HPV Infection

What is HPV?

HPV stands for Human Papilloma Virus. There are over 100 different types of HPV virus. Some HPV types can cause genital warts, other HPV virus can cause cell changes on the cervix and HPV is also instrumental in the development of cancer of the rectum, penis and tonsils. Most types of HPV will not cause the disease in humans.

Genital wart scan occur in women around the vaginal opening, on the labia, in the vagina, on the cervix, and around the anus of the throat. Men can also get genital warts. Most frequently on the penis and around the anus but they can also sit in the throat.

The HPV types, in particular, induces genital warts, is HPV type 6 and type eleventh

cell changeson the cervix are caused by other types of HPV virus than those who give warts. Cell changes in the cervix gives no symptoms and often can not be seen by a regular gynecological examination. Cell changes can only be detected by a cell sample from the cervix (one smear examination). HPV types 16 and 18 are responsible for 70% of all cases of cervical lesions, while other more rare HPV types are responsible for the other cases.

How common is HPV infection?

HPV infection is very common and gives in most cases not cause cell changes or other diseases. Throughout life, 80% of South African women have had HPV in the cervix. The infection often disappears without giving either genes or permanent changes.

How do you get HPV infection?

HPV infects predominantly through sexual activity. The virus sits in the vagina, labia, perineum, anus and penis.

What are the symptoms of HPV infection?

Most infections with HPV are handled completely without symptoms. Both men and women can be infected with HPV without the experience discomfort and without knowing it, but they can pass the infection to others.

By an infection with the HPV types which may cause genital warts, it takes 3-6 months before being developed visible genital warts. When you have warts, you can infect others. In the time it takes from one becomes infected, for being developed visible genital warts, can also pass the virus. Many become infected without any symptoms and are silent carriers. They can pass the virus to others without realizing it.

By infection with the HPV types which may cause cell changes, that it takes several months before the development of cell changes in the cervix. In most cases, the lesion to be transient and will disappear by itself within 1-2 years. The types of HPV that can cause cell changes very rarely give rise to discomfort or disease in men.

What symptoms should you pay particular attention to?

Most often there are no symptoms of HPV, and it is discovered in most cases during routine cell sample from the cervix.

If you experience irregular bumps in the vagina, the labia, the perineum, the penis or anus, it may be genital warts. One should consult a doctor for diagnosis and treatment.

HPV that have led to cell changes on the cervix, the first symptoms when there are serious cell changes. Therefore, because the vast majority of symptoms of cervical something other than HPV infection. Women who experience bleeding during intercourse should consult a doctor.

How is it diagnosed?

It does not examine routinely for HPV when you know that most have it, and as there is no proper treatment for it. In connection with the study of cell changes of the cervix can be supplemented with a study of high-risk HPV, as it can give the doctor additional information about which treatment to choose. Also see cell changes.

Is HPV dangerous?

HPV infection is, in most cases harmless and transient. It is estimated that 80% of adults over the life has been infected with HPV. Most have been infected without knowing it. Usually, the body’s immune system fight the virus, just as happens with most other infections.

Most cases of both genital warts and mild dysplasia will disappear sooner or later – even without treatment.

When there is still so high research activity and media coverage of HPV, it is because some types of HPV can contribute to the development of cancer in particular cervix and tonsils.

Infection with the HPV types which may cause cell changes, can develop into a chronic infection of the cervix, which in some cases may lead to the development of precursors of cervical cancer. Over a period of years can change develop into cancer. We do not know exactly how long it takes before the cancer develops and is probably different from person to person. But you think that goes 10 years or more between initial infection and the development of  cancer cells.

Unfortunately, doctors do not yet know why the infection in some transient, while in others becomes a chronic infection. It is believed today that there is a risk of developing into cancer if there is a chronic infection with certain types of HPV. Women with impaired immune systems, for example. transplant women and women with HIV have an increased risk of chronic HPV infection. In these women may be due to annual Pap smear.

Furthermore, smokers often harder to get rid of the virus.

By taking the cell sample from the cervix – called smear examination – can the lesion be detected at an early stage. In this way, pre-cancerous changes in the cervix be detected before they develop into cancer. The precursors can be treated, while the even mode is simple and harmless.

HPV infections can not be detected in a blood test, and you can today not even ask for an HPV test.

Can HPV be prevented?

HPV is sexually transmitted and is not present in virgins. HPV infection of the cervix occurs more frequently in women who have had many sexual partners. Not because the number of partners as such increase the risk, but because the risk of having had a partner with HPV increases with the number of partners. The risk of cervical lesions is higher in smokers than in non smokers, presumably because nicotine affects the immune conditions of the cervix.

The best protection against HPV is to use condoms. This protects you also against STDs and pregnancy.

Vaccination against HPV

Research in recent years has shown that certain HPV infections can be prevented by vaccination. Vaccination can prevent cell changes, cervical cancer, and some vaccines to prevent genital warts. As with other infectious diseases, the vaccine against HPV is given before exposure to the infection. Since HPV is sexually transmitted, the vaccine should preferably be given before sexual debut, but it also has value for women who are not infected despite intercourse.

Free vaccination

HPV vaccination is recommended for girls 12 years of age as part of the general childhood. Vaccination is done by the GP.

Information on HPV vaccination from the Health Protection Agency:

• HPV vaccination
• Folder about HPV vaccine

How effective is HPV vaccination?

South Africa has so far two kinds HPV vaccines on the market.

The vaccines will prevent 70% of the cell changes that may occur on the cervix and probably also 70% of all cases of cervical cancer. HPV vaccines do not work against all HPV types, and even if you have been vaccinated, you can still develop cell changes. Girls who have been vaccinated against HPV should still be re-vaccinated in later life as adults.

HPV vaccines are relatively new, and we therefore do not know how long the effect lasts. Perhaps it may be necessary to re-vaccination later in life.

Side effects of HPV vaccines:

The side effects of the HPV vaccine are closely monitored. In South Africa made professional and scientific assessments of the possible side effects of the HPV vaccine of Health.

There have in South Africa and in many other countries has been a debate about whether HPV vaccines were responsible for serious side effects in young girls. It is important when considering the side effects that distinguishes them from conditions that occur in the same age group, and having only temporal association with the vaccine, but not caused by the vaccine.

By the end of 2014, sold 1.6 million doses of HPV vaccine and reported 322 serious suspected adverse reactions.

The vast majority of side effects are quite small and transient. These include redness at the injection site, nausea and slight temperature increase. Some may develop soreness of muscles.

The more serious possible side effects described, covering a wide range of nervous system symptoms from headaches to convulsions and paralysis. It is important to emphasize that the National Board of Health did not find evidence of an association between vaccination and symptoms, as these genes are also found in young girls who have not been vaccinated.

Health continues to believe that the major effect of vaccination outweigh any side effects both for the individual and society as a whole.

How is long-term prospects?

If all vaccinated before they have sexual maturity, one can theoretically reduce the incidence of HPV-related diseases – including cervical cancer – quite considerably. There are vaccines under development that protects against several types of viruses. There are ongoing discussions among doctors and politicians about whether boys should also be vaccinated since both can carry the virus and thus infect other sexual partners, and since HPV in some cases contribute to the development of penile cancer, tonsil cancer and anal cancer.

Boys can therefore be vaccinated just like the girls before sexual debut, but the vaccine is not currently a recommended part of the childhood immunization program.