HPV or human papilloma virus is the most common sexually transmitted infection in the US, affecting 75-80% of males and females in their lifetime.  You read that correctly, 75-80 percent! If you want another shocking number, approximately 20 million people between 15 and 19 years old have HPV in the US.  This is what makes it the most common STD in the US, and as such everyone should know a little more than they already do about it. Education is the key to prevention and proper treatment.

What is HPV?

Human papilloma viruses are actually a group of more than 150 related viruses. They typically cause warts (papillomas) which are benign tumors, which is where the name comes from.  HPVs that cause warts on your hands and feet typically do not spread easily.  HPVs that cause other warts, such as genital warts, are spread more easily via sexual contact and are referred to as sexually transmitted infections.  Some types of sexually transmitted HPVs cause cervical or other types of cancer and are referred to as “high-risk”, “oncogenic” or “carcinogenic” HPVs.  High-risk HPV doesn’t necessarily equate to cervical cancer.  It is high-risk HPVs that do not go away, or are persistent, that are the biggest risk factor for cervical cancer.  Other sexually transmitted HPVs do not cause cancer and are referred to as “low-risk” HPVs.  Some HPV infections will not produce any symptoms or cause any health problems and will go away without treatment.  On the other hand, the HPVs that persist for many years can eventually cause cancer.  

How is HPV detected?

HPV is detected in females via Pap, or Pap smear, tests.  These are typically done at routine gynecological visits.  Currently, there is no routine screening exam for HPV in men.

How are HPV and cancer related?

Persistent HPV infections are the cause of almost all cervical cancers.  Annually, about 500,000 women worldwide are diagnosed with cervical cancer and 250,000 die from it. HPVs can also cause other genital cancers, and oral HPVs can cause oropharynx cancer, a type of throat cancer. It is estimated that HPV causes around 5% of all cancers worldwide.

What are the risk factors for HPV infection?

Having multiple sex partners is the main risk factor for infectionof HPV.  Over half of sexually active people will have HPV at some point in their lives without ever knowing it.  Many people never develop papillomas or have any symptoms of infection.  HPV can affect both protected (i.e. condom) and unprotectedgenital areas.

Are there vaccines to protect against HPV?

Gardasil and Cervarix are two FDA approved vaccines that are highly effective in preventing 70% of cancer-causing HPV infections and 90% of genital wart-causing HPV infections in both men and women.  These are given in a series of 3 shots at 0, 1-2 and 6 months.  You should get the vaccines before the age of 26 and work best before a person starts being sexually active.  For the most part, there are no side effects related to getting the vaccine.

What are the treatment options for individuals with HPV?

There is no treatment or cure for HPV infections.  However, the warts and lesions that result from HPV infections can be treated via cryosurgery (freezing of tissue) or excision (surgical removal by cutting).  Some warts can be treated with prescription drugs.  If cancer develops from the infection, it can be treated with surgery, radiation therapy or chemotherapy depending on the type or severity.

HPV and men

Most men who contract HPV never develop symptoms or experience health problems.  This is probably one of the contributing factors to how it is easily spread, and why it is so common. HPV often disappears on its own, your body fights it like any other infection, without causing any problems.  While some people may never have any HPV related issues, some types of HPV can cause genital warts, genital cancers or head and neck cancers.  Just about 1% of sexually active men in the US have genital warts at some time in their life.  Annually in the US about 800 men develop HPV-related penile cancer, 1100 men develop HPV-related anal cancer and 5700 develop HPV-related head and neck cancers.  There is no test or routine screening to detect HPV in men, and while using condoms can lower the chance of passing HPV to a partner or developing HPV-related diseases, there is no guarantee. Careful use of condoms during sex or abstinence (the only true guarantee) are the best ways to reduce the chance of HPV infection.