Human papillomavirus (HPV) is the most common sexually transmitted infection with most sexually active men and women being exposed to the virus at some point during their lifetime.1,2
The virus is common in the United States, there are approximately 14 million newly diagnosed cases of HPV annually.2 HPV is comprised of approximately 100-150 viral strands, with more than 40 affecting the genitals.1,3
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Here are some key points about human papillomavirus. More detail and supporting information is in the main article.
- Around 80% of sexually active men and women will contract the HPV virus at some point during their lifetime.2
- Annually, there are 14 million newly diagnosed cases of HPV.2
- There are approximately 79 million men/women actively infected with the virus at any point in time.2
- HPV is not spread via bodily fluid; it is a skin-to-skin contact virus and can infect anyone who is or has ever been sexually active and many times, most infected individuals are asymptomatic, meaning they display no symptoms of the virus.1,2
- HPV can be spread through oral, vaginal or anal sex.1,2
- At times, HPV can be transmitted during birth to an infant causing genital or respiratory system infections.3
- There is no cure for HPV.2
- The strains of HPV known to cause genital warts are low-risk HPV 6 and 11, while the strains of HPV associated with cancer include high-risk HPV 16, 18, 31, 33, 45, 52 and 58.2
What is human papillomavirus?
While most HPV infections are benign causing warts on areas of the body including the hands, feet and genitals, there are certain strains that put a person at a higher risk of developing certain types of cancers.1-3
HPV is a common and highly contagious infection that can affect your skin, cervix, anus, mouth and throat.
The strains of HPV, which cause a person to develop warts, is not the same group of HPV strains that cause cancer.1
The strains of HPV known to cause genital warts are low-risk HPV 6 and 11, while the strains of HPV associated with cancer include high-risk HPV 16, 18, 31, 33, 45, 52 and 58.2
HPV is a virus which is passed skin-to-skin through sexual intercourse or other forms of skin-to-skin contact of the genitals.
HPV can infect anyone who is or has ever been sexually active, and sometimes the most infected individuals are asymptomatic, meaning they display no symptoms of the virus.1-3
Most HPV infections self-resolve on their own, however, at times they can remain dormant and later infect a new or existing sexual partner.2
At times, HPV can be transmitted during birth to an infant causing the infant to experience a genital or respiratory system infection.3
Symptoms of human papillomavirus
HPV generally self-resolves however when it persists, it can cause warts, such as genital warts, or certain cancers.1 When genital warts become present, they may appear as a small bump, cluster of bumps or stem-like protrusions. They can range in size and appearance and be large, small, flat or cauliflower shaped and may be white or flesh tone.1-3
The most common area affected in women includes the vulva. However, they can also be present near the anus, on the cervix or within the vagina.2,3 Warts in men may appear on the penis, scrotum or around the anus.2,3 In both men and women, the groin may also be another area where genital warts are found.2
HPV may contribute to the development of cancer of the cervix, vulva, vagina, penis, anus and oropharynx.
Other warts associated with HPV include common warts, plantar and flat warts.3 Common warts are rough, raised bumps most commonly found on the hands, fingers and elbows. Plantar warts are described as hard, grainy growths on the feet, most commonly appearing on the heels or balls of the feet.
Flat warts, which generally affect children, adolescents and young adults, appear as flat-topped slightly raised lesions which are darker than normal skin color and are most commonly found on the face, neck or areas having been scratched.
If HPV has contributed to the development of cancer, a person may become symptomatic of the cancer itself in the later stages of the disease.1 These cancers include cancer of the cervix, vulva, vagina, penis, anus and oropharynx.
Who is at risk for contracting a human papillomavirus infection?
There are certain risk factors that place a person at a higher risk of contracting an HPV virus including:3
- Age: common warts occur most commonly in children, genital warts occur most commonly in adolescents and young adults, and plantar warts occur most commonly in adults but initially occur in adolescents and young adults
- A higher number of intimate partners
- Having sexual intercourse with a partner who has had a higher number of intimate partners
- Those who are immunocompromised
- Having areas of damaged skin
- Personal contact with warts or surfaces where HPV exposure has occurred.
A new study claims to provide further evidence that oral human papillomavirus infections can be transmitted via oral-to-oral and oral-to-genital routes.
