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Human Papillomavirus (HPV) Infection |
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Genital HPV infection is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own. Some of these viruses are called "high-risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped. HPV is one of the most common causes of STD in the world. About 6.2 million Americans get a new genital HPV infection each year.
Symptoms and DiagnosisMost people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get visible genital warts, or have pre-cancerous changes in the cervix, vulva, anus, or penis. Very rarely, HPV infection results in anal or genital cancers. Genital warts usually appear as soft, moist, pink, or flesh-colored swellings, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. After sexual contact with an infected person, warts may appear within weeks or months, or not at all. Most women are diagnosed with HPV on the basis of abnormal Pap tests. A Pap test is the primary cancer-screening tool for cervical cancer or pre-cancerous changes in the cervix, many of which are related to HPV. Another test to diagnose HPV infection detects the HPV DNA, which may indicate possible infection. Genital warts are diagnosed by visual inspection.
ComplicationsSome types of HPV can cause cervical cancer. Other types are associated with vulvar cancer, anal cancer, and cancer of the penis (a rare cancer). Most HPV infections do not progress to cancer. Genital warts may cause a number of problems during pregnancy. If the warts are in the vagina, they can make the vagina less elastic and cause obstruction during delivery. Sometimes they get larger during pregnancy, making it difficult to urinate if the warts are in the urinary tract.
TreatmentThere are treatments for genital warts, though they often disappear even without treatment. Depending on factors such as the size and location of genital warts, the health care provider may recommend one of the following options to treat them.
If you are pregnant, you should not use podophyllin or podofilox because they are absorbed by your skin and may cause birth defects in your baby. In addition, you should not use 5-fluorouracil cream if you are pregnant. If you have small warts, your health care provider can remove them by one of three methods.
If you have large warts that have not responded to other treatment, you may have to have surgery to remove them. Some health care providers inject the antiviral drug alpha interferon directly into warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return. Although treatments can get rid of the warts, none get rid of the virus. Because the virus is still present in your body, warts often come back after treatment.
References: Centers for Disease Control and Prevention, USA.
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