HPV Infection - Symptoms & Causes

1. What is Human Papillomavirus (HPV)

HPV is a widespread sexually transmitted infection that many sexually active individuals will encounter at some point, often without noticeable symptoms (1). This virus can impact the skin, genital areas, and throat.

While condoms can provide some protection against HPV, it's important to note that they may not offer complete defense since they don't cover all genital skin.

Some types of genital HPV can lead to genital warts, while others may progress to abnormal cell development, potentially evolving into cancer. While cervical cancer is the most prevalent type of cancer linked to HPV, less common cancers affecting both men and women include anal, vulvar, vaginal, mouth/throat, and penile cancers.

Vaccines can help protect against the strains of HPV. The primary purpose of the HPV vaccine is preventive – it's not intended to treat ongoing HPV infections or associated diseases but rather to minimize the risk of cancer development.

Currently, there are screening tests available for HPV-related cancer. These screenings play an important role in detecting precancerous cell changes before they develop into cancer. Regular HPV screening for cervical cancer is an integral part of routine health care for individuals with a cervix, including women who still have this reproductive organ and transgender men.

1.1. How Do I Get HPV?

If you've ever been sexually active, you could be at risk of contracting HPV. This virus can be transmitted through skin-to-skin sexual contact, involving fingers, mouths, or other body parts, including genital-to-genital contact, anal intercourse, and even oral sex.

While condoms are great at protecting against sexually transmitted infections (STIs), unwanted pregnancies, and HPV in general, they may not offer complete protection since there can still be direct skin-to-skin contact involved.

The timeframe from exposure to the virus until the development of warts or diseases can vary significantly, and HPV can remain dormant in some individuals for extended periods. It's often challenging to pinpoint exactly when or from whom the infection originated.

High-risk HPV infections are quite common, and individuals with HPV typically won't display any symptoms. This makes it tricky to determine whether you're carrying the virus or not.

1.2. How Is HPV Related to Cervical Cancer?

Certain strains of HPV, particularly types 16 and 18, can lead to changes in the cells of your cervix, a condition known as cervical dysplasia. If left untreated, cervical dysplasia can progress to cervical cancer.

For individuals under 30, most HPV infections resolve on their own. Once you reach 30, detecting HPV through a Pap smear helps determine the frequency of necessary follow-up testing. If you receive a positive result, you may require more frequent monitoring to manage any potential risks effectively.

Regular Pap smears play a vital role in screening for cervical cancer. Remember, having HPV or cervical dysplasia does not automatically mean you will develop cancer.

1.3. How Do You Spread HPV?

Genital HPV is primarily spread through skin-to-skin contact during intercourse, oral sex, and anal sex. If your genitals — including the vulva, vagina, penis, scrotum, rectum, and anus — come into contact with these same body parts on an infected partner, you can contract the infection.

It's important to note that the virus can also be transmitted through hand-to-genital contact, such as fingering and handjobs, although this form of transmission is less likely and less understood compared to genital-to-genital contact.

HPV is highly contagious due to its transmission through skin-to-skin contact. Unlike some infections, you don't have to exchange body fluids with someone to contract or spread the virus. Our team is here to provide guidance, support, and reliable information to empower you in safeguarding your sexual health. If you have any concerns or need further information, we're always here for you.

1.4. How long does it take for HPV to turn into cancer?

The virus doesn’t directly transform into cancer, but high-risk strains of HPV can trigger precancerous cell alterations. These changes have the potential to progress into cancer if left unaddressed. However, this transformation typically unfolds over years or even decades.

Regular screenings such as Pap smears, and HPV testing play a crucial role in identifying these precancerous cells before they have the chance to develop into cancer. By catching these changes early, we can effectively manage your health and ensure the best possible outcomes.

2. HPV Symptoms

Most people will not show any symptoms of an HPV infection. Most of the time, your body's immune system successfully fights off an HPV infection before it leads to warts. But when warts do show up, they can vary in appearance based on the type of HPV involved:

Genital Warts: These can appear as flat lesions, small cauliflower-like bumps, or tiny protrusions. In women, they're commonly found on the vulva but can also occur near the anus, cervix, vagina, and rarely the throat. In men, genital warts typically show up on the penis, scrotum, or around the anus. While genital warts usually don't cause pain, they may itch or feel tender.

Common Warts: These rough, raised bumps often appear on the hands and fingers. While usually just a nuisance, they can sometimes be painful or prone to injury or bleeding.

Plantar Warts: Tough, grainy growths that tend to develop on the heels or balls of your feet. These warts can be uncomfortable.

Flat Warts: These flat-topped, slightly raised lesions can show up anywhere, with children often getting them on the face, men on the beard area, and women on the legs.

2.1. Are All Warts HPV?

All warts are caused by HPV, but not every strain or type of HPV leads to warts. For instance, the HPV types that may progress to cancer, such as cervical cancer, do not typically cause warts.

