What is HPV?
Human papillomavirus (HPV) is a common sexually transmitted DNA virus. It is transmitted through vaginal, anal, or oral sex, and can be spread even when an infected individual does not show any symptoms. Although most women effectively clear HPV infections within 6 to 12 months (1), there are specific HPV genotypes that increase the risk of cervical cancer (2).
How common is HPV?
HPV is the most common sexually transmitted disease in the United States. An estimated 43 million Americans were infected with HPV in 2018, with many infections among people in their late teens and early 20s. Almost every non-vaccinated sexually active individual will get HPV at some time in his or her life (3).
Are there different types of HPV?
There are more than 100 genotypes of HPV, of which 14 are considered high-risk for cervical disease – genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Women who have persistent infection with one of these pathogenic genotypes have an increased risk for cervical carcinoma or severe dysplasia (4).
What are the symptoms of an HPV infection?
Usually, HPV does not cause any symptoms and is effectively cleared without any medical interventions. However, in some cases, warts can occur on the cervix, vagina, anus, or back of the throat. These warts may lead to itching or burning sensations and unusual discharges.
Other types of HPV can cause cell changes that lead to cervical cancer and other cancers of the vulva, vagina, penis, anus, or throat. Generally, the types of HPV that cause warts differ from those that cause cancer (3).
Who is at risk of HPV? How can I lower my risk?
Anybody who is sexually active is at risk of catching HPV, as HPV is a very common sexually transmitted infection.
Using condoms correctly lowers the risk of catching HPV, but HPV can still infect areas that are not covered by a condom, so condoms do not provide full protection.
HPV vaccination is safe and effective to prevent diseases (including cancer) caused by HPV. It is recommended at age 11 or 12 years, and for everyone through to 26 years, if not vaccinated already. Vaccination for individuals older than 26 years provides less benefit, as most sexually active adults have already been exposed to HPV (3).
Routine screening for cervical cancer with pap smears is also recommended for women aged 21–65 years (3).
How is HPV diagnosed?
Most HPV infections are asymptomatic and clear up without medical intervention within 6 to 12 months. Hence, most infected individuals are unaware of their diagnosis. There are no tests to find out a person’s “HPV status”, as there are so many different types of HPV (3). However, nucleic acid tests (such as this one) are available to accurately identify individuals who are infected with one of the 14 high-risk HPV strains. Detection of HPV nucleic acid (a positive test result) is indicative of an active HPV infection but does not mean that cervical dysplasia or cervical cancer is present.
Follow-up testing is recommended for any positive results, with protocols varying based on the results of recent pap smears. Another HPV test and/or pap smear in a shorter time period from routine testing may be all that is required. Alternatively, a colposcopy to further examine the cervix, vagina, or vulva can be used to detect abnormal cells or blood vessels. Other options include tissue biopsies, removal of abnormal cervical cells, and referral to a gynecologist (5).
How is HPV treated?
There is no treatment for HPV itself; however, there are treatments for the health problems associated with HPV. Genital warts can be treated with prescription medication, and cervical precancer can be effectively treated. Any cancers that are associated with HPV are more treatable when diagnosed and treated early; hence the importance of routine screening (5).
1. Cuschieri KS, Whitley MJ, & Cubie HA. (2004). Human papillomavirus type-specific DNA and RNA persistence–implications for cervical disease progression and monitoring. J Med Virol, 73 (1), 65-70.
2. Cervical Cancer. WHO.
3. Genital HPV Infection – Fact Sheet. (2021, January). CDC.
4. Kjaer SK, et al. (2002). Type-specific persistence of high-risk human papillomavirus (HPV) as an indicator of high grade cervical squamous intraepithelial lesions in young women: population-based prospective follow-up study. BMJ, 325 (7364), 572-579.
5. Human Papillomavirus (HPV) Treatment and Care. (July 2021). CDC.