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HPV(Human Papillomavirus)

There are over 100 subtypes of HPV virus. About 40 or so strains are implicated in genital infections. The genital strains are very infectious and can be transmitted by oral, genital, anal and even genital-to-genital non-penetrating contact. It has been estimated than more than 80% of the population will get 1 or more infections with one of these genital strains. According to the CDC, presently almost 80 million Americans are infected with a genital strain of HPV and about 14 million acquire infection yearly. Being infected with 1 strain does little to protect against infection with a different genital strain. The virus grows very slowly so Infections with these strains are often not clinically apparent or take time to develop symptoms. In women the most common manifestation of infection is an abnormal cervical Pap smear. Fortunately, 90% of these infections spontaneously resolve in 2 years. However, in a small percentage of women the infection becomes chronic and may even progress to cancer years to decades later. This is especially true if infected with one of the more virulent, cancer-causing strains.
Orange County AAP Chapter, CME Committee Chair, Dr. Harry Pellman

How is HPV Transmitted?

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). More than 40 HPV types can also infect the mouth and throat. Most people who become infected with HPV do not know they have it. HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

Symptoms of HPV

Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV within two years. But there is no way to know which people who get HPV will go on to develop health problems.

Diagnosis

The HPV test checks for the virus that can cause these cell changes on the cervix. It may be used to screen for cervical cancer, with the Pap test, in women aged 30 years and older. If both tests are negative, the risk for cervical cancer is very low and women can wait five years before another screening. HPV tests also may be used to provide more information when a Pap test has unclear results. Currently, there is no routine screening test recommended for other HPV-related health effects, such as genital warts or other HPV-associated cancers (cancers of the vulva, vagina, anus, penis, and oropharnyx). The Pap test does not screen for cancers other than cervical cancer. Women should start getting the Pap test at age 21 years, and then every three years after that. Although there is no routine screening test for other HPV-associated diseases, you should visit your doctor regularly for checkups.

Pap Test Results
It can take as long as three weeks to receive your Pap test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why Pap test results might not be normal. It usually does not mean you have cancer. If your Pap test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

Prevention

HPV vaccines are given as a series of three shots over 6 months to protect against HPV infection and the health problems that HPV infection can cause. Two vaccines (Cervarix and Gardasil) protect against cervical cancers in women. One vaccine (Gardasil) also protects against genital warts and cancers of the anus, vagina and vulva. Both vaccines are available for females. Only Gardasil is available for males. HPV vaccines offer the best protection to girls and boys who receive all three vaccine doses and have time to develop an immune response before being sexually active with another person. That's why HPV vaccination is recommended for preteen girls and boys at age 11 or 12 years.

Centers for Disease Control and Prevention