Your healthcare provider can usually diagnose genital warts and other bodily warts simply by visual examination. However, high-risk forms of HPV often don't present symptoms, making detection challenging. In such cases, you'll likely discover the infection through routine screenings like a Pap smear or HPV test. These tests play a crucial role in identifying HPV infections that may lead to more serious health issues like cervical cancer.

3. Cervical Screening

Regular cervical screening plays a crucial role in safeguarding your health against cervical cancer. Missing out on cervical screening is one of the major risk factors for developing this type of cancer.

It's important to understand that cervical screening isn't about finding cancer—it's a vital tool for uncovering abnormalities, known as pre-cancerous changes, in the cervix's cells at an early stage.

During cervical screening, a sample of cells is taken from the cervix and then carefully examined to identify any abnormalities that could potentially develop into cancer down the line. By detecting these precancerous or abnormal cells early on, we can take proactive steps to prevent the progression of cancer. For more details on HPV testing, you can find additional information in the HPV testing tab below.

3.1. Cervical Screening - PAP Test, PAP Smear Test

Cervical screening is a critical process that involves taking a sample of cells from your cervix to identify any abnormalities that could lead to cancer in the future. These cells are placed in a liquid medium, known as Liquid-Based Cytology (LBC), for analysis in the laboratory.

By conducting this screening, we can detect precancerous or abnormal cells early on, allowing for successful treatment that often prevents the development of cancer. It's important to note that changes in these cells are commonly triggered by certain types of human papillomavirus (HPV). Additionally, testing for the HPV virus can be performed on the same LBC sample examined under the microscope.

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3.2. Cervical Screening for Those with Weakened Immune System

If you have a cervix and a significantly weakened immune system, like with HIV, it's essential to consider getting screened annually. This is because individuals with compromised immune systems are more prone to developing a persistent HPV infection that could potentially lead to cervical abnormalities over time. If you're HIV positive, attending screening yearly becomes even more crucial. For more insights on screening and vaccination, it's best to consult your healthcare provider for personalized guidance.

Similarly, men and individuals with a penis who have a compromised immune system also face an increased risk of contracting HPV. This underscores the importance of seeking advice from your healthcare professional regarding vaccination.

3.3. Why Does Cervical Screening Start at 25?

Cervical screening typically begins at age 25 (2) because HPV is highly prevalent in females under 25 years old. Persistent HPV infections after the age of 25 are more likely to progress to HPV-related cancers[1]. While most cases of high-risk HPV clear within 12 to 18 months, medical experts currently lack a reliable method to determine which abnormalities will resolve on their own and which could develop into cancer. Consequently, if abnormal cells in the cervix persist beyond the age of 25, it may indicate a greater need for intervention or treatment

4. HPV Testing

If you're a woman aged thirty or older, you have the option to determine if you have a high-risk strain of the HPV virus by taking an HPV test. This test is conducted similarly to a pap smear and typically costs around 80 euros, with results usually available within two weeks. It's important to understand that there are numerous strains of the HPV virus, and some of these strains can lead to conditions like cervical cancer. As a result, it's recommended that any individual with a cervix who is thirty years or older consider opting for an HPV test due to its higher accuracy.

Combining the results of an HPV test with cervical screening cytology (Pap Smear test) allows for a quicker assessment of individuals at a higher risk of developing cervical cancer while providing reassurance to those at very low risk. This approach can also help minimize the need for unnecessary screening appointments and colposcopies, particularly for women with borderline or mild cervical screening cytology results or those who have been treated for abnormal cells. If you're interested in undergoing an HPV test, don't hesitate to discuss this with your doctor during your next Pap test.

It's worth noting that the HPV test is performed using the same sample of cells collected during a cervical screening test, with the cells being analyzed in the laboratory for any current HPV infection. For additional insights into HPV facts, you can find more details in the "Understanding HPV" section in the first tab above.

5. What Are the Complications of HPV?

The most serious complication of HPV is cancer, with cervical cancer being the most common type of HPV-related cancer. Other less common cancers related to HPV include

• Anal

• Penile

• Throat

• Vaginal, and

• Vulvar cancers.

Remember, having HPV, even a high-risk strain, does not guarantee the development of these cancers.

Another complication of HPV infection is the occurrence of genital warts. Genital warts may cause itching, and discomfort, and disrupt your daily life. Although bothersome, genital warts typically do not pose significant harm beyond these symptoms.

