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Human papillomavirus (HPV)

Human papillomavirus, or HPV, is a group of over 200 related virus strains that can infect the skin and mucous membranes of both women and men. It occurs when the virus enters your body, usually through a cut, abrasion or a small tear in your skin.

A vial of Human papillomavirus (HPV) vaccine

According to the Cancer Association of South Africa (CANSA), HPV is so common that 80% of all women and men would have tested positive for the HPV virus at least one time in their life by age 50. 

About 40 of these HPV strains may affect the genital area and are spread through sexual intercourse (including vaginal, oral and anal sex), as well as genital skin-to-skin contact. HPV is, in fact, the most common sexually transmitted disease (STD), or sexually transmitted infection (STI). It's estimated that approximately 50% of all sexually-active people contract HPV at some point in their lives. 

While most HPV infections don't result in any symptoms and are cleared by the immune system, some forms of the virus can cause warts and certain cancers.

The most common HPV-related cancers are throat cancer in men and cervical cancer in women – the World Health Organisation estimates that 70% of cervical cancers and pre-cancerous cervical lesions are caused by HPV. HPV can also lead to cancer of the vulva, vagina, penis, or anus. 

What are its symptoms?

Most HPV infections show no symptoms and so people are usually unaware that they have the virus. When it comes to sexually-transmitted HPV, you can develop symptoms years after you have sex with someone who is infected with HPV making it impossible to determine when exactly you first became infected.

Where HPV symptoms are present, they can be any of the following: 

  • Abnormal cells: These develop on the cervix and are detected through Pap smears (a test that determines whether precancerous or cancerous cells are present on the cervix, the opening of the uterus).
  • Genital warts: These are either small bumps resembling cauliflower, flat lesions, or stem like protrusions. In women, genital warts appear on the vulva, around the anus, in the vagina or on the cervix, and in men, they can be found around the anus, and on the penis and scrotum. 
  • Common warts: Usually affecting the hands, fingers and elbows, common warts are rough, elevated bumps. 
  • Flat warts: Flat warts are raised lesions that are often darker than the rest of the skin. Women tend to get these on their legs, while men get them in the beard area, and children on the face. 
  • Plantar warts: Appearing on the heels or balls of the feet, plantar warts are small, hard growths. 

Warts may appear anywhere from several weeks to several months after exposure to HPV, and in some cases, they don't appear at all. This makes it difficult to determine when the virus was contracted, and from whom. 

The HPV strains that cause genital warts differ from those that cause cancer. It can take years, even decades, for cancer to develop following HPV infection. There is unfortunately no way to determine whether those who have HPV will develop cancer or other HPV-related ailments.

How is it diagnosed?

In cases where warts are present, a doctor can diagnose an HPV infection through a visual examination. 

For women carrying HPV strains that can cause cancer, the first step towards an HPV diagnosis is a Pap smear – sexually-active women should have a pap smear annually before turning 30, after which the test should be done every three years at least. The Pap smear helps identify abnormal cell changes in the cervix, and if any are found, the doctor can then perform a DNA analysis to confirm whether or not the changes are the result of an HPV infection. 

At the moment, there is no HPV test that can detect cancer-causing strains in men.

What are your treatment options?

There is no cure for HPV, but most cases clear without any intervention. The treatment that is available is targeted at HPV symptoms.

Abnormal cells: When HPV causes cell changes that could lead to cancer, doctors may choose to monitor the cells since they sometimes heal on their own. Other HPV treatment options include removing the abnormal cells through freezing with liquid nitrogen (cryotherapy), a biopsy (conization), laser therapy, or the use of an electrical current  in a process called loop electrosurgical excision procedure (LEEP). 

Warts: Products containing salicylic acid and prescription creams can gradually clear genital warts. Trichloroacetic acid can be used to chemically burn off warts, but this must be carried out by an expert. Cryotherapy, laser therapy and LEEP are also options, and for warts that are large or don't respond to other treatments, surgical removal can be performed. 

It's important to note that although treatments may clear warts, they don't get rid of the HPV infection, and because of this the warts may return at a later stage. 

Can it be prevented?

There are HPV vaccines that protect against strains that are most likely to cause cancer. It’s recommended to have the HPV vaccine before first becoming sexually active, but those who have passed this stage can still benefit if they haven’t yet been exposed to the specific strains targeted by the vaccines.

As persistent infection with HPV may lead to cervical cancer, CANSA encourages all women in the age group of 9 to 26 years (provided they're not sexually active) to get the HPV vaccine.

The government is currently running the National Department of Health (DoH) HPV Vaccination Programme in all public schools, including former Model C, around South Africa, providing all grade four (9 to 10-year old girls) with the opportunity to receive the HPV vaccination.

Using condoms during sex offers protection from HPV, however this is only partial since the infection doesn't only spread through sexual intercourse, but through genital skin-to-skin contact as well. Sticking to one sexual partner also reduces your risk of contracting HPV.

How Clicks Clinics can help you

The HPV vaccine is available at Clicks Clinics. To make an appointment at a Clicks Clinic, call 0860 254 257 or visit Clicks Clinics online.

Shop online at Clicks.co.za for condoms

Stock up on condoms so that you can ensure you're practising safe sex at all times.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in December 2016
Read More: Cancer Super Section