Medicine for Africa - Medical Information Service

APILLOMA VIRUS

Definition:
  
Human Papilloma Virus, HPV, belongs to the family of sexually transmitted diseases and is, in fact, one of the most common sexually transmitted diseases. The virus can be transmitted during sexual contacts between two people; 'sexual contact' does not only imply sexual intercourse, it includes any close bodily contact, that is oral as well as anal contact and intercourse.

More than 100 subtypes of HPV have already been identified. While only a few appear in the genital area, these can be either benign, so-called low risk types of HPV, causing genital warts, or develop into malignant tumors, so-called high-risk types of HPV, causing cancer of the cervix and probably of the uterus, as well as cancers of the vulva, penis, genital skin area and anus. HPV has also been identified in several benign and malignant tumors of other organs; however, a relationship of these types of tumors to sexual contacts has not yet been established

 
Symptoms:
 
HPV classically causes genital warts on the vulva, in the vagina as well as on the cervix, the tip and shaft of the penis and in the anal area. High-risk types can cause cervical cancer as well as other types of cancer, predominantly in the genital area (Verrucous cancer of the penis, squamous cell cancer, etc.). Symptoms are often not obvious or take a long time to appear as a wart (=condyloma acuminatum) or to develop into atypical (=dysplastic) cells, which then may have the potential to further develop into cancer. Nevertheless, the viral infection is present and the person is capable of transmitting the virus to his/her partner. The warts can be small, single or multiple in clusters, they can be slightly raised or have a cauliflower-like appearance of small to large dimensions. All of them contain the virus and are highly contagious. They usually develop within about 2 to 3 months after infection, their growth rate can be slow or fast and, even if untreated, some disappear after a while. However, whether the wart will disappear or grow is impossible to predict, therefore, anybody who discovers newly developed genital warts should consult a physician and be treated for them.

 
Diagnosis:
 
HPVs' characteristic cell changes can be seen on a Pap smear, prepared from a cervical cell swab. The typical cauliflower-like warts can be identified by the physician and are highly suggestive of the diagnosis. A biopsy of large lesions or the completely removed wart can further be diagnosed by a pathologist according to characteristic cell changes. The tissue with the infected cells can be stained by various methods to identify viral proteins or parts of the viral DNA. These tests are very sensitive, are expensive, and need to be performed by specially trained personnel

 
Therapy:
 
There is no effective treatment for the virus. Recently developed and (in the USA) marketed vaccines to 'prevent' an infection show some effect (see below). However, there is no treatment for an already infected person at this point in time.

 
Prevention:
 
After many years of research, there are, at long last, two vaccines available - one of them being Gardasil® by Merck&Co, available since June 2006, which is said to protect against four types of HPV which account for 90% of HPV-caused genital warts and about 70% of HPV-caused cervical cancer. The other, more recently available vaccine by GlaxoSmithKline, is called Cervarix®, which is marketed as providing up to 100% protection for up to four years, especially to women ages 25 to 55.

While these vaccines are badly needed preventive options for women of all ages, one has to be aware of the fact that no vaccine can really provide 100% protection to 100% of all vaccinated women. Also, vaccines are only effective for a certain period of time and need to be repeated regularly. Furthermore, men can also carry the virus, even without showing any obvious symptoms or the typical papillooma warts, yet they can transmit the virus to their next sexual partner.

Thus, the ultimate prevention of HPV is once again the same as for all sexually transmitted diseases - based primarily on avoiding and eliminating sexual contact with an infected person. Since one cannot always be assured of the sexual hygiene of a partner, prevention is best achieved, with a relatively high degree of success, by using a latex condom. Non-latex condoms are not as certain to prevent contact with the infected person's organisms, since some organisms can penetrate non-latex materials and infect the partner. In addition to the condoms used by men, there are now also condoms for women who can take the initiative if the man does not. A condom should never be used more than once, because contamination with or leaking of semen occurs frequently upon repeated usage of any kind of condom. If a person knows that he/she is infected by one of these diseases, he/she should take responsibility and abstain from sexual contacts with anybody during the time of contagion.

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DISCLAIMER: The above article is only intended to provide general information regarding this topic. It is not intended and does NOT replace the need to consult a medical or other professional person, if you have or believe to have this disease/disorder. While the article was researched, written and reviewed by medical professionals, and Medicine for Africa, its staff and publisher made every effort to assure accuracy and correctness, it does not claim to be complete, correct or to reflect the very latest stand of medical/scientific knowledge in the disease’s/syndrome’s pathology, diagnostic and/or therapeutic development. Medicine for Africa, its founder, management, staff, writers, reviewers or publishers may NOT be made responsible or legally bound to any information provided above, and cannot be held liable to any conclusions or decisions the reader may draw after reading this article. The reader is explicitly advised to consult a licensed physician and to present his/her specific situation before making any health related decisions.