Human Papilloma Virus

Human Papilloma Virus (HPV) is a very common virus (germ) that causes abnormal cells or growth of tissue on the skin of the body. HPV can cause abnormal tissue changes on the feet, hands, vocal cords, mouth and genital (sex) organs. Over 60 types of HPV have been identified so far. Each type infects certain parts of the body. In gynecology, we are concerned about the types of HPV that infect the female organs.

Why Is HPV Important?
HPV is important because the abnormal tissue caused by some types of the virus can lead to cancer of the female organs. Finding and treating HPV-related tissue changes is a way to prevent cancer.

Where Does HPV Grow?
HPV can grow on the cervix (opening to the uterus), vagina (birth canal), vulva (lips of the vagina), urethra (opening urine comes through) and the anus (opening for bowel movements).

There are two kinds of abnormal tissue caused by HPV: CONDYLOMA (warts) and DYSPLASIA (pre-cancer). Doctors can evaluate you for presence of the abnormal tissue by examining the skin of the vulva and vagina and by doing a Pap smear.

• CONDYLOMA (GENITAL WARTS) are wart-like growths found in the genital area, most commonly on the outside or vulva. They are usually painless, but may cause itching, burning or slight bleeding. Warts can also be found around the urethra and anus. Inside the vagina and on the cervix, warts are usually flat and Pap smears usually alert us to their presence.
• DYSPLASIA is the presence of abnormal cells on the surface of the skin. Dysplasia is not cancer, but may turn into cancer over a period of years if it is not treated. Treatment gets rid of dysplasia so that the tissue cannot turn into cancer.

The only way to tell if dysplasia is present on the skin of the genital organs is by taking a Pap smear or a biopsy (piece of tissue). Dysplasia can be evaluated through a magnifying glass called a colposcope, but only the biopsy gives the final diagnosis. Dysplasia is most often found on the cervix, but can also be found on the vagina and vulva.

How Is Human Papilloma Virus Spread?
At this time, very little is known about how or when people become infected with HPV. There is research being done to answer some of these questions. What we do know is that HPV is mainly spread through sexual contact. Women may be exposed to HPV and not develop dysplasia or genital warts for many years. Both men and women can be infected with the virus and not know it.

What we do not know about HPV
1 When can a person with HPV give it to another person?
2 How long is a person with HPV able to give it to somebody else?
3 Why do some people who are exposed to HPV get condyloma or dysplasia and other people do not?

Prevention
There are three ways to decrease exposure to HPV and other sexually transmitted diseases.
1 Using condoms (rubbers) during sex.
2 Monogamy - have sex with only one partner. To be effective, monogamy must include both partners and be long term. It is helpful to discuss this with your partner.
3 Abstinence - not having sex. This does not mean that other forms of closeness need to be eliminated.

Examination Of Male Sexual Partners
We recommend that male sexual partners of women with genital warts be examined by a physician. If warts are found on exam the partner can be treated. If warts are not found, the male may still carry HPV, but show no signs of it. Some physicians are more knowledgeable about genital warts than others. Dermatology, Family Practice or Urology specialists will likely be most helpful. Ask the nurse or physician if you have more questions.

Cigarette Smoking
If you have been exposed to HPV and also smoke, the chance that you will develop dysplasia is much higher. If you already have dysplasia, stopping smoking may reduce your chance of the dysplasia coming back after treatment.

Peer Review Status: Internally
Peer Review Date: 1997