Human Papillomavirus

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Introduction

What is human papillomavirus?

The human papillomaviruses (also known as HPV) are a group of more than 150 viruses, 40 of which are known to infect the genital areas. Other types infect the skin and the lining of the throat. It is possible to be infected with HPV without knowing you have it, and the majority of infections do not produce any symptoms. HPV affects both men and women and can cause warts, or papillomas, on the genitals and around the anus, as well as at other sites. The virus is passed through direct contact, including sexual contact. HPV is the most common sexually transmitted infection (Source: CDC).

Certain strains of HPV can cause precancerous changes in cells in the area where the infection occurs. The infection can lead to different types of cancers, including cervical cancer in women. Cancer-causing HPVs are referred to as high-risk, carcinogenic, or oncogenic HPVs. HPV infection is also linked to cancers of the oral cavity, anus, penis, vagina and vulva.

Approximately 50% of sexually active men and women will have HPV at some point in their lives. Approximately 20 million Americans have HPV, with six million new cases occurring each year (Source: CDC).

Symptoms of HPV include warts on the genital areas that may appear small or large, flat or raised, or cauliflower shaped. Warts can also appear in the throat, in a condition called recurrent respiratory papillomatosis. Skin (cutaneous) warts are also caused by certain types of HPV.

HPV does not always cause symptoms, but it is highly contagious. People do not always realize they have it and may transmit the virus unknowingly. Seek prompt medical care if you suspect that you or your partner may have contracted or may be at risk for HPV infection.

Symptoms

What are the symptoms of human papillomavirus infection?

Symptoms of human papillomavirus (HPV) infection include the appearance of warts that may vary in size from small to large and may be raised, flat, or cauliflower shaped. Warts can appear on the skin (cutaneous warts), in the throat (recurrent respiratory papillomatosis), or in the genital areas. Left untreated, warts may persist, disappear, or increase in size and number. Many cases of HPV do not cause symptoms and the great majority of HPV infections resolve by themselves without treatment.

Other types of HPV can cause cancers, including oropharyngeal, cervical, anal, penile, vaginal and vulvar cancers. They also cause precancerous, or dysplastic, changes at these sites. Among the types of HPV that can infect the genital area, the so-called low-risk HPV types are most likely to result in genital warts, while the high-risk HPV types are more likely to cause cancers and precancerous changes.

Common symptoms of human papillomavirus infection

The visible signs of HPV vary, and some people do not experience symptoms at all. Symptoms that may appear include:

  • Warts of varying size and shape (including large, small, flat, raised, and cauliflower shaped) on the skin, including on the genitals

  • Warts in the throat that cause problems with speaking or breathing

  • Warts that appear weeks or months after sexual contact

Symptoms that might indicate a serious condition

In some cases, HPV infection can lead to cancers, such as cancer of the cervix in women. Seek prompt medical care if you have symptoms of cervical cancer including:

Causes

What causes human papillomavirus infection?

Human papillomavirus (HPV) is a contagious virus transmitted through direct contact, including sexual contact. People may have HPV for months or years without knowing they have it and without experiencing any problems, and they may unknowingly pass it along to others. It is possible to be infected with more than one type of HPV.

What are the risk factors for human papillomavirus infection?

A number of factors increase the risk of developing human papillomavirus (HPV) infection. Not all people with risk factors will get HPV. Risk factors for HPV infection include:

  • Adolescent sexual relations

  • Contact with (touching) genital or skin warts of others

  • Multiple sexual partners

  • Unprotected sex (without the proper use of condoms)

Reducing your risk of human papillomavirus infection

You may be able to lower your risk of HPV infection by:

  • Avoiding contact with warts on other people

  • Avoiding unprotected sex. The use of condoms can limit the transmission of HPV.

  • Quitting smoking, as smoking has been found to be associated with an increased risk of HPV infection and related cancers

  • Reducing your number of sexual partners

An HPV vaccine is available for the prevention of the HPV types most commonly associated with cervical cancers, as well as genital warts. Gardasil 9 prevents infection with the types of high-risk HPVs most commonly associated with cervical cancer, anal cancer, throat cancer, and genital warts.

The vaccine is available for girls and boy sas young as age nine, and they can be given to women and men up to age 45 who did not have the vaccination when they were younger.

Treatments

How is human papillomavirus infection treated?

Currently, there is no cure for human papillomavirus (HPV) infection. The majority of HPV cases resolve on their own, but flare-ups of skin or genital warts may occur. The warts can be removed by a physician using chemical or laser treatments, or they may disappear on their own.

Cervical cancer, which is caused by the HPV virus, is best treated when detected early through regular Pap tests or HPV testing, which can detect the virus itself in the same cell sample used for the Pap test. Visiting your physician regularly, being aware of your risk factors, and taking steps to prevent HPV are the best ways to avoid problems later.

What are the potential complications of human papillomavirus?

The cancers associated with human papillomavirus (HPV) can be life threatening. Controlling your risk factors and visiting your physician regularly are the best prevention. For women, getting regular screenings is critical, since you will have the best prognosis if cervical cancer is detected early. Complications of HPV infection include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 30
  1. Genital HPV infection - fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/HPV/STDFact-HPV.htm
  2. Human papillomavirus (HPV). Centers for Disease Control and Prevention. http://www.cdc.gov/hpv/WhatIsHPV.html
  3. Einstein MH, Schiller JT, Viscidi RP, et al. Clinician's guide to human papillomavirus immunology: knowns and unknowns. Lancet Infect Dis 2009; 9:347.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  5. What Should I Know About Screening? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/cervical/basic_info/screening.htm
  6. FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old. U.S. Food and Drug Administration. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622715.htm 
  7. Human Papilloma (HPV) Vaccines. National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet

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