Human Papillomavirus is one of the most common STIs (sexually transmitted infections) worldwide. This viral infection encompasses more than 100 different strains, with various types affecting different parts of the body.
Contracting HPV can be from non-sexual and sexual skin-to-skin contact, such as oral sex. It is very common in sexually active people, that’s why it is one of the most common sexually transmitted diseