Human papillomavirus (HP ) is a very common virus that can affect many parts of your body. There are more than 100 types of HPV, including strains that cause warts on the hands, feet, and face. About 30 strains of HPV can affect the genitals, including the vulva, vagina, cervix, penis, and scrotum, as well as the rectum and anus. This includes the types of HPV that cause genital warts.

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Human papillomavirus is the most common sexually transmitted infection (STI) in the world. According to the U.S. Centers for Disease Control, it is so common that most sexually active people who have not been vaccinated against it will likely be infected with it at some point in their lives. Most people who are infected do not know they have HPV.

Some strains of HPV are high-risk and can cause cancer, such as cervical, vulvar, and vaginal cancers. Early detection (with a Pap test or HPV screening) and treatment of precancerous cells are usually effective in preventing cancer.

How is human papillomavirus (HPV) linked to cervical cancer?

Some strains of human papillomavirus (most commonly strains 16 and 18) cause changes in the cells of the cervix called cervical dysplasia. If left untreated, cervical dysplasia can progress to cervical cancer.

If you are under 30, most human papillomavirus infections will go away on their own. By age 30, the presence of HPV on a Pap test will determine how often you will need further testing. If the test is positive, you may be at higher risk and need to be tested more often.

It is important to have regular Pap tests to screen for cervical cancer (usually starting at age 21). However, it is important to remember that having human papillomavirus or cervical dysplasia does not necessarily mean that you will develop cervical cancer.

How long does it take for human papillomavirus to turn into cancer?

The virus itself does not cause cancer. However, high-risk strains of human papillomavirus infection can cause precancerous cell changes. If left untreated, these cell changes can eventually lead to cancer. However, this process takes years, sometimes decades. Screening, such as a Pap test, can help detect precancerous cells before they become cancerous.

Symptoms and causes of APV

What are the symptoms of human papillomavirus?

Strains of human papillomavirus that affect the genitals usually do not cause symptoms. When symptoms do occur, the most common sign of the virus is warts in the genital area. Genital warts are rough, raised growths that grow on the skin. They can also appear as flesh-colored growths. They can appear weeks, months, or even years after infection with a low-risk papillomavirus. Genital warts are contagious (like all forms of papillomavirus). They can be itchy and uncomfortable.

High-risk forms of human papillomavirus often do not cause symptoms until they progress to cancer.

Are all warts papillomavirus?

Yes. And it can be a little confusing — especially when you’re trying to understand the difference between the seriousness of different types of HPV.

The strains of papillomavirus that cause warts, including genital warts, are very unsightly, but they do not pose a health risk. HPV types 6 and 11 most often cause genital warts. Other types of papillomavirus cause warts on other parts of the body. These warts include:

Common warts
Plantar warts
Flat warts

All warts (regardless of where they appear) are caused by the papillomavirus, although not all strains or types of papillomavirus cause warts. The types of papillomavirus that can progress to cancer do not cause warts.

How is papillomavirus spread?

Genital papillomavirus is spread through skin-to-skin contact during sexual intercourse, oral sex, or anal sex. A person can become infected if their genitals — including the vulva, vagina, penis, and scrotum, as well as the rectum and anus — come into contact with the same parts of an infected partner’s body.

It is also possible to spread the virus through genital contact, such as fingering (stimulation of the vulva, vagina, or anus with the fingers) and handjobs (stimulation of the penis with hands). This method of spreading the virus is less likely and less well known than genital-to-genital contact.

How easily is papillomavirus spread?

Human papillomavirus is highly contagious, partly because it is transmitted through skin-to-skin contact and does not require the exchange of bodily fluids to spread the virus.

Who is affected by human papillomavirus?

Anyone can become infected with HPV if they have sex or close skin-to-skin genital contact with a partner who has the virus. Similarly, a person who has the virus can spread it to a partner during intercourse, oral sex, anal sex, or other close genital contact.

If you have HIV, your immune system may have difficulty fighting HPV infections. Men who have sex with men may be at higher risk of getting HPV strains that can cause cancer. If this is the case, your doctor may recommend an anal Pap test. An anal Pap test does not directly test for HPV in the body, but it can detect cell changes that can lead to cancer.

