Genital Human Papillomavirus (HPV)

Infection in Women

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HPV is human papillomavirus or wart virus.

It is the most common viral sexually transmitted infection for both men and women.

There are about 100 different types of HPV. About 30 types of HPV are exclusive to the lower genital tract. A few of these types infect internal genital areas and can sometimes cause precancerous or cancerous changes on the cervix in the vagina or on the vulval skin. Vaginal, oral and anal sex can all spread HPV. The virus is passed on by genital skin to genital skin sexual contact. Penetrative intercourse is not required.

Other HPV types that cause warts on the hands and feet do not tend to infect the genital skin area.

The risk of developing genital warts after having one episode of sexual intercourse with someone who has genital warts is not known, but several studies would appear to establish a risk in the range of 65%. Most people who have HPV do not know they have it – they can spread it to their sexual partners without knowing it. Most people who become infected with HPV have gotten it from a partner who had no symptoms at all.

The more sexual partners you have, the greater your chances are of getting an HPV infection. Using condoms may reduce your chances of getting infected, but condoms do not always help because HPV can be present in areas not covered by the condom. The immune system also determines whether one may develop a HPV infection when exposed. People with poorly functioning immune systems are more likely to get a HPV infection. Smoking increases the risk for getting HPV when exposed to the virus.

There is no good evidence that toilet seats, doorknobs, towels, soaps, swimming pools or hot tubs, can transmit HPV. However, some unexplained cases of HPV lesions do occur and one should never rule out the possibility of non-sexual transmission.

HPV can remain latent or dormant in some people for years or decades before developing warts or cervical disease, so it is usually not possible to determine exactly when, or from whom, an individual contracted the virus. There is no test that can identify ALL types of HPV infection and there is no test that can identify past exposure to infection. Like all other virus infections, HPV infection cannot be cured.

Gardasil, is a vaccine for HPV types 6, 11, 16 and 18, which confers immunity to genital warts and cervical dysplasia that is resultant from these types (particularly types 16 and 18).

Compiled by Dr Min Karen Lo (a sexual health physician in private practice in Auckland)

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