HPV is short for human papillomavirus. As inherent in the name, HPV has more than 100 different strains, some of which are deadly. Many people have been infected with varying strains or types of HPV without realizing it. Plantar warts on the feet, flat warts on the body, warts on the fingers and hands— these are all caused by different strains of the human papillomavirus.
You may already be aware that certain strains of HPV can cause cervical cancer. You may also be familiar with the vaccine developed to protect against the strains of the virus that cause 70 percent of cervical cancers. The Gardasil vaccine was FDA approved in 2006, and Cervarix was approved by the FDA last year. Gardasil protects against four types of HPV, two low-risk strains that cause genital warts and two high-risk strains that cause the majority of cancers. Cervarix protects against the two high-risk strains and provides no protection for the lower risk types. A vaccine is also now available for men and boys.
HPV is transmitted through skin-to-skin contact with an infected area. Although HPV is considered the leading sexually transmitted infection, intercourse is not a requirement for contracting the virus. In fact, some believe the virus can be transmitted via fomites, or inanimate objects, which also have come in contact with an HPV-infected area. Because there is no test to determine if a man is carrying HPV, a woman can remain celibate until marriage and contract the virus from her husband if he has the virus.
While an increased number of sexual partners is considered a risk factor, HPV is a very contagious virus and can be transferred on a single occasion. Unlike bacteria, the virus is not affected by antibiotics and utilizes your own cells to reproduce. It has a unique way of “hiding” from our immune system, while other properties of the virus function to disable our body’s cancer defenses. As a result, potentially cancer-causing cells can reproduce again and again.
For the majority of people, the body’s immune system functions to cause the virus to become dormant. Many healthcare professionals tell patients that their body will clear the virus. This doesn’t mean that a person is virus-free, or that it has been eradicated from one’s system. HPV can remain dormant within the body for months, years and even decades. No one can predict who will go on to develop a deadly cancer, nor when. This is why it is crucial to maintain regular screenings.
The virus may cause other cancers aside from cervical, such as vaginal and vulvar cancers in women, anal cancers in both men and women, and penile cancer in men. There has also been shown to be an increase of 75 percent in the number of oropharyngeal cancers related to HPV. It has also been shown in some studies to cause 25 percent of head/neck cancers. High-risk, cancer-causing HPV strains often have no real symptoms, which is another reason why regular screenings are important. If there are symptoms, the most common is intense itching.
The general HPV test does not reveal which strain of the high-risk types a person has. It is simply reported as positive or negative. Treatment is the same regardless of the type. The HPV test is typically done in conjunction with a Pap smear test. If a Pap test is abnormal, a doctor then requests that a lab perform the HPV test. However, the Pap test is not as sensitive in picking up HPV as the HPV test. A person can have a normal Pap but still be positive for high-risk HPV. You may want to request that your ob-gyn has both tests done together regardless of the outcome of your Pap.
A person diagnosed with high-risk HPV (HRHPV) may need a colposcopy to look for lesions on the cervix. The vagina, the vulva and the peri-anal and anal areas should also be examined for lesions. Any woman who has cervical involvement from HPV has an increased risk of anal involvement, making observation of this area imperative. While anal cancers, which claimed the life of Farrah Fawcett two years ago, affects about 5,000 people annually, the number continues to rise by 2 percent each year. The illness is sometimes misdiagnosed as bleeding hemorrhoids.
Unfortunately, healthcare professionals may not be as educated as they should be about HPV. But you need to be. Be your own advocate and don’t allow anyone to minimize or dismiss your concerns about this virus and its potential.
As to whether to get your child vaccinated, think about this: If your son or daughter developed an HPV-induced cancer in the future, could you handle being accountable for the decision that might have prevented it?
For further information about HPV, visit thehpvsupportnetwork.org.