Regardless of a person’s reproductive anatomy, it is important to prevent the spread of HPV through vaccination and protection during sex (using condoms correctly and consistently).

Human papillomavirus in different sexes

In general, human papillomavirus is most dangerous for people with female anatomy, because high-risk HPV, if left untreated, can progress to cervical cancer. Pap smears and HPV DNA tests can help detect precancerous cell changes and prevent cervical cancer. In addition, human papillomavirus can also cause genital warts in people with female anatomy.

As for people with male anatomy, the papillomavirus is less dangerous to their health. HPV can cause genital warts here too, but in most cases the infection goes away on its own. HPV can also cause cancers of the penis, anus, and head and neck, although these cancers are rare.

What complications can human papillomavirus cause?

The most serious complication of human papillomavirus is cancer, most commonly cervical cancer. Other types of cancer are much rarer and include:

Anal cancer
Penile cancer
Throat cancer
Vaginal cancer
Vulvar cancer

► It is important to remember that having HPV — including high-risk strains — does not mean that you will definitely develop these cancers.

Another complication of HPV is genital warts. They can be itchy, uncomfortable, and interfere with your daily life. However, beyond these symptoms, genital warts do not cause much harm.

Diagnosis and testing for APV

What tests are used to diagnose HPV infection?

There are several tests for diagnosing human papillomavirus infection.

A doctor can usually identify warts on the genitals and other parts of the body by visual inspection. However, high-risk HPV does not cause symptoms, so the infection is usually detected by a routine Pap test or HPV test.

Pap test: This test checks for cervical cancer and precancerous cells, which, if left untreated, can develop into cancer. Cervical cancer is almost always caused by a high-risk strain of HPV.
HPV DNA test: This test can detect high-risk strains of HPV, which, if left untreated, can lead to cervical cancer.

If a Pap test reveals abnormal cells or a positive HPV test, your doctor may order a colposcopy, an examination of the vagina and cervix. During this procedure, a special lighted instrument, a colposcope, increases the visibility of the cervix, allowing the doctor to see abnormal cells. If necessary, your doctor may take a sample of the cells for a biopsy to examine them for signs of precancerous or cancerous cells.

Management and treatment of APV

HPV treatment cannot eliminate the virus from the body, but it can remove visible warts on the genitals or other parts of the body and abnormal cells on the cervix. Treatment options include:

Cryosurgery : Local freezing of warts or abnormal cells with liquid nitrogen;
Loop electrosurgical excision procedure (LEEP) : Use of a special loop to remove warts and abnormal cells from the cervix;
Electrocoagulation : Removal of warts with electric current;
Laser therapy : destruction of warts and abnormal cells with an intense beam of light;
Conization (cone biopsy) : Removal of a cone-shaped piece of tissue from the cervix that contains abnormal cells;
Prescription cream : Applying a medicated cream to warts to remove them;
Trichloroacetic acid (TCA) : A chemical that burns off warts.

Only a small percentage of people with high-risk HPV will develop abnormal cells on the cervix that need to be treated to prevent cancer.

Can HPV be prevented?

The only guaranteed way to prevent HPV is to abstain from sexual intercourse. However, for many, a more realistic goal is to reduce the risk and prevent cervical cancer while maintaining an active sex life.

The risk of infection and complications can be reduced in the following ways:

HPV vaccination: The HPV vaccine is most effective if you get it before you become sexually active (around age 11-12). However, even if you are already sexually active, the vaccine can protect you from HPV strains you have not yet been exposed to. Talk to your doctor about your vaccination options;
Screening and regular testing: Early detection of HPV and abnormal cells can prevent the development of cervical cancer. You should start having regular Pap tests starting at age 21. Work with your doctor to determine a screening schedule that is right for you;
Safe sex: Unlike other sexually transmitted infections (STIs) that are spread through semen or vaginal fluids, condoms and dental dams are less effective against HPV. However, consistent and correct use of these methods of protection will still reduce the risk of HPV transmission.
Protecting your partner : If you have HPV, tell your partner so they can get tested too. If you are being treated for genital warts or a high-risk HPV strain, you may need to temporarily stop having sex. Talk to your doctor about specific precautions you should take if you have HPV.

HPV vaccination

The HPV vaccine protects you from human papillomavirus infections that can develop into genital warts or cancer. It is important to remember that the vaccine is designed to prevent infection, not treat an existing infection. If you already have a specific strain of HPV, the vaccine will not protect you from that infection.

However, the HPV vaccine can protect you against strains of HPV that you haven’t been exposed to yet. These include both low-risk and high-risk strains. Low-risk HPV strains don’t increase your risk of cancer, but they can cause unsightly genital warts.

The HPV vaccine prevents infections that can lead to:

Cervical cancer
Vaginal cancer
Vulvar cancer
Penile cancer
Anal cancer
Oropharyngeal cancer
Genital warts

The first vaccine against HPV, Gardasil, was approved by the US Food and Drug Administration back in 2006, and since 2007 it has been available in 80 countries. The quadrivalent vaccine against HPV, Gardasil, has been included in the national preventive vaccination calendar in Georgia since 2019. It protects the body against infections associated with:

Human papillomavirus strains 16 and 18 — which are linked to 70% of cervical cancer cases, 90% of anal cancer cases, and many other cancers that can affect the genitals and throat;
Human papillomavirus types 6 and 11 — which are associated with 90% of genital warts.

This vaccine is over 90% effective in protecting people from infection with these strains of human papillomavirus.

Who should get vaccinated?

Everyone, regardless of gender, should be vaccinated against HPV before they become sexually active, because the vaccine only protects you against strains of HPV that you haven’t been infected with yet.

According to the recommendations of the US Centers for Disease Control, the following people should get the HPV vaccine:

Children aged 10-12. Vaccination against human papillomavirus is carried out according to the Georgian national calendar for girls and boys aged 10-11-12, which is fully funded by the state. Vaccination is most effective in this age group, since it is carried out before the onset of sexual activity;
Adults under 26 years of age. Vaccination is also recommended for adults under 26 years of age, including those who started the vaccination series as a teenager but did not complete it;
Some adults under the age of 45. In 2018, the U.S. Food and Drug Administration (FDA) increased the recommended age for HPV vaccination from 26 to 45 years, based on research showing that the vaccine is effective in preventing HPV infections in this age group.

It is worth noting that starting in 2023, as part of the Expanded Immunization Program in Georgia, girls and women aged 10-45, as well as boys and men aged 10-26 , can be vaccinated free of charge.

Who should not get the vaccine?

You should not get the HPV vaccine if:

You are pregnant. The safety of the vaccine during pregnancy has not been well studied, so it is best to get the vaccine after giving birth. However, if you find out you are pregnant after getting the HPV vaccine, don’t worry — the HPV vaccine has not been linked to complications during pregnancy;
You have had a negative reaction to a previous dose. If you have had a negative reaction to any dose of the vaccine or any of its ingredients, be sure to tell your doctor. Tell your doctor about any allergies you have, including allergies to mold or latex, as these may increase your risk of an allergic reaction.
You have a moderate or severe illness. If you have a serious medical condition, it may be best to wait until you have recovered before getting the vaccine. Talk to your doctor about when it is best and safest for you to get the HPV vaccine.

How long does the vaccine protect us?

According to the National Center for Disease Control and Public Health , studies and vaccination monitoring have shown that post-vaccination serum antibodies peak soon after the third dose and maintain their effectiveness for 8 years.

Vaccination procedural details

How does the HPV vaccine work?

The vaccine contains a simulated virus, not a real, live virus. It stimulates your immune system to produce antibodies to fight the human papillomavirus. If you are later infected with the real virus, these antibodies will prevent infection.

What is the schedule for the HPV vaccination?

The number of shots during the vaccination course depends on the age of the first dose.

