What is Human Papilloma Virus?
Human papilloma virus (HPV) is a sexually-acquired virus that is difficult to avoid – up to 80% of people who’ve ever had sex will meet it over the course of their lives!
There are over 100 subtypes or strains of HPV, and around 40 of them are known to infect the skin around the genitals. These strains can be divided into low-risk and high-risk types – high-risk types have been found in certain cancers of the genital tract.
What problems can HPV cause?
Like with many sexually-transmitted infections, most people who have HPV will never have any symptoms. HPV can behave similarly to the herpes virus, lying dormant for a while before causing any problems. So, it can be impossible to tell when you got the virus, and who might have given it to you – if you are diagnosed with a HPV-related problem, it’s wise not to jump to conclusions!
One of the most common problems caused by HPV is genital warts. These are mostly caused by low-risk subtypes of HPV, including 2 subtypes that the “Gardasil” vaccine is protective for – subtypes 6 and 11. Genital warts are generally easy to see and can be quite large in a minority of cases. The warts are highly infectious.
Most warts will go away on their own over time, without any treatment, but many people who have them will opt for treatment due to the appearance of the warts, or to decrease the risk of transmission to others. There are many treatment options available but none is perfect – it’s your body’s immune system that eventually fights off the virus, and this can take years.
HPV is also a cause of genital tract cancers, the most well-known being cervical cancer. These are usually caused by high-risk subtypes of HPV – most commonly subtypes 16 and 18, again contained in the “Gardasil” vaccine.
How is HPV detected?
Unless you have genital warts, you may never know that you have HPV. As HPV is responsible for the cervical cell changes that precede cervical cancer, it is important for women to have regular pap smears – even if they have had the “Gardasil” or “Cervarix” HPV vaccination.
HPV causes typical cellular changes that can be seen on pap smear, allowing these changes to be examined in more detail, and treated before they become cancerous. Currently, Australian guidelines recommend a pap smear every 2 years beginning at the age of 18 (or 2 years after commencing sexual activity – whichever is later). However, in May 2017 the screening program will change in a few ways:
Screening starts at age 25 (as cancer is extremely rare in younger women)
Screening will consist of a HPV test initially, then a pap smear depending on the HPV results
If the HPV test is negative, your next test will be due in 5 years (instead of the current 2 years)
The tests will be collected the same way that current pap smears are collected – with a speculum examination. Note that I have called HPV testing and pap smears screening tests – this means that they suggest there may be a problem, but cannot make a firm diagnosis. Diagnosis requires an in-depth cervical examination (called a colposcopy) and biopsies of the cervix, performed by a gynaecologist.
In summary…I cannot stress how important it is to have regular pap smears (or soon, HPV testing)! Cervical cancers are slow-growing in most cases, which means that pre-cancerous changes can be detected and treated before they develop into cancer. It’s also very important to know that even if you have been vaccinated against HPV, you still need your regular cervical screening tests – as the vaccines don’t protect you against all of the human papilloma virus strains that are out there.