Knowledge about HPV and the benefits of vaccination does not appear to spur parents - or the kids who need it - to take it up. The new study that came to this conclusion found neither more nor less knowledge about the Human Papillomavirus and the vaccine seems to affect the take-up rate, leading researchers to question the value of public knowledge and education campaigns.
Diagnosis of human papillomavirus
If warts or lesions are visible, a health care provider can generally make a diagnosis of HPV during a visual inspection. However, additional tests may need to be completed to evaluate further for the presence of HPV.3
Tests that often need to be completed to evaluate for HPV may include a Pap smear, a DNA test and the use of acetic acid.
Tests to evaluate for HPV or HPV-related cervical cellular changes include a Pap smear, a DNA test and the use of acetic acid (vinegar).
A Pap smear is a test that collects cells from the surface of the cervix or the vagina and will reveal any cellular abnormalities that may lead to cancer.2,3
The use of a DNA test will evaluate for the high-risk types of HPV and is recommended for women 30 and older in conjunction with a Pap smear.2,3
Currently, there is also a DNA test for HPV, which can be used alone without the need for concurrent Pap testing starting at age 25.2
The use of an acetic acid solution test will identify lesions that are not easily seen as any abnormal areas affected by HPV will turn white.3 At times, a biopsy of any abnormal areas may be necessary.2
At this time, there is no test available for men to directly test for HPV and diagnosis is made primarily on visual inspection. In certain situations, if men or women have a history of receptive anal sex, it may be advisable to speak with a health care provider regarding the possibility of undergoing an anal Pap smear.2
Two new studies published in the journal Gynecologic Oncology find that screening for human papillomavirus infection alone provides more accurate results for both human papillomavirus infection and cervical cancer screening than the alternatives of a Pap or a co-test for these conditions.
Blood and saliva tests to predict human papillomavirus-related cancers have been developed by researchers at Johns Hopkins Medicine in Baltimore, MD. However, the scientists warn that more work needs to be done before the test can be used clinically.
Treatments for human papillomavirus
At times, warts will often self-resolve without treatment. However, there are topically applied medications to remove the wart itself and include over-the-counter salicylic acid for common warts, and prescription medications including:2,3
HPV vaccines are given as a series of three shots over 6 months to protect against HPV infection and the health problems that HPV infection can cause.
- Podophyllin (chemical applied by a health care provider)
- Imiquimod (Aldara, Zyclara)
- Podofilox (Condylox)
- Trichloroacetic acid (chemical applied by a health care provider).
In certain situations, surgical interventions may be necessary and include:2,3
- Cryotherapy: a method that uses liquid nitrogen to freeze the abnormal areas
- Electrocautery: a method that uses an electrical current to burn the abnormal areas
- Laser therapy: method using a light beam to remove abnormal areas
- Interferon injection: rarely used due to a high side effect profile and cost
- Surgical removal.
It is important to speak with your health care provider about which treatment is best for you depending on the type and location of the wart being treated. It is also important to note that although warts and cellular changes may be removed or resolve, the virus can remain in the body and can be passed to others, as there is no treatment to remove the virus from the body.2,3
Prevention of HPV
Although HPV is a very commonly contracted virus, there are certain things that can be done to try to prevent contracting the virus and include abstinence, monogamous sexual relationships, not having sex with visible genital warts and the use of HPV vaccines.2,3
Currently, there are three HPV vaccines on the market and include Gardasil, Cervarix and Gardasil 9.2 Speak with your health care provider to see if vaccination is appropriate for you.
Prevention of common warts is difficult. However, not picking a wart or biting the nails when a wart is present is recommended. For plantar warts, it is recommended that shoes/sandals be worn in public areas such as pools and locker rooms.3
The US is accompanied by few other places where routine vaccination of boys against human papillomavirus is recommended in addition to the more widespread practice of a program for all girls only. The authors of a study in The BMJ say such a policy can bring worthwhile benefit for some male populations.
Researchers have demonstrated that human papillomavirus vaccination is not associated with an increase in sexually transmitted infections, offering reassurance that the vaccine does not promote risky sexual disinhibition.
Latest research into HPV
Medical News Today is a leading publisher of medical research. All of our latest news about HPV can be found in our HPV news section.