Genital human papilloma virus (HPV) is a very common sexually transmitted disease. There are 40 HPV types that cause 40 genital infections in men and women. These HPV types also settle in the mouth and throat. Most people infected with HPV do not know they are sick. HPV is not like herpes or HIV (Aids virus). Although all these viruses are transmitted during sexual intercourse, they cause different symptoms and health problems.
Signs, symptoms and health problems
The majority of people with HPV do not develop symptoms or health problems. In 90% of cases, the body’s immune system naturally destroys HPV within 2 years. Some HPV types cause genital warts in men and women. Rarely, they can also settle in the throat. This is called recurrent respiratory papillamatosis (RRP).
Other types of HPV cause cervical cancer in women. They also cause some rare, serious cancers. Such as vulva, vagina, penis, anus, head and neck (tongue, tonsil, larynx) cancer.
HPV types that cause genital warts are different from types that cause cancer. There is no way to predict which people infected with HPV will develop cancer or have other health problems.
Signs and symptoms of HPV related problems
Genital warts usually appear as single or group blisters in the genital area. They can be small or large, fluffy or flat, or have the appearance of cauliflower. They can be easily diagnosed in the office setting, during a visual examination by a specialist physician.
Genital warts develop within weeks or months after sexual contact with an infected partner (even if that person does not have genital warts). If left untreated, they may disappear on their own, remain unchanged, or increase in number and size. It does not turn into cancer.
Cervical cancer does not show symptoms until it has progressed sufficiently. Therefore, women should be screened regularly. In these scans, early signs of the disease are detected and treated early.
Other cancers related to HPV do not show signs and symptoms until they have progressed sufficiently. They are difficult to treat. These are cancers of the vulva, vagina, penis, anus, head and neck.
In RRP, warts occur in the larynx. Sometimes the windpipe is blocked. There is a hoarse voice and shortness of breath.
HPV is transmitted through sexual contact. It is mostly transmitted through vaginal or anal sexual intercourse. It is also transmitted by oral sex or contact of genital areas. It can also be transmitted from a fixed and same sexual partner (even if this person has no signs or symptoms). Even years after sexual contact with an infected person, this person can still have HPV. Many infected people (who have the HPV virus) do not know that they carry the virus and transmit it to their sexual partner. This person may also have more than one HPV type.
Very rarely, a pregnant woman with genital HPV can transmit HPV to her baby during delivery. In this case, the child may develop RRP.
Formation of genital warts and cancer
Normal cells in HPV-infected skin turn into abnormal cells. In general, the body naturally fights this HPV. Infected cells return to normal. But in some cases, the body does not fight HPV. Changes in the form of warts or cancer become visible. Warts develop within weeks or months of being infected with HPV. Cancer occurs years after HPV is removed.
HPV (virus) is so common that 50% of sexually active men and women encounter this virus at some point in their lives. Genital warts are also very common. Compared to cervical cancer, other types of cancer caused by this virus are less common.
People in some groups have a higher risk of health problems related to HPV. These are gay and bisexual men and people with a low immune system ( HIV – AIDS ).
RRP is very rare.
There are many ways to reduce the risk of HPV transmission.
Vaccines protect men and women against common HPV types. The vaccine is administered in 3 doses. For good protection, it is necessary to have all 3 doses. The protective efficacy of the vaccine administered in the period before the first sexual contact is higher.
Girls and women: The vaccine, called Gardasil, protects against most HPV types that cause cervical cancer. It also protects from many types of genital warts. It is applied to women between the ages of 13 and 26 (also for girls from the age of 9). It is recommended to start vaccination as soon as possible, provided that all 3 doses are fully administered.
Boys and men: The vaccine, called Gardasil, protects men from many types of genital warts. It is done between the ages of 9-26.
Using a condom (condom) during sexual intercourse reduces the risk of HPV. In order to be effective, the condom should not be removed from the beginning to the end of sexual contact. Condom use reduces the risk of HPV-related diseases. Like genital warts and cervical cancer. However, there is a risk of contamination in exposed areas that are not covered with a condom. In other words, condom does not provide complete protection against HPV.
Having a single partner, reducing the number of sexual partners, choosing people who have never or few sexual partners before reduces the risk of HPV transmission. It is not known whether a person who has been sexually active in the past carries the virus. For this reason, the safest way to protect against HPV is to stay away from all sexual acts.
Protection from HPV-related diseases
There are many ways to protect yourself from HPV-related health problems.
Genital warts:The vaccine, called Gardasil, protects both men and women from many types of genital warts.
Cervical cancer: The vaccine, called Gardasil, protects most women from cervical cancer. Routine cervical cancer screening tests and treatment and follow-up of abnormal results are also important prevention methods. Abnormal cells in the cervix are detected with the PAP test. Cancer is cleared before it develops. The HPV DNA test is used to look for viruses in the cervix. In some cases, it is requested together with the PAP test. Even if women are vaccinated at a very early age, cervical cancer screenings should be done. Because the vaccine is not protective in all cervical cancers.
Anus and penile cancers: There is no test to detect their early-stage findings. Some experts recommend annual anal PAP testing for gay and bisexual men and HIV-positive people. Because, the risk of anal cancer is higher in people who fall into this group. However, these tests are not very reliable in anal cancer screening. It is not routinely recommended.
Head and neck cancers: There are no approved tests to detect early signs. Tests are performed by the specialist physician according to possible findings.
RRP: Caesarean section is not recommended for women with genital warts. Because there is no conclusive evidence that cesarean delivery protects infants and children from RRP.
HPV tests on the market are only suitable for detecting cervical cancer. There is no test to show the status of HPV in the body in men and women or the presence of HPV in the genital area, mouth and larynx. However, HPV usually progresses without causing any health problems. What we know about HPV today will be very different in a few years.
There is no treatment that will destroy the virus itself. However, diseases caused by HPV can be treated.
Visible genital warts:Treatments such as chemical cauterization, electrocauterization, cryotherapy can be applied by the specialist physician.
Cervical cancer: The results are satisfactory with early diagnosis and treatment. In those who have routine PAP tests, problems are detected before cancer occurs and solutions are easier to find. Prevention methods are more important than treatment.
Other HPV-related cancers:Results are better with early diagnosis and treatment.
RRP: It is treated surgically or with medication. Requires multiple treatment sessions.