5.1. Signs and Symptoms of Cancer

Keeping an eye out for warning signs and symptoms of cancer empowers you to prioritize your health and well-being. Some noteworthy indicators to watch for include:

• Persistent fatigue or extreme tiredness that doesn't improve with rest

• Unexplained weight loss or gain of 10 pounds or more

• Unusual changes in appetite

• Difficulty swallowing

• Abdominal pain

• Nausea, vomiting, or unexplained lumps or thickening in the body

• Skin changes, such as unusual lumps, bleeding moles, or yellowish discoloration

• Lingering cough, hoarseness, or coughing with blood

• Unexplained bleeding, bruising, or changes in bowel or bladder habits

• Fever, night sweats, headaches, or vision and hearing changes

• Persistent mouth sores, bleeding, pain, or numbness

5.2. Signs and Symptoms of Cervical Cancer

Cervical cancer takes root in the tissues of the cervix, the vital link between the uterus and vagina. While it often progresses slowly and may not present noticeable symptoms, it's important to know that regular screening can be a powerful prevention tool. Through this procedure, cells are collected from the cervix and examined under a microscope, offering valuable insight into your cervical health.

99.7% of cervical cancers stem from persistent high-risk human papillomavirus (HPV) infections, which can bring about changes in cervical cells (3). HPV is remarkably common, with approximately four out of five individuals encountering the virus at some point (3). Despite its prevalence, many people may not even realize they've been exposed, as the body's immune system typically clears the infection on its own.

Persistent high-risk HPV infections lay the groundwork for cervical abnormalities, with the potential to evolve into cancer over time. However, it's essential to note that these abnormal cells, often detected through cervical screening, are not initially cancerous and can return to normal on their own with the passage of time.

When it comes to safeguarding against cervical cancer, regular screening remains the most effective method for detecting early changes in the cervix. Additionally, for younger women, the HPV vaccination stands as a potent tool in preventing seven out of ten cervical cancers, marking a significant stride in cancer prevention. With the right measures in place, cervical cancer is largely preventable, and catching it early significantly boosts survival rates.

5.2.1. Symptoms of Cervical Cancer

Cervical cancer is a significant concern, and it's essential to be aware of the signs and symptoms that may indicate its presence. This form of cancer originates in the cells of the cervix, the lower part of the uterus that connects to the vagina.

Here are some key signs and symptoms of cervical cancer to keep in mind:

Abnormal vaginal bleeding: This can manifest as bleeding after sexual intercourse, post-menopausal bleeding, or bleeding between menstrual periods.

Watery, foul-smelling vaginal discharge: If you notice a heavy, watery, and bloody vaginal discharge accompanied by an unpleasant odor, it's crucial to take note.

Pelvic pain or discomfort during intercourse: Any persistent pelvic pain or discomfort during sexual activity should be addressed.

While experiencing abnormal bleeding doesn't automatically point to cervical cancer, it's important to seek guidance from a healthcare provider promptly. We encourage you to reach out for an evaluation if you notice any of these symptoms.

6. Prevention

Get the HPV vaccine: Getting vaccinated is a key step in safeguarding yourself against HPV infection, cervical cancer, and other HPV-related cancers. By undergoing regular screening, we can detect cervical precancers early and treat them before they progress into cancer.

It is recommended that HPV vaccines be administered to all girls aged 9–14 years, ideally before they become sexually active. Depending on individual circumstances, the vaccine can be given as 1 or 2 doses, with individuals with weakened immune systems advised to receive 2 or 3 doses. Consult with your healthcare provider to determine the best vaccination regimen for you.

Practice safer sex: In addition to vaccination, practicing safe sex by using condoms can help prevent HPV infection. Voluntary male circumcision has also been shown to reduce the risk of infection. Furthermore, being a non-smoker or quitting smoking can lower the likelihood of developing persistent HPV infections.

Get screened and tested regularly: Screening for cervical cancer involves testing cells from a woman's cervix for HPV. It is recommended that women undergo screening every 5–10 years beginning at age 30, with more frequent screening (every 3 years) starting at age 25 for women living with HIV.

Following a positive HPV test or other screening methods, healthcare providers can identify any changes in the cervix or precancers that have the potential to progress into cervical cancer if left untreated. Treatment of precancers is crucial in preventing the development of cervical cancer, especially since precancers typically do not present noticeable symptoms, underscoring the importance of regular cervical health screenings.

6.1. How to get HPV Vaccination in Rome

Your healthcare provider can give you a prescription to get the HPV vaccine and administer it.

If you are a resident of Rome and have a positive test result for HPV, you can also call IFO San Gallicano - Istituti Fisioterapici Ospitalieri to make an appointment to get vaccinated in a public facility.

7. Treatment

   
   

At the moment, there is no specific treatment for HPV infection. However, treatments are available for conditions like genital warts, cervical precancers, and cervical cancer.

Non-cancerous genital warts and precancerous lesions in various regions like the cervix, vagina, vulva, anus, or penis can be effectively removed or treated through methods such as ablation (freezing or heating) or surgery.

Cervical cancer is currently the only cancer caused by HPV for which screening tests are accessible.

Early detection is key for effective treatment of HPV-related cancers, including cervical cancer. Starting treatment swiftly after a diagnosis can significantly improve outcomes and overall prognosis.

References

1. Human papillomavirus and cancer, World Health Organization, 5 March 2024

2. When you'll be invited for cervical screening, NHS, 14 June 2023

3. More about HPV, HPV Global Action