The vaccination course for girls and boys under 15 years of age is single-dose and the minimum interval between vaccinations is 6 months;
The vaccination course for girls and women aged 15 to 45 is three doses.
The vaccination course for boys and men aged 15 to 26 is three doses.

Three-dose vaccination is carried out according to the following scheme: 0 – 2 – 6 months. The minimum interval between the first and second doses should be at least 1 month, and the minimum interval between the second and third doses should be at least 3 months.

Anyone of any age who has a health condition that weakens their immune system should get a three-dose course of the HPV vaccine, regardless of age.

What side effects can the HPV vaccine have?

The HPV vaccine is safe, but as with any vaccination, there may be some short-term side effects after the shot. Your doctor will monitor you for a few minutes after the shot to make sure you are okay before you go home.

The most common side effects of the HPV vaccine include:

Pain, swelling, or redness at the injection site
Headache or feeling tired
Muscle or joint pain
Dizziness
Heat
Feeling nauseous
Allergic reaction (rare)

All of the above side effects are short-term, and the HPV vaccine has no long-term side effects.

Who is the HPV vaccine free for?

Starting in 2023, girls and women aged 10-45 and boys and men aged 10-26 will be able to receive free vaccinations in Georgia as part of the Expanded Program on Immunization.

Where can I get vaccinated?

The HPV vaccine can be administered at any medical facility providing HPV vaccination services, in more than 50 cities and towns in Georgia, a full list of which can be found on the website of the National Center for Disease Control and Public Health.

To start vaccination, you can contact your family doctor or the desired facility on the list.

Prognosis

What should I expect if I have APV?

The prognosis for HPV is generally quite good. It depends on which strain you have and how effectively your body can fight off the infection. If you have a low-risk strain and a healthy immune system, there’s a good chance your body will clear the infection on its own within 12 to 24 months.

Some strains have been linked to cancer. In these cases, your doctor will monitor the virus and prescribe additional testing or treatment if necessary.

► Remember that early detection of high-risk strains and regular Pap testing can prevent the development of cervical cancer from HPV.

Is human papillomavirus curable?

No. There is no cure for HPV. However, your immune system often clears the virus on its own. About 90% of HPV infections go away within a year or two.

Is HPV contagious throughout life?

Not necessarily. You are contagious as long as HPV is in your body — regardless of whether you have symptoms or not. For example, if you had genital warts and you got rid of them, you can still spread the virus as long as it remains in your body.

Living with papillomavirus

When should I see a doctor?

You should contact your doctor if you have:

Genital warts — cauliflower-shaped warts that can appear on the vagina, anus, or mouth;
Abnormal Pap test results — If your Pap test reveals abnormal cells, it means you may need additional testing for HPV.

Additionally, ask your doctor how often you should have HPV tests, such as a Pap test. Discuss any concerns you have about HPV, especially if you have a health condition that weakens your immune system. This can make it harder for your body to fight the virus.

What questions should I ask the doctor?

It’s perfectly natural to have questions about HPV. You can ask your doctor:

Do I need treatment for HPV?
Is this strain of HPV high-risk?
Do I need to get screened for HPV more often?
Can I transfer my APV to someone else?
Can I get the HPV vaccine?

Finding out you have HPV may be scary or confusing, but it’s important not to panic — first, talk to your doctor to understand how HPV can affect your health. Don’t assume you’ll definitely get cancer — not all types of HPV are the same.

HPV, which causes genital warts, can be uncomfortable or embarrassing, but it is not a health risk;
In most cases, the body copes with the virus on its own and the infection disappears on its own;
If your body cannot cope with the virus, your doctor will monitor cellular changes and, if necessary, intervene in a timely manner to reduce the risk of developing cancer.

What can you do?

Talk to your doctor about the HPV vaccine.
Get regular screenings, especially if you are in a risk group.

Human papillomavirus is very common and, in most cases, does not cause serious problems. Awareness and timely intervention are the best ways to stay healthy.

Sources: Cleveland Clinic — HPV, Cleveland Clinic — HPV Vaccine, Civil.ge, NCDC.ge, National Center for Disease Control and Public Health.