Human Papilloma Virus HPV

1. Human Papilloma Virus (HPV) Ana H. Corona, MSN, FNP-C Nursing Instructor September 2008 www.cdc.gov, www.lib.uiowa.edu/, www.gfmer.com, Dermatlas.com

2. Description The human papillomavirus is typically spread through direct skin-to-skin contact. It's the most common sexually transmitted disease It does not cause symptoms 20 million people in the United States are infected. There is no cure for HPV -- treatment typically involves managing any symptoms that do appear while the body fights the infection.

3. What is HPV? Human papillomaviruses, or HPVs, are a group of viruses that can infect the skin and mucous membranes of both men and women. They got their name because certain types may cause warts, known medically as papillomas. HPV is the most common type of sexually transmitted disease (STD).

4. Epidemiology At least 50 percent of sexually active men and women get genital HPV at some time in their lives. At least 80 percent of women will have been infected by genital HPV by the time they turn 50. Approximately 5.5 million new cases of sexually transmitted HPV infections are reported every year in the United States. At least 20 million people are already infected.

5. Types of Human Papillomavirus There are over 100 different types of HPVs. Over 30 types are transmitted sexually. Most people infected with HPV never develop any symptoms. There are a number of conditions that HPV can cause. This includes: Common, Plantar & Flat warts Genital warts Precancerous changes Cervical cancer Laryngeal papillomatosis.

6. High-risk HPV and low-risk HPV. High-risk HPV may cause abnormal Pap smear results and could lead to cancers of the cervix, vulva, vagina, anus, or penis. Low-risk HPV may also cause abnormal Pap smear results or genital warts.

7. How is it Spread HPV is transmitted by direct skin-to-skin contact. Genital HPV is spread through genital-to-genital contact, most commonly through vaginal or anal intercourse. HPV may also spread through touching something that has been contaminated with the virus and then touching the skin. Transmission most often occurs from another person.

8. Signs and Symptoms People infected with HPV may never develop symptoms, including warts. If someone does develop symptoms, the exact type will depend on which HPV type is transmitted and the location of transmission. In rare cases, a pregnant woman can pass the virus to her baby during a vaginal delivery. A baby that is exposed to HPV can develop warts in the throat, voice box, or genitals.

9. How is it Diagnosed? Most cases of HPV in women are suspected following an abnormal Pap test. Pap test may include HPV DNA test that detects most of the high-risk types of HPV and helps with screening for cervical cancer. HPV tests are currently unavailable for men. HPV may also be diagnosed if warts are visible.

10. Treatment There is no cure for HPV. The body's own immune system may get rid of the virus . Colposcopy and Biopsies are recommended to rule out cervical cancer.

11. Prevention The best way to prevent HPV infection is abstinence or a monogamous relation. HPV can infect male and female genital areas that are covered by a condom, as well as areas not covered by the condom. A vaccine is also available, sold under the brand name Gardasil. The recommended age for vaccination is between 11 and 12. It can be given to girls at 9 yrs of age. "Catch-up" vaccinations for girls and women are recommended for ages 13 to 26. The vaccine is given as a 3-shot series. The 2nd and 3rd doses should be administered 2 & 6 months, respectively, after the first dose. Note: The HPV vaccine only protects against HPV virus Types 6, 11, 16, and 18

12. Is HPV Linked to Cervical Cancer? There appears to be a definite link between HPV and cervical cancer. Human papillomaviruses (HPVs) are now recognized as the major cause of cervical cancer. Studies also suggest that HPVs may play a role in cancers of the anus, vulva, vagina, and some cancers of the oropharynx and penile cancer Only the "high-risk" viruses that are more likely to lead to the disease.

13. HPV types and cancer risk Some types of HPVs are referred to as "low-risk" viruses because they rarely turn into cancer. HPVs that are more likely to lead to the development of cancer are referred to as "high-risk" viruses. Both high-risk and low-risk HPVs can cause the growth of abnormal cells.

14. Only the high-risk HPVs lead to cancer. Sexually transmitted high-risk HPVs include the following types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 69. These high-risk HPVs cause growths that are usually flat and nearly invisible. These are different from the warts caused by types HPV-6 and HPV-11. HPV types low risk

15. Risk Factors for HPV and Cervical Cancer Risk factors for HPV and cervical cancer include having many sexual partners, smoking, not getting regular Pap tests, and having a weak immune system. Having many sexual partners is a risk factor for HPV infection. High Risk HPV infection increases the chance that mild abnormalities will progress to cervical cancer.

16. Oral warts: Condyloma Acuminata caused by HPV

17. Normal and Abnormal Cervix

18. Abnormal Cervix: