General Health

HPV infections : Most common STD in women

Introduction

The human papillomavirus (HPV) is the most common sexually transmitted infection (STD) in the world and is considered the most fatal STD after HIV AIDS, since HPV infection is the primary cause of cervical cancer, one of the leading causes of death in women around the world. Men can get the virus from women and HPV is one of the leading causes of male mouth and throat cancer, and men can get genital warts, too.

HPV has about 100 types, and nearly 40 HPV types are sexually transmitted during unprotected sex through the mucous membranes and skin-to-skin contact of the genital areas. In addition, HPV can be vertically transmitted by an infected mother to her baby during pregnancy.

Clinical presentation

HPV types 16 and 18 are high-risk HPV strains and cause about 75% of cervical cancers. About 60 HPV types that penetrate human cells can cause papillomas (warts), most commonly on hands and feet. HPV types 6 and 11 cause genital warts. High-risk HPV strains can cause cervical, vulvar, penile, anal, and oral cancer.

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HPV infections may be asymptomatic and individuals may not be even aware that they are HPV carriers. The use of condoms during sex can reduce the risk of HPV infections. One of the most effective methods of HPV prevention is vaccination. The World Health Organization (WHO) has recommended vaccinating girls aged 9 to 14 years before they become sexually active.

Fortunately, most HPV strains are cleared from the body after approximately one year. However, recent studies have reported that HPV infections that affect women during menopause can be a reactivation of a previous infection.

Genital warts appear as flat lesions, small cauliflower-like bumps or tiny stem-like protrusions and usually appear in women on the vulva but can also occur near the anus, in the vagina or on the cervix. In men, genital warts appear on the penis and scrotum or around the anus. Genital warts rarely cause pain or discomfort, although they may be tender and may cause itching.

Common warts appear as rough, elevated bumps and usually occur on the hands and fingers. In most cases, common warts are simply unsightly, but they can also be painful or susceptible to injury or bleeding.

Plantar warts are hard, grainy growths appearing on the heels or balls of your feet and may cause discomfort.

Flat warts. Flat warts are flat-topped, slightly elevated lesions that can appear anywhere, but children usually get them on the face and men tend to get them in the beard area. Women tend to get them on the legs.

Risk factors

  • Several sexual partners. The risk of contracting genital HPV infection increases with an increase in the number of sexual partners. Having sex with a partner who has had multiple sex partners also increases your risk.
  • Age. Common warts occur mostly in children and genital warts usually occur in young adults and adolescents.
  • Weakened immune system. Immunosuppressed individuals such as those with HIV AIDS or organ transplantation history are at an increased risk of HPV infections.
  • Skin damage. Areas of skin that have been punctured are more prone to develop common warts.
  • Personal contact. Touching someone’s warts or not wearing protection before contacting surfaces that may have been exposed to HPV such as swimming pools and public showers can increase the risk of acquiring HPV infections.

Diagnosis, treatment and prevention

Sex should be avoided during an outbreak of genital warts since they’re highly contagious. The HPV vaccine can also protect your partner from getting HPV. The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for girls and boys ages 11 and 12, although it can be given as early as age 9Home remedies such as green tea extracts, apple cider vinegar, tea tree oil and witch hazel have been used to treat HPV warts. However, there is limited scientific evidence supporting these treatments, whereas medical treatments are very effective.

Early cervical cancer doesn’t cause symptoms and therefore, women must have regular screening tests to detect precancerous changes in the cervix that might lead to cancer. Current guidelines recommend that women aged 21 to 29 have a Pap smear test every three years. Women aged 30 to 65 years are advised to continue Pap test screening for HPV every three years, or every five years if they also get the HPV DNA test at the same time. Women over 65 can stop testing if they’ve had three normal Pap tests in a row, or two HPV DNA and Pap tests with no abnormal results.

If you have a common wart, you can prevent the spread of the infection and the formation of new warts by not picking at a wart and not biting your nails. To reduce the risk of contracting HPV infections that cause plantar warts, wear shoes or sandals in public pools and locker rooms. One can decrease their risk of developing genital warts and other HPV-related genital lesions by being in a mutually monogamous sexual relationship and reducing the number of sex partners.

Medications for HPV infections include salicylic acid, imiquimod, podofilox and trichloroacetic acid. Surgical approaches include surgical excision, cryotherapy, electrocautery and laser surgery.

Author

Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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