Human Papillomavirus - Symptoms, Transmission and Treatment

Human papillomavirus, better known by the acronym HPV is a virus that can be transmitted by sexual contact or by direct contact with skin.


HPV is responsible for the appearance of common warts of the skin and genital warts, also known as condyloma acuminata or rooster combs. But what makes HPV a great medical relevance virus is the fact that he is related to virtually 100% of cases of cervical cancer of the uterus, the most common types of cancer in the female population.

In this article we will explain what the HPV virus, how it is transmitted, what are its symptoms and complications, which are the treatment options and their chances of a cure.

What is HPV

HPV is a virus that infects only human and attacks the skin and epithelial cells of the mucosa. The action of the virus on the skin cells promotes tumor formation, most of them small and benign, such as the common skin warts or genital warts. However, when the infected area is the mucosa of the cervix, vagina, penis or anus, the virus can induce the formation of malignant tumors, generating, for example, cervical cancer, and anal cancer.

There are more than 150 subtypes of HPV. Each virus subtype has attracted to a particular area of the body. For example, the HPV and HPV-2 are associated with four common skin warts while HPV-1 which causes warts preferably affect the soles. Since HPV-6 and HPV-11 are related to the development of genital warts. The cervical cancer can be caused by several subtypes, as we shall see, but most cases occur when a woman is infected with HPV-16 or HPV-18.

Cancers related to HPV

As already mentioned, which makes HPV a serious public health problem is its ability to cause some cancers. 99% of cervical cancers, 93% of anal cancers, 60% of vulvar cancers and 50% of penile and vaginal cancers are related to HPV infection. Rarely, HPV is also capable of causing cancer of the larynx, mouth, sinuses and esophagus.

Among all these mentioned cancers, cervical cancer is triggered the most common reason is much more often hear talk about your association with HPV than for other types of cancer.

However, it is important to note that not every HPV infection leads to the formation of a malignant tumor. Among the more than 150 known HPV subtypes, few are considered more hazardous as subtypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68, while others are less aggressive with low risk of malignant transformation, such subtypes 6, 11, 40, 42, 43, 44, 53, 54, 61, 72, 73 and 81.

In fact, around 70% of cases of cervical cancer are caused by only two subtypes, 50% HPV-16 and HPV-20 18%. HPV-16 is also behind most cases of anal cancer, penile, vaginal, vulvar and some types of oropharyngeal cancer, which is therefore the most dangerous HPV subtype for both men and women.

In addition the HPV subtype, another important factor for the generation of a malignant tumor is the time of infection. Most people infected with HPV can get rid of the virus spontaneously after 1 or 2 years. To do so, just have an immune system able to cope with HPV. About 10% of infected individuals, however, develop what we call persistent infection. These are the people who have the highest risk of having cancer.

The HPV need 10-20 years to be able to cause cellular changes that generate a malignant tumor. Therefore, screening tests of cervical cancer, as the famous Pap test (preventive gynecological exam), it is essential for us to identify the occurrence of premalignant changes that occur years before the malignant tumor appears.

HPV transmission methods

HPV that infect the skin and cause common warts are normally contracted when there are minor skin injuries such as cuts or scratches which allow the virus invasion into the body. The transmission is made, so with skin contact with skin.

The subtypes of HPV that cause common warts are not related to cancers that occur in the lining of the genitals, anus or cervix, as they are unable to infect the region. The opposite is also true, as the subtypes that usually cause damage to mucous usually not attack the skin.

However, there are some exceptions to the above rule. Some subtypes able to cause warts on the skin can also possibly cause genital warts, such as HPV-1, HPV-2 and HPV-4. These subtypes, but rarely cause genital warts and when they do have low capacity to generate malignant tumors.

The contagion of the mucous membranes of the vagina, vulva, anus, penis and cervix is through sexual contact. Many do not know, but the HPV infection is the most common sexually transmitted disease in the world, often more than AIDS, gonorrhea, syphilis, or any other known STD.

Transmission of HPV through oral sex is possible, but is far less common than transmission through vaginal or anal sex. Some cases of cancer of the oropharynx, larynx and esophagus are related to this type of contamination.

Except for sharing sexual objects, transmission of HPV other inanimate objects such as towels, bed linen and underwear, does not seem to occur. Similarly, we can not catch HPV in public bathrooms, swimming pool, sauna or beach.

Symptoms of HPV

As explained above, each HPV subtype has a preference for a certain area of the body:
  • Subtypes 1, 2, 4, 26, 27, 29, 41, 57, 65 and 75 to 78 often cause common skin warts.
  • The subtypes 3, 10, 27, 28, 38, 41 and 49 also cause warts on the skin but are generally called flat warts.
  • Subtypes 1, 2, 4, 60, 63 cause warts on the soles of the feet.
  • Subtypes 1 to 6, 10, 11, 16, 18, 30, 31, 33, 35, 39 to 45, 51 to 59, 70 and 83 can cause genital and anal warts (condyloma acuminata). Note: 90% of cases of genital warts are caused by subtypes 6:11.

HPV-16 and HPV-18, which are those more related to cervical cancer do not usually cause any symptoms. The vast majority of women infected with HPV do not even suspect who has the virus. The diagnosis of infection usually occurs through preventive gynecological examination.

Diagnosis of HPV

In the case of skin or genital warts, HPV diagnosis is clinical, using a simple physical examination. Just identify the presence of the wart, it is not required other tests. In the specific case of genital warts, although the diagnosis of HPV be obvious, it is important that (a) patient is tested (a) for other STDs, it is very common for a person to have more than one STD at the same time.

Since the diagnosis of HPV in women with uterine cervix infected is more complex. There are symptoms and not always found in the Pap smear are characteristic of HPV infection. For the presence of the virus, the gynecologist needs spoon during pelvic examination a small sample of cervical material and inside the vagina. This material is sent to the laboratory so that it can look for the presence of HPV. If HPV present, the laboratory is able to provide information on the subtype of the virus responsible for the infection.

Treatment of HPV

As previously mentioned, about 90% of HPV infections to heal themselves after 1 or 2 years.

In fact, HPV has a curious feature: it is an infection that has no treatment but no cure. There are no drugs to kill the virus or accelerate the healing process. The only option is to wait for the immune system to eliminate virus spontaneously over time.

In patients who develop warts, treatment is only for the removal of the lesion. When the wart is removed it does not mean that the virus has been eliminated from the body. The patient remains infected and can develop new warts while HPV is present.

The situation is equal to the women who develop pre-malignant lesions (intraepithelial neoplasia) uterine cervix. When a premalignant lesion is identified, the gynecologist to remove surgically, but that does not mean that the patient was cured of HPV. If it remains infected, new potentially malignant lesions may arise over the years.

HPV prevention

Despite being an important prevention measure, condoms are not 100% effective against HPV transmission. This is because the virus may be present in areas of the genitalia that are not covered by the condom.

To be real prevention of infection, the best option is the vaccine. There are two HPV vaccines, one that protects against subtypes 16 and 18, the most dangerous for cancer of the cervix, and another that protects against subtypes 16, 18, 6 and 11, effective against cervical cancer uterus and against genital warts.

HPV vaccines are very effective, with success rates above 95%, especially when administered in young girls who have not started their sex life and therefore never had contact with the HPV virus.

Despite the frequent obscurantist and slanderous campaigns that try to disqualify the importance of vaccination, the fact is that the HPV vaccine has sound scientific basis, both on the issue of efficacy and the safety.

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