Human Papilloma Virus
What is genital HPV infection?
It is a sexually transmitted disease (STD) caused by the Human Papilloma Virus (HPV), a viral group that includes more than 100 different types. More than 30 are sexually transmitted and may affect the ano-genital area in both men and women. Most people infected by HPV have no symptoms and the infection disappears by itself.
However, some types of this virus are known as "high risk" and may show abnormal results in Papanicolaou tests (cervico-vaginal cytology). Other types of virus are known as "low risk" and may give rise to slight abnormalities in the Papanicolaou tests or cause genital warts.
What are the symptoms pf genital HPV infection?
HPV infections of the mucuous membranes or genital regions are classified as latent (whithout any symptoms), subclinical or clinical.
Clinical lesions are noticeable and often appear in the form of genital warts, benign lesions known as condylomata, and are caused by "low risk" HPV.
"High risk" oncogenic HPV infections follow a predominantly "silent" course, tending to establish persistent infections generating characteristic cytological disorders belonging mainly to the group of low-grade squamos intrapithelial lesions (L-SIL). At a lower prevalence, high-risk oncogenic HPV infections can lead to high-grade squamos intrapithelial lesions (H-SIL).
How common is HPV?
Approximately 20 million people are currently infected by HPV. It is the most common sexually transmitted virus. Most infections are transitory and asymptomatic and disappear after 12 or 18 months. At least 80% of women will have contracted an HPV genital infection by the time they are 50.
Is it important to have regular gynecological check-ups?
Early detection of infection by the human papillomavirus (HPV) by changes in cervico-vaginal cytology (Papanicolaou tests) is effective in reducing the incidence of cervical cancer.
How does one catch HPV?
Mainly by genital contact. Most HPV infections present neither signs nor symptoms; that is why most people who have the infection do not even realise it, although they can transmit the virus to their sexual partner.
What are the symptoms of HPV?
Most people who have genital HPV infections do not know that they are infected. The "low-risk" types of virus cause visible genital warts or present precancerous changes in the uterine cervix, vulva, anus or penis.
Genital warts generally appear as pinkish or skin-coloured excrescences or wettish lumps, usually in the genital area. The warts may be flat or raised, single or multiple, large or small, and in certain cases may assume the shape of a cauliflower.
How is HPV genital infection diagnosed?
Genital warts can be diagnosed by a visual examination and can be eliminated with medication, although there is no one treatment that is better than another.
When the lesions are not apparent, they can mainly be diagnosed by Papanicolaou tests (Pap smears). Specific tests also exist for detecting HPV that can be performed in women giving slightly abnormal results for the the Papanicolaou test, or in those older than 30 when taking the Papanicolaou test. There are no tests for detecting HPV in men.
Can HPV genital infection be cured?
There is no "cure" as such for HPV, although in most women the infection disappears on its own.
What is the connection between HPV infection and cervical cancer?
The Papanicolau test is able to detect cancerous and precancerous cells in the uterine cervix. Regular Papanicolaou tests and careful medical monitoring, with treatment if required, can help to ensure that any precancerous changes in the uterine cervix caused by HPV infection do not develop into cervical cancer, which is potentially fatal.
How can the risk of HPV genital infection be reduced?
The safest way is to avoid genital contact with another person. If people decide to be sexually active, the best strategy is a stable monogamous relationship with a medically tested, uninfected partner. HPV is so widespread that only those people who have had no sexual relations can be sure that they have not been exposed to it.
People who decide to be sexually active and are not in a long-term, mutually monogamous relationship can reduce their risk of infection by limiting their number of sexual partners, and by choosing one who has previously had few or no sexual partners in the past.
HPV infection can appear in both male and female genital areas, whether or not they are or have been covered or protected by a latex condom.
What are condylomata?
Condylomata acuminata or venereal warts are caused by some types of HPV. They are transmitted sexually and appear within 3 months after contact with an infected partner. In women, they appear in the labia of the vulva, vagina, uterine cervix or around the anus. In men, they appear on the penis and the scrotum, or around the anus if the patient has homosexual relations.
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