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Human Papillomavirus (HPV)

About This Disease


Human papillomavirus (HPV) is a group of more than 150 related viruses.
Each HPV virus in this group is given a number which is called its HPV type.

HPV is named for the warts (papillomas) some HPV types can cause. Some
other types of HPV can lead to cancer.

HPV infections are so common that nearly all men and women will get at
least one type of HPV at some point in their lives. About 79 million
Americans are currently infected with some type of HPV. About 14 million
people in the U.S. become newly infected each year.

While in most cases HPV goes away on its own and does not cause any health
problems, HPV infections can sometimes cause certain cancers and other
diseases. HPV infections can cause:

Cancers of the cervix, vagina, and vulva in women


Cancers of the penis in men
Cancers of the anus and back of the throat, including the base of the
tongue and tonsils (oropharynx) in both men and women.

Every year in the U.S., HPV causes 30,700 cancers in men and women. HPV
vaccination can prevent most of these cancers (about 28,000) from
occurring.

Signs and Symptoms


Most people with HPV never develop symptoms or health problems. In 9 out
of 10 cases, the infection goes away within two years. But occasionally, HPV
infections will last longer and can cause certain cancers and other diseases,
such as genital warts (usually appear as a small bump or groups of bumps in
the genital area. They can be small or large, raised or flat, or shaped like a
cauliflower).

HPV cancers usually do not have symptoms until they are quite advanced,
very serious and hard to treat. Cancer often takes years, even decades, to
develop after a person gets HPV. There is no way to know which people who
have HPV will develop cancer or other health problems. People with weak
immune systems (including individuals with HIV/AIDS) may be less able to
fight off HPV and more likely to develop health problems from it.

Transmission
HPV is transmitted through intimate skin-to-skin contact during vaginal,
anal, or oral sex. A person can get HPV even if their partner doesn’t have any
signs or symptoms of HPV infection. Most people do not realize they are
infected. They also don’t know that they may be passing HPV to their sex
partner(s). You can develop symptoms years after being infected, making it
hard to know when you first became infected. It is possible for someone to
get more than one type of HPV.

Although uncommon, sometimes a pregnant woman with HPV can pass the
virus to her baby during delivery. The child might develop recurrent
respiratory papillomatosis (RRP), a rare but dangerous condition where
warts caused by HPV grow inside the throat.

There have not been any documented cases of people getting HPV from
environmental surfaces, such as toilet seats. However, someone could be
exposed to HPV from objects shared during sexual activity, if the object has
been used by an infected person.

Diagnosis
Most people with HPV do not know they are infected and never develop
symptoms or health problems from it. Some people find out they have HPV
when they get genital warts. A healthcare provider can usually diagnose warts
by looking at the genital area. Women may be diagnosed with HPV when
they get an abnormal Pap test result (during cervical cancer screening).

While there is screening for cervical cancer, there is no routine screening for
the other 20,000 cancers caused by HPV infections each year in the U.S.
Often these cancers, such as cancers of the back of the throat (oropharyngeal)
and cancers of the anus/rectum, are not detected until later stages when they
are difficult to treat.

Treatment
There is no specific treatment for HPV infection. Medical management
depends on treatment of the specific clinical signs of the infection (such as
genital warts or abnormal Pap smear).

Immunity
Infection with one type of HPV does not prevent infection with another type.

The HPV9 vaccine protects against nine types of HPV, including those types
responsible for the majority of HPV-associated cancers.

Risk in Hawaii
HPV is the most common sexually transmitted infection in the United States.
HPV is so common that almost every unvaccinated person who is sexually
active will get HPV at some time in their life. Because health care providers
are not required to report HPV infections to the Department of Health, the
number of cases occurring annually in Hawaii is unknown.

Prevention
The HPV vaccine prevents infection with HPV types that are associated with
many cancers.

For HPV vaccine to be most effective, the series should be given before
exposure to HPV. Preteens should receive all recommended doses of the
HPV vaccine series long before they begin any type of sexual activity.
However, people who have already been infected with one or more HPV types
can still get protection from other HPV types in the vaccine.

All preteens aged 11 or 12 years should receive two doses of HPV vaccine, with
the second dose administered 6 – 12 months after the first.

If the first HPV dose is administered on or after age 15 years, a 3-dose series
is recommended. The 3-dose schedule is also recommended for persons with
certain medical conditions affecting the immune system. The second dose
should be administered 1 – 2 months after the first dose, and the third dose is
recommended 6 months after the first dose.

“Catch-up” vaccination is recommended through age 26 years for persons not


previously immunized.

Additional Resources
Hawaii State Department of Health HPV Factsheet (PDF)

Centers for Disease Control and Prevention (CDC)

HPV Vaccine Information Statement

HPV Vaccine Locator

Information for Clinicians


Centers for Disease Control and Prevention (CDC)

Last reviewed April 2018

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