abnormal vaginal bleeding, pelvic pain, and abnormal vaginal discharge.
Anal Cancer: Symptoms may include anal bleeding, pain, and anal mass.
Oropharyngeal Cancer: Affects the middle part of the throat, including the tongue and tonsils. Symptoms may include persistent sore throat, pain when swallowing, and voice changes.
Other Genital Cancers : These include cancers of the vulva, vagina and penis, which can present symptoms such as masses, pain and bleeding.
HPV Diagnosis
The diagnosis of HPV can be made through several tests:
Pap Tests and HPV Tests
Papanicolaou (Pap) tests are used to detect precancerous changes in the cervix that may be caused by HPV. HPV tests can detect the DNA of the virus and determine if a person has a high-risk HPV infection.
Biopsies
If abnormalities are found during a Pap test or physical examination, a biopsy may be performed to confirm the presence of cancerous or precancerous cells.
Visual Exams
Genital warts can be diagnosed through a visual examination by a health professional.
HPV treatment
There is no cure for HPV, but there are treatments available to manage the symptoms and conditions caused by the virus.
Treatment of Genital Warts
Genital warts can be treated using several methods:
Topical Medications: Imiquimod cream, podofilox gel, and trichloroacetic acid solution.
Medical Procedures: Cryotherapy (freezing warts), electrocautery (burning warts), surgical removal and laser therapy.
Treatment of Precancerous and Cancerous Conditions
Precancerous conditions caused by HPV, such as cervical dysplasia, can be treated using procedures such as loop electrosurgical excision (LEEP) or cervical conization.
HPV-associated cancers are treated depending on their stage and location, with options including surgery, radiation therapy, and chemotherapy.
HPV prevention
HPV prevention is possible through several approaches:
HPV vaccines
HPV vaccines are highly effective at preventing infections with the types of HPV that most commonly cause cancer and genital warts. Vaccines available include Gardasil, Gardasil 9 and Cervarix. These vaccines are recommended for preteens and teens, but can also be given to young adults.
Condom Use
Correct and consistent use of condoms can significantly reduce the risk of HPV transmission, although it does not completely eliminate the risk because HPV can infect areas not covered by the condom.
Screening Tests
Regular screening tests, such as Pap smears and HPV tests, are crucial for early detection of precancerous changes in the cervix and other HPV-associated cancers.
Education about HPV and its transmission is essential for prevention. Public health campaigns and educational programs can help increase awareness about the importance of vaccination and the use of safe sexual practices.
HPV has a significant impact on public health due to its high prevalence and its association with several types of cancer. The World Health Organization (WHO) estimates that HPV is responsible for approximately 5% of all cancers worldwide. In particular, cervical cancer is one of the leading causes of cancer death in women worldwide.
Treatment of conditions caused by HPV, including genital warts and cancers, represents a considerable economic burden on healthcare systems. The costs associated with HPV screening, treatment, and management of complications are significant.
Global strategies for HPV control include promoting vaccination, access to screening and treatment, and implementing educational programs. WHO has established a strategy to eliminate cervical cancer as a public health problem, including targets for vaccination, screening and treatment.
Myths and Facts about HPV
Myth : Only women can get HPV.
Fact : Both men and women can contract HPV and suffer its consequences, including genital warts and cancers.
Myth : HPV always causes cancer.
Fact : Most HPV infections do not cause cancer and go away on their own. However, persistent infections with high-risk types can lead to precancerous changes and cancer.
Myth : If I don't have symptoms, I don't need to worry about HPV.
Fact : Many people with HPV have no symptoms, but can still spread the virus to others. Additionally, high-risk asymptomatic infections can progress to cancer if not detected and treated early.
Myth : HPV vaccines are only effective if given in adolescence.
Fact : Although vaccines are most effective when given before exposure to HPV, young adults can also benefit from vaccination.
HPV is a common infection that can have serious health consequences. Through vaccination, screening, and the use of safe sexual practices, the public health impact of HPV can be significantly reduced. Education and awareness are crucial to combat myths and promote behaviors that prevent HPV transmission. With continued global efforts, progress can be made toward eliminating cervical cancer and reducing the burden of other HPV-related diseases.