If your doctor, nurse or health worker has told you that your abnormal cervical screening or Pap smear result may be due to an infection with HPV, you may be wondering what it is, how you got it and what it means for your health.
HPV is a very common virus, with four out of five people having it at some stage of their lives. In some cases, it can increase a woman’s risk of cervical cancer. However, most women with HPV do not develop cervical cancer.
There are many different types of HPV, including some that affect the genitals. Genital HPV is similar to the virus which causes warts on other parts of the body.
Genital HPV is so common that it could be considered a normal part of being a sexually active person. Most people will have HPV at some time in their lives and never know it. You may become aware of HPV if you have an abnormal cervical screening test result, or if genital warts appear.
HPV infection is very common and in most people, it clears up naturally in about 1-2 years.
How did I get HPV?
Genital HPV is spread through genital skin contact during sexual activity. As viruses are microscopic, HPV can pass through tiny breaks in the skin. HPV is not spread in blood or other body fluids. While condoms are an important barrier to many sexually transmitted infections, they offer limited protection against HPV as they do not cover all of the genital skin.
Because the virus can be hidden in a person’s cells for months or years, having a diagnosis of HPV does not necessarily mean that you or your partner has been unfaithful. For most people it is probably impossible to determine when and from whom HPV was contracted.
Can HPV be cured or treated?
There is no treatment for HPV. It will, in most cases, be cleared up by your immune system. Most people with a HPV infection have no symptoms and will never know they have it. If your body does not clear a HPV infection, it can cause changes to cells in your cervix, which in rare cases can develop into cervical cancer. If cervical cell changes are found as a result of your Cervical Screening Test, further testing and treatment will be needed.
Some types of HPV can cause genital warts. Consult your doctor or health practitioner if you are concerned about genital warts because of their appearance, or if they are causing you discomfort. There are a range of treatment options for warts.
What does HPV have to do with cervical cancer?
A few of the many types of HPV have been linked to causing abnormalities of the cervix and in some cases the development of cancer of the cervix.
It is important to remember that most women who have HPV clear the virus naturally and do not go on to develop cervical cancer. In a small number of women, the HPV stays in the cells of the cervix. When the infection is not cleared, there is an increased risk of developing abnormalities. In very rare cases, these abnormalities of the cervix can progress to cancer. When cervical cancer develops, HPV is found in almost all cases.
Cervical cancer is preventable with regular cervical screening. The Cervical Screening Test is more accurate at detecting HPV. By detecting a HPV infection early, it allows your healthcare provider to monitor the infection and intervene if there are any changes to cells in your cervix.
What about a vaccine for HPV?
Cervical cancer is one of the leading causes of cancer morbidity and mortality in women throughout the world. Persistent infection with oncogenic Human Papilloma Virus (HPV) is associated with the development of cervical cancer. Infection with oncogenic HPV types is also implicated in the development of other cancers, including cancer of the vulva, vagina, anus and penis.
Vaccination to prevent infection with oncogenic HPV types has the potential to reduce the incidence of precursor lesions and cervical cancer.
The HPV vaccine works best if you have it before you are sexually active and exposed to the HPV virus. If you have already been exposed to HPV, you may have less protection from the vaccine.
The HPV vaccine protects against the two main HPV types that cause around 70% of cervical cancers, as well as some anal, vaginal, oropharyngeal, vulva and penile cancers. It also protects against two HPV types that cause up to 90% of genital warts.
In Australia, the HPV vaccine is given to adolescents through the school-based immunisation program and is approved for use in females 9 to 45 years and in males 9 to 26 years.
Anyone who engages in genital skin-to-skin contact with a person of any gender (Lesbian, Gay, Bisexual, Transgender, Intersex [LGBTI] people) should get a HPV vaccine.
The HPV vaccine can be given to females who:
- Are lactating.
- Have minor acute illnesses (diarrhoea or mild upper respiratory tract infections, with or without fever)
- Are immunocompromised, either from disease or medication. However, vaccine efficacy might be less
The HPV vaccine should not be given to females who:
- Are pregnant (category B2)
- There is no evidence to suggest that administration of HPV vaccine adversely affects pregnancy or infant outcomes
- Have hypersensitivity to yeast
- Have moderate or severe acute illnesses
Vaccination is Not Treatment
The HPV vaccine is not therapeutic and is not intended to treat patients with abnormal cervical screening test, abnormal Pap smear or genital warts.
Vaccination of Women Older Than 26 Years
Although the peak incidence of genital HPV infection is within the first five years after commencement of sexual activity, new HPV infections do occur throughout a woman’s life, particularly in the context of new sexual partners and changing sexual behaviour. HPV vaccine is licenced for use in female up to the age of 45.
It should be emphasised to them that vaccination is about prevention of future HPV infections, whilst continuation of cervical screening is vital to detect pre-cancerous changes related to past infections.
Two prophylactic HPV vaccines are currently available in Australia
- Gardasil – licensed for use in females aged 9 to 45 years of age for the prevention of cervical cancer and its precursor lesions due to HPV types 16 and 18 and HPV types 6 and 11, the latter two which cause 90% of genital warts. To be given in a three dose schedule at 0, 2 and 6 months Gardasil® is also approved for use in males aged 9 to 15 years for the prevention of HPV infections.
- Cervarix – licensed for use in females from 10 to 45 years of age for the prevention of cervical cancer and its precursor lesions due to HPV types 16 and 18. It is given at 0, 1 and 6 months.
Cervical screening after HPV vaccine
Even if you have had the HPV vaccine you should have regular Cervical Screening Tests.
The HPV vaccine protects against the types of HPV that cause around 70% of cervical cancers. It does not protect you against all types of HPV.
You do not need to stop having sex if your Cervical Screening Test shows you have a HPV infection.
The HPV virus is very common and there is no way of knowing if your partner currently has, or has previously had, this type of virus. Most of the time your body can clear the virus without causing any problems.
It is your choice whether you discuss your Cervical Screening Test results with your partner.
Having a HPV infection does not necessarily mean that you or your partner have been unfaithful. HPV infection is very common and the HPV virus can remain inactive for long periods of time in the body. For most people, it is impossible to know when or from whom they were infected with HPV.
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