HPV: Human Papillomavirus

Human Papillomavirus (HPV) is a sexually transmitted virus which can infect both the cells of the skin and mucosal surfaces of the genital area. 

For many years, HPV has been known to cause genital warts. With the advent of DNA technology and years of research, HPV has been proven to be the cause of many female genital tract cancers; i.e., the cervix, vulva, vagina, and anorectal area.   HPV genetic material has been found in the cells of oral and laryngeal cancers as well. Most infected individuals will have no symptoms.

Over 100 numbered subtypes of HPV exist, but most are not believed to cause human disease.  Roughly 95% of disease is caused by HPV subtype numbers 6, 11, 16, and 18.  Subtype 6 and 11 most commonly cause warts, and 16 and 18 cause the viral changes which, if not properly treated, can ultimately lead to cancers in young women.

HPV is ubiquitous.  Over 90% of sexually active Americans have been infected, most prior to age 30, by skin to skin contact during conventional and oral sexual activities. Fortunately, for most, the immune system suppresses the viral infection within a few years; however, some patients will have a resurgence of the HPV virus and go on to develop warts or cancers. It is impossible to discern who will fail to fight off the virus.  We do know that immunosuppressed patients have a greater risk factor for progression of disease.  Examples are those who use tobacco (smoking is a major risk factor), take steroids for autoimmune diseases, and take anti-rejection drugs (for organ transplant recipients).

Genital warts are treated with various topical agents, cautery (burning them off), or laser therapy. Local recurrence is common and repeat treatments may be necessary.

Cervical (dysplasia) pre-cancer and surface cancers of the cervix are treated by surgical removal of the affected tissue using a thin wire loop powered by an electrical energy source.  New tissue then grows in its place.  Although highly effective, recurrences can happen and retreating may be needed.

Fortunately, a vaccination series is now available to immunize people against types 6, 11, 16, and 18.  Pediatricians are advising boys and girls to be vaccinated before becoming sexually active, usually in the early teens.  Most insurances will now cover most of the vaccinations cost up until the age of 26.  If more young people are vaccinated, HPV may become much less of a problem for our society in the future.