A human papillomavirus infection (HPV infection) is a viral infection caused by the human papillomavirus (HPV). Usually these infections cause no symptoms and the viruses disappear spontaneously within two years.
However, for some people, an HPV infection persists and leads to warts or lesions that increase the risk of cancer of the mouth or genitals.
HPV vaccines can prevent the most common types of infections, and other preventative measures are available to minimize the risk of contracting the virus.
- Causes of HPV infection
- Risk factors for human papillomavirus infection
- Symptoms of mouth, skin and genitals
- Cancer or pre-cancerous stage
- Diagnosis and investigations
- Prevention of the viral infection
- Genital warts
- Plantar warts
Causes of HPV infection
An HPV infection is the result of the human papillomavirus, a DNA virus from the papillomavirus family. As of October 2020, more than two hundred species have been described. The virus enters the body through a cut or tear in the skin. The virus is transmitted mainly through skin-to-skin contact. The spread of genital HPV infections occurs through oral, vaginal, or anal sex and other skin-to-skin contact in the genital region. Some oral or upper respiratory tract injuries that result from HPV infection are transmitted through oral sex. An HPV infection can also spread from mother to baby during pregnancy. Warts also spread through direct contact with a wart or touching a contaminated surface (that has been touched by the wart).
Risk factors for human papillomavirus infection
Risk factors for a viral infection caused by the human papillomavirus include:
- contact with the warts or contaminated objects (objects touched by the warts) such as a swimming pool
- a weakened immune system
- age: children (skin warts), adolescents and young adults (genital warts)
- multiple sexual partners
- damage to the skin
Symptoms of the mouth, skin and genitals
HPV types cause the following possible conditions.
Cancer or pre-cancerous stage
The following types of (precursors to) cancer may be caused by an infection with the human papillomavirus:
- anal dysplasia (lesions that increase the risk of cancer): 6, 16, 18, 31, 53, 58
- epidermodysplasia verruciformis (type of skin cancer): more than 15 types
- genital cancers (vulva, vagina, cervix, penis and anus): 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82
- oropharyngeal cancer (mouth, throat, larynx, head and neck): 16
Oral lesions that may be due to an HPV infection include:
- focal epithelial hyperplasia (mouth): 13, 32
- laryngeal papillomatosis: 6, 11
- Oral papilloma: 6, 7, 11, 16, 32
The virus causes the following possible types of warts:
- anal warts and genital warts: 6, 11, 42, 44 and others
- skin warts (often on the hands, fingers or elbows): 2, 7, 22
- flat warts: 3, 10, 28
- plantar warts: 1, 2, 4, 63
Diagnosis and examinations
It is possible to detect cervical cancer or vaginal cancer through a smear test (collection of abnormal cells from the cervix or vagina). Genital lesions caused by HPV can be detected by applying a vinegar solution; the lesions then take on a white color. Furthermore, a DNA test is possible to detect HPV-infected cells. A visual examination of the oral cavity may detect oropharyngeal cancer, but because some parts of the oropharynx are difficult to see, this cancer is often not discovered until later stages. The diagnosis of oropharyngeal cancer is made by a biopsy of suspicious cells or tissues.
As of October 2020, there is no specific treatment for an HPV infection. The body’s immune system naturally removes warts caused by HPV within two years in most cases. However, the virus remains present in the body, which means that the warts may return in the same place or elsewhere. Medication and medical and surgical procedures treat warts. In women with an abnormal Pap smear, a colposcopy (internal examination of the cervix, vagina and vulva) is performed during which the doctor further inspects the cervix and removes abnormal areas for further examination. He also removes precancerous lesions on the cervix. There are various options available for this (such as laser therapy, freezing, etc.). The doctor treats cancers of the vulva, anus and throat through surgery and/or chemotherapy and radiotherapy.
Prevention of the viral infection
Methods to reduce the risk of genital warts include sexual abstinence/having only one bed partner, the use of condoms and vaccination.Condoms The use of latex condoms can reduce the risk of genital HPV infection.Vaccines There are three vaccines available to prevent infection by some HPV types: Gardasil, Gardasil 9 and Cervarix; all three protect against initial infection with HPV types 1, 6 and 18, which cause most HPV-related cancers. Gardasil also protects against HPV types 6 and 11, which cause 90% of genital warts. The vaccines provide little benefit to women already infected with HPV types 16 and 18. Therefore, the vaccine is mainly recommended for those women who have not yet been exposed to HPV during intercourse.
Wearing shoes or sandals in public swimming pools and changing rooms is recommended to reduce the risk of spreading the virus.
- Warts: Types of warts and treatments for warts on skin
- Cervical cancer: Symptoms of vaginal bleeding
- Vaginal cancer: Cancer in vagina with vaginal bleeding
- Vulvar cancer: Cancer of the external genital organ in women
- Genital warts: STD due to human papillomavirus (HPV)