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Wednesday, November 14, 2007

A Simple Guide to Human papilloma virus Infection

A Simple Guide to Human papilloma virus Infection
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What is Human papilloma virus Infection ?
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Human papilloma virus infection is a sexually transmitted disease that is caused by human papilloma virus (HPV).
Human papilloma virus includes more than 100 different strains.
About 30 of these viruses are sexually transmitted.
They can infect the penis, vulva, anus in men, and the linings of the vagina, cervix, or rectum in women.

Some of these viruses may also cause cancer of the cervix, vulva, vagina, anus, or penis.

How is Human papilloma virus spread?
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The types of HPV that infect the genital area are spread primarily through sexual contact.
Because most HPV infections have no signs or symptoms, many infected persons are unaware they are infected and may transmit the virus to a sex partner.

Very rarely, a pregnant woman can pass HPV to her baby during vaginal delivery. If that happens, the baby usually develops warts in the throat.

What are the Symptoms of Human papilloma virus infection?
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Most people who have a genital HPV infection do not know they are infected.
The virus lives in the skin or mucous membranes and do not usually cause any symptoms.
Some people get visible genital warts in the vulva, vagina, cervix or rectum in women and on the penis, scrotum, or anus in men.

Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.

After sexual contact with an infected person, warts may appear within weeks or months, or not at all.

Some may cause pre-cancerous changes in the cervix, vulva, anus, or penis.
Very rarely, HPV infection results in anal or genital cancers.

How do you diagnose Human papilloma virus infection?
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Genital warts can be diagnosed by visual inspection especially in men.

Most women are diagnosed with HPV on the basis of abnormal Pap tests which can detect cervical cancer or pre-cancerous changes in the cervix.
Many of these changes are related to HPV.

There is also a specific test is available to detect HPV DNA in women.
The test may be used in women with mild Pap test abnormalities.

No HPV tests are available for men.

What is the treatment for Human papilloma virus infection?
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There is no cure for HPV infection.

In most women the infection goes away on its own.
The treatments provided are directed to the warts and pre-cancerous changes in the cervix(Surgical coning of the cervix).

Visible genital warts can be removed by medications the patient applies such as Podophyllin,Imiquimod cream, 5-fluorouracil cream ,Trichloroacetic acid (TCA) .
Podophyllin and 5-fluorouracil cream should not be used in pregnant women because these may cause deformity in the baby.

Small warts can be removed by one of three methods.
Freezing (cryosurgery)
Burning (electrocautery)
Laser treatment

Large warts may require surgery.

Although the above treatments may remove the visible warts, the virus may still be in the body and recurrence may occur.

Sometimes the warts will disappear on their own.
If that happens, nothing else need to be done.

What are the complications of Human papilloma virus infection?
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All types of HPV can cause mild Pap test abnormalities
which may not be serious.
In most cases (90 percent), cervical HPV infection in women becomes undetectable within two years.
Only a small proportion of women have persistent infection.
About 10 of the 30 identified genital HPV types can lead to the rare development of cervical cancer.


How do you prevent Human papilloma virus infection?
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Education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors:
1.The surest way to eliminate risk for genital HPV infection is to refrain from any sexual contact with another individual.

2.A long-term, mutually monogamous relationship with an uninfected partner is the prevention for future genital HPV infections.

3.The use of a latex condom has been associated with a lower rate of cervical cancer which is related to HPV disease.

4.Follow up is important in order to watch for recurrences which can occur most frequently during the first 3 months after treatment.
Pap smear screening of women every 3-6 months is important to check for recurrences.

5. preexposure vaccination of persons at risk for HPV infection.
The new vaccine Gardasil is effective against HPV types 16 and 18 which cause approximately 70% of cervical cancers, and against HPV types 6 and 11 which cause approximately 90% of genital warts.


Added 4th October 2008
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The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.

Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.

However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.

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