Genital HPV Infection
What is genital HPV infection?
Genital HPV infection is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus, or HPV, is the name of a group of viruses that includes more than 100 different strains or types. Over 30 of these are sexually transmitted, and they can infect the genital area, like the skin of the penis, vulva, labia, or anus, or the tissues covering the vagina and cervix.
Some of these viruses are considered "high-risk" types and may cause abnormal Pap smears and cancer of the cervix, anus, and penis. Others are "low-risk," and they may cause mild Pap smear abnormalities and genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes form a cauliflower-like shape.
How common is HPV?
Approximately twenty million people are currently infected with HPV. Fifty to 75% of sexually active men and women acquire genital HPV infection at some point in their lives. About 5.5 million Americans get a new genital HPV infection each year.
How do people get genital HPV infections?
The types of HPV that infect the genital area are spread primarily through sexual contact. Most HPV infections have no signs or symptoms; therefore, most infected persons are completely unaware they are infected, yet they can transmit the virus to a sex partner. Rarely, pregnant women can pass HPV to their baby during vaginal delivery. A newborn that is exposed to HPV during delivery can develop warts in the larynx (voice box).
What are the signs and symptoms of genital HPV infection?
Most people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucus membranes and usually causes no symptoms. Other people get visible genital warts.
What are genital warts?
These usually appear as soft, moist, pink or red swellings. They can be raised or flat, single or multiple, small or large. Some cluster together forming a cauliflower-like shape. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. Warts can appear within several weeks after sexual contact with an infected person, or they can take months to appear.
Genital warts are diagnosed by inspection. Visible genital warts can be removed, but no treatment is better than another, and no single treatment is ideal for all cases.
Who is at risk for genital HPV infection?
Anyone who has sex is at risk for genital HPV infection.
How is genital HPV infection diagnosed?
Most women are diagnosed with HPV on the basis of abnormal Pap smears. Pap smears are the primary screening tool for cervical cancer or pre-cancerous conditions, many of which are cell changes related to HPV. Current HPV tests are fairly sophisticated and expensive and are commercially available for women with an abnormal Pap smear. They cannot identify which HPV infections will lead to cervical cancer or pre-cancerous conditions. Research is underway to determine the role of HPV tests for cervical cancer screening.
Is there a cure for HPV?
There is no "cure" for HPV, although the infection usually goes away on its own. Cancer-related types are more likely to persist.
What is the connection between HPV infection and cervical cancer?
All types of HPV can cause mild Pap smear abnormalities that do not have serious consequences. Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to development of cervical cancer. Research has shown that for most (90%) women, cervical HPV infection becomes undetectable within two years; only a small proportion have persistent infection. Persistent infection with certain types of HPV is the key risk factor for cervical cancer.
A Pap smear can detect pre-cancerous and cancerous cells on the cervix. Frequent Pap smears and careful medical followup, with treatment if necessary, can help ensure that pre-cancerous cells in the cervix caused by HPV infection do not develop into life-threatening cervical cancer. The Pap test used in U.S. cervical cancer screening programs is responsible for greatly reducing deaths from cervical cancer. The American Cancer Society estimated that about 12,800 women in the United States were diagnosed with invasive cervical cancer in 2000. In 2001, approximately 4,600 women will die from cervical cancer.
How can genital HPV infection be prevented?
Abstinence is the most effective strategy to prevent HPV infection.
Two uninfected individuals who have no other sex partners besides each other cannot get genital HPV infection. The following practices for sexually active people will help prevent infection:
Do not have sex with anyone who has genital sores or unusual growths in the genital area or the anus
Be aware that condoms can reduce, but do not eliminate, the risk for transmission to uninfected partners.
If you are a sexually active women, you should have a regular Pap smear to screen for cervical cancer or other precancerous conditions.
For more information:
DSTD Web address www.cdc.gov/std/
Prevention of Genital HPV Infection and Sequelae: Report of an External Consultants' Meeting.
1998 Guidelines for Treatment of Sexually Transmitted Diseases www.cdc.gov/std/treatment/
CDC National STD Hotline
(800) 227-8922 or (800) 342-2437
En Espanol (800) 344-7432
TTY for the Deaf and Hard of Hearing (800) 243-7889
National HPV and Cervical Cancer
Hotline (919) 361 - 4848
Resource Center www.ashastd.org/hpvccrc/
National Herpes Hotline
P.O. Box 6003 Rockville, MD 20849-6003
Fax 1-800-243-7012 TTY
American Social Health Association
P. O. Box 13827 Research Triangle Park, NC 27709-3827
American Social Health Association. Sexually transmitted diseases in America: How many cases and at what cost? Research Triangle Park, NC, 1998.
CDC. 1998 guidelines for treatment of sexually transmitted diseases. Morbidity and Mortality Weekly Report 1998;47(RR-1).
Ho, G.Y.F., Bierman, R., Beardsley, L., Chang, C.J., Burk, R.D.: Natural history of cervicovaginal papilloma virus infection in young women. N Engl J Med 1998;338:423-8.
Koutsky, L.A., Kiviat, N.B. In: K. Holmes, P. Mardh, P. Sparling et al (eds). Sexually Transmitted Diseases, 3rd edition. New York: McGraw-Hill, 1999, 347-359.
Kiviat, N.B., Koutsky, L.A., Paavonen, J. In: K. Holmes, P. Mardh, P. Sparling et al (eds). Sexually Transmitted Diseases, 3rd edition. New York: McGraw-Hill, 1999, 811-831.
Watts, D.H., Brunham, R.C. In: K. Holmes, P. Mardh, P. Sparling et al (eds). Sexually Transmitted Diseases, 3rd edition. New York: McGraw-Hill, 1999, 1089-1132.
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