HPV: Causes, Vaccination, Treatment, Prevention, Prognosis

HPV is very common these days, especially in developing nations. The symptoms are not very clear hence one doesn’t realize the same. Most people contract HPV at some point in life. They don’t notice any significant symptoms except small warts hence they feel completely fine. This article on HPV and vaccination is important to understand the infection and vaccination to prevent it.

Cancer is the second leading cause of death globally and is estimated to account for 9.6 million deaths in 2018.¹ Lung, prostate, colorectal, stomach and liver are common types in men, while breast, cervix, thyroid, colorectal and lung are more common in women. While early detection is the key to effectively manage cancers, very few types of cancers can be prevented and cervical cancer is one of them.

Cervical cancer is most likely to be caused by HPV infection, which is very common. However, some vaccines can prevent HPV infection and thus prevent precancers and cancers of cervix.² Let us understand HPV and vaccination in detail.

HPV stands for Human papillomavirus. It is one of the most common viral infections of the reproductive tract. There are about 200 types of virus, out of which around 40 types of virus infect the genital of humans which include anus, scrotum, cervix, vagina, vulva, and penis. These kinds of HPV are transmitted through sexual contacts.

Although around 10% of the Human papillomaviruses are known to be cancer-causing, the rest of them don’t affect much. Two types of viruses (16 and 18) are together responsible for about 70% of cervical cancer cases globally.³

HPV mainly affects reproductive tracts but some type of viruses can affect the mouth and throats. Warts, inside the mouth and behind the throat are the testimony of this viral infection. Sometimes, HPV can be transmitted during birth to an infant causing various problems. Some kinds of HPV cause genital warts, which are hard, rough lumps that grow on the surface of the skin.

Dealing with rough and hard lumps might be difficult but ignoring the wart can worsen the situation. The developing nations are facing the harshest consequences of HPV because of a lack of awareness. Unprotected sex due to lack of awareness or availability of resources is increasing the risk of this viral infection.

HPV mainly spreads through skin to skin. The biggest myth revolving around HPV is that it spreads because of penetrative sex and it’s not the case. Doctors believe that physical interactions like touching the genital organs like vulva, anus, penis, cervix to someone’s genitals or mouth and throat too can transmit the infection, thus causing the disease.

They can remain dormant in someone’s body till later they can infect any new host or sexual partner. They generally infect those who are sexually active i.e. they do it frequently, but they don’t display any sort of symptoms. HPV is a highly contagious infection hence proper safety is required. However, genital warts are common, hence it is best to seek medical advice, as needed.

Various tests are available for doctors to examine the extent and severity of the infection. Some of them include:

Using the solution of CH3COOH (acetic acid) commonly known as vinegar, doctors can identify difficult-to-see bruises of flat warts, which are common symptoms of HPV.

Pap test or Papanicolaou test is another test through which the doctor comes to know about the abnormalities of the lesion. They collect the sample from the patient’s cervix or vagina which is the most vulnerable part of HPV. This test is mainly done for cervical cancer, as it helps to detect the presence of any abnormal cells.

A DNA test is conducted on the sample that the doctor collects from the vagina and cervix. Through this test, they try to match the strain of cancer-causing cell’s DNA with the sample. A positive result means that it has converted into a cancerous cell.

Both Pap tests and DNA tests are conducted on women because they have greater chances of contracting HPV. Meanwhile, Acetic acid is used on both men and women. There are no similar tests for the strain of HPV in men. For many severe cases, the doctor may ask the patient to go for colposcopy, in which the doctor uses a magnifying glass like device colposcope to examine the vulva, vagina, and cervix.

USA saw a breakthrough in medical science when FDA approved HPV vaccines in 2006. However, many people are still unsure about the usage and their effects. HPV and vaccination is an important area that needs attention to create more awareness.

According to WHO, there are three HPV vaccines available, a bivalent, quadrivalent, and a nonavalent vaccine and all these vaccines are highly effective in preventing infections of virus types 16 and 18.3

Two vaccinations have been approved by the FDA to counter HPV. They are GARDASIL and GARDASIL-9. Both differ in their ability to counter. While GARDASIL can counter 90% of genital warts, its predecessor GARDASIL-9 can counter 5 more types of viruses. CERVARIX is another type of vaccine which is available, it is similar to GARDASIL but has less number of virus cover.

The most suitable one is best decided by the physician, hence it is necessary to follow medical advice. No matter which vaccine a person takes, completing all three shots at a regular interval of 6 months is necessary for the vaccine to work. The best time to get the vaccine is before the person starts any sexual activity. The tender age of 11 or 12 is better to get immunized. This vaccine is safe and is rigorously tested by drug agencies. Though many people can be allergic to this solution, it is safe for wide consumers. Pregnant women should consult their doctors first to avoid any unintentional harm to the baby.

If the doctor finds any abnormal growth of cells in the woman’s genital the doctor may prefer to observe and evaluate further. Sometimes abnormal cells go away, hence they would normally follow wait and watch approach to confirm.

Once assured of the presence of the abnormal cells, the doctor may make use of one of these techniques:

• Cryotherapy, which involves freezing the abnormal growth with liquid nitrogen, the temperature of liquid nitrogen is below -170 degrees Celsius, which allows it to retard the growth of cancerous cells.
• Conization is a process in which the surgeon removes the infected part surgically.
• Laser therapy or radiation therapy is a process in which the doctor uses a highly polarized laser to burn the abnormalities away.
• LEEP or Loop Electrical excision procedure is a process in which electric current is used to remove all the abnormal cells including one which is infected with HPV.

For visible warts, it is advisable to let them grow for longer, removing them straight away is not a better idea as it can grow much aggressively. For any sort of treatment, the doctor may prescribe the patient, some creams. Generally, wart goes within a few months using these treatments but if the treatment doesn’t work then the doctor may prescribe some more tests to check if something else is going on.

Although HPV is a very common STD, ignoring the consequences can only worsen the situation. Some of the ways to prevent HPV include:

• Women should take pap tests regularly, Pap test provides better results and can help in early detection of cancerous tendency.
• Men and women should stop sexual contact as soon as they realize that they are suffering from HPV. Contraceptives like condoms are not effective for areas around the scrotum, vagina, vulva or anus.
• Vaccination is the best way to prevent infection. Consult a doctor as soon as possible. These vaccines are clinically proven and children can be vaccinated at a tender age of 9.
• Prevention is better than cure hence vaccines are the most optimized way to live a better life. HPV vaccination can be very useful in preventing infection and reducing the risk of cancer.

There is no exact cure for HPV itself, while 70% to 90% percent of cases may be cleared by the body within 6 months by the immune system. In some cases, treatment is not necessary. Only a small fraction of women infected with HPV will develop cellular changes that are termed as abnormal. Hence, following medical advice is essential.

Remember, HPV is the most common sexually transmitted disease which has no severe consequences. Although it goes away on its own, one should visit a gynecologist if the symptoms persist. Most people who have sex get HPV at some point in their life. So, there is no need to feel shy or afraid. Keeping some prevention points in mind will help anyone to lead a better life. HPV and vaccination is an important area that you should be aware of and consult the doctor accordingly.

References:  

Also Read:

• HPV or Genital Warts: Symptoms, Causes, Treatment, Prevention, Complications, Risk Factors, Diagnosis
• Do’s and Don’ts of Vaccination
• What is HPV Vaccine For & Can You Take it After Being Infected?
• Importance of Vaccination During Pregnancy
• Vaccinations for Adults: Why Should You Take & Which Vaccinations Should be Taken
• What do the Warts of HPV Look Like & How to Get Rid of HPV?
• A Vaccination Schedule for the Elderly
• Pap Plus HPV For Cervical Cancer – Why Co-Testing In Cervical Cancer Is Better?