Human Papillomavirus (HPV)


Human Papillomavirus (HPV)

What is HPV?

HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). HPV is so common that nearly all sexually active people get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.

How is HPV spread?

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected.

Does HPV cause health problems?

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

Does HPV cause cancer?

HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

How can I avoid HPV and the health problems it can cause?

You can do several things to lower your chances of getting HPV.

Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below) CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/hpv/parents/questions-answers.html

Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active

  • Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;
  • Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Who should get vaccinated?

All boys and girls ages 11 or 12 years should get vaccinated.

Catch-up vaccines are recommended for males through age 21 and for females through age 26, if they did not get vaccinated when they were younger.

The vaccine is also recommended for gay and bisexual men (or any man who has sex with a man) through age 26. It is also recommended for men and women with compromised immune systems (including those living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger.

How do I know if I have HPV?

There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

How common is HPV and the health problems caused by HPV?

Kenya has a population of 13.45 million women ages 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 4802 women are diagnosed with cervical cancer and 2451 die from the disease. Cervical cancer ranks as the 1st most frequent cancer among women in Kenya and the 1st most frequent cancer among women between 15 and 44 years of age. About 9.1% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 63.1% of invasive cervical cancers are attributed to HPVs 16 or 18.

 

Table 1. Crude incidence rates of HPV-related cancer

Male Female
Cervical cancer 22.4
Anal cancer
Vulva cancer
Vaginal cancer
Penile cancer
Pharynx (excluding nasopharynx) 0.9 0.6

Source: ICO Information Centre on HPV and Cancer

Table 2. Burden of cervical cancer

Incidence Mortality
Annual number of new cases/deaths 4802 2451
Crude rate 22.4 11.5
Age-standarized rate 40.1 21.8
Cumulative risk 0-74 years (%) 4.4 2.5
Ranking of cervical cancer (all years) 1st 1st
Ranking of cervical cancer (15-44 years) 1st 1st

Source: ICO Information Centre on HPV and Cancer

Table 3. Burden of cervical HPV infection Kenya

No. Tested % (95% CI)
HPV prevalence in women with normal cytology 924 39.8 (36.7-43.0)
HPV 16/18 prevalence: Normal cytology 823 9.1 (7.3-11.3)
Low-grade cervical lesions 42 21.4 (11.7-35.9)
High-grade cervical lesions 20 45.0 (25.8-65.8)
Cervical cancer 233 63.1 (56.7-69.0)

Source: ICO Information Centre on HPV and Cancer

I’m pregnant. Will having HPV affect my pregnancy?

If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant.

Can I be treated for HPV or health problems caused by HPV?

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

  1. Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
  2. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment
  3. Other HPV-related cancers are also more treatable when diagnosed and treated early

What’s the Treatment for HPV?

Many people have HPV (human papillomavirus), and the infection often clears up on its own, without treatment. And it often doesn’t make people sick.

But if it doesn’t go away by itself, and if it causes problems, your doctor can treat the symptoms of the infection. These may include genital warts linked to low-risk HPV types (which don’t generally lead to cancers) and the precancerous changes sometimes linked to certain types of HPV.

If You Have HPV and No Symptoms

You might not need any treatment, at least not immediately. If you have HPV, your doctor will want to make sure you don’t develop any problems from it.

If you’re a woman, your doctor may swab cells from your cervix, just like when you get a Pap test, and send them to a lab for testing. This analysis looks for genetic material, or DNA, of HPV within the body’s cells. It can find the HPV types that can cause problems. There’s no similar test for the strains of HPV that cause cancer in men.

If your doctor finds that you have a type of HPV that can lead to cancer, she may suggest you get Pap tests more often to watch for signs of abnormal cell changes in the genital area. Abnormal cell changes in the cervix may be a warning sign cervical cancer. Your doctor may also do a test called a colposcopy, in which she uses a special magnifying device called a colposcope to look closely at your cervix, vagina, and vulva.

If you’re pregnant or trying to conceive, tell your doctor before you start HPV treatment, which could affect your pregnancy. Your doctor may want to delay treatment until after you have your baby.

What If There Are Changes?

If the HPV infection has caused abnormal cell changes that could lead to cervical cancer, your doctor might want to take wait-and-see approach. Sometimes the cell changes — called cervical dysplasia, precancerous cell changes, or cervical intraepithelial neoplasia — will heal on their own.

If your doctor decides to treat the abnormal cells, she may use one of these methods:

  • Cryotherapy. This involves freezing the abnormal cells with liquid nitrogen.
  • Conization . This procedure, also known as a cone biopsy, removes the abnormal areas.
  • Laser therapy. This uses light to burn away abnormal cells.
  • Loop electrosurgical excision procedure (LEEP). The abnormal cells are removed with an electrical current. The goal is to remove all the abnormal cells, including most or all of the cells with HPV.
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