Human Papilloma Virus (HPV or Wart Virus)

What is Human Papilloma Virus ?

Human Papilloma Virus (HPV) is a very common infection; 75-80% women (and men) get it at some stage in life. It usually produces no symptoms and many women will not even know that they have had the infection. Most women who have HPV will clear it as their immune system will be able to tackle it – this can often take one to two years. If HPV lingers on, it can sometimes lead to abnormal cells developing on the cervix. These abnormalities are picked up on routine smear tests.

Is HPV infection sexually transmitted?

HPV infection can be sexually transmitted but can also be acquired by genital skin contact. Barrier contraception is protective to some extent but not 100%. HPV infection can persist in the body for many years and it may not be possible to pinpoint exactly who you got the infection from. HPV infection is in fact so common that it is just a marker of having had sexual contact in the past.

Can HPV cause cervical cancer?

HPV does cause cervical cancer, but only in a very, very small proportion of cases. Hence HPV infection is common, but cervical cancer is very rare. In most cases of HPV infection, the immune system will get rid of the infection for you. From acquiring HPV infection to getting cervical cancer, it takes between 10 to 15 years. This means that if you have regular smear tests, any abnormality on the cervix can often be detected before it becomes a serious problem. The risk of getting cervical cancer is extremely low if you have regular smear tests as suggested by your GP. There are over 100 different types of HPV virus and only 14 of them are high risk types associated with cervical cancer. The commonest high-risk types are 16, 18, 31, 33 and 45.

Does HPV also cause genital warts?

In addition to high-risk types of HPV, there are also low-risk types which are not associated with causing cervical cancer. Two common low-risk HPV types are 6 and 11 which are associated with causing genital warts. It is possible to have an infection with low-risk HPV without any symptoms. Some women and men however will develop lumps on the genital skin or inside the vagina or anus, these are known as genital warts. If you are worried or concerned that you may have genital warts you can speak to a doctor or nurse who will be able to look at them. Although genital warts do not always require treatment and may resolve on their own, there are several options available which can help may them go away.

Is it possible to test for HPV?

HPV test is now used as a screening test for cervical abnormalities instead of the traditional smear test. The new primary HPV screening test looks for presence of Human Papilloma Virus and is more sensitive. It is important to realise that having high risk HPV, does not been that you have cervical abnormality.

What about self-testing?

HPV self-testing kits are now available and very reliable, in fact in Australia self-testing kits are now part of the national cervical screening programme. Evidence suggests that HPV self-collected test is more sensitive than a physician collected smear. Self-testing kits can be purchased at: www.london-gynaecology.com/hpv-test-kits

Is it necessary to treat HPV infection?

It is not necessary to treat HPV infection unless it causes a persistent or high-grade smear abnormality. Your immunity will usually get rid of the infection. If you have had an abnormal smear test, your doctor or nurse will explain whether the changes have reached a stage that requires treatment.

What about HPV vaccination?

Some common types of HPV (16, 18, 31, 33, 45, 52, 58,6 and 11) can be vaccinated against. Gardasil-9 vaccination is now available and is a three-injection course that will protect against 90% of all cervical cancers and genital warts.

Ideally vaccination should be carried out before sexual debut. However, less than 1% of women are exposed to all nine types that the vaccine protects against therefore 99% of women are likely to benefit from the vaccination even if sexually active.

Cervical screening (smear test) is necessary even after vaccination.

How can I boost my immunity?

  1. Give up smoking – there is evidence to confirm that giving up smoking helps improve your immunity.
  2. Favour berries – choose purple and red veg and fruits which are high in lycopene, so tomatoes, beetroot and blueberries.
  3. AHCC shiitake mushroom extract; taking a 3gm daily supplement of AHCC has been proven to boost immunity and help clear HPV infection in some people. (The results of a trial in 2019 showed 60% reduction in HPV infection). One should be taken daily for at least 6 months.
  4. Green tea has benefits to help boost immunity. If you choose this option, one should be taken daily for at least 6 months.

Talking to your partner about HPV

Do I need to tell my partner?

This is entirely your decision.

  • Pros of sharing the information: Honesty is often the best policy. Though the risk for men is significantly less than women, being aware is important.
  • Cons of sharing the information: Currently, validated testing for men is neither needed nor available. Sharing the information may lead to anxiety as well as misunderstanding.

If either or both of you also have genital warts, you may need treatment so it would be important to tell your partner and use barrier contraception.

What are the important things to consider when telling my partner?

It is important to stress that HPV infection is often transient and no treatment is necessary unless there are abnormal cells (this applies to women). Most men and women would get rid of it through their own immunity

For men, no further action is necessary unless they have any obvious lesions on the external organs. It is not necessary to carry out any other tests or treatment.

Does it mean they/I have been unfaithful?

Not at all. HPV infection can sometimes remain dormant in the body for several years and it is extremely difficult to say when you acquired it or who from.

Does my partner need an HPV test?

This is not necessary.

If my partner doesn’t have HPV, how can I prevent passing it to him?

It is very likely that you both carry the same subtypes of the virus and will have already developed immunity.

Can my partner re-infect me?

Currently, there is no evidence that you can be reinfected by the same subtype of HPV. So no additional precautions are needed.

I’m bisexual/gay, can I pass this to another woman through sexual contact?

Yes, this is possible through skin to skin contact.

Where can I find out more information or access any useful support services?

For support visit Jo’s Trust, the UK’s leading cervical cancer charity that provides vital support services in addition to events, an information hub, and a dedicated helpline.

To learn about gynaecological cancer, visit the Eve Appeal; the UK’s leading national charity funding research and raising awareness into the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal.

Summary:

  1. Human Papilloma Virus (HPV) is a very common infection; 75-80% women (and men) get it at some stage in life.
  2. Most women who have HPV will clear it as their immune system will be able to tackle it – this can often take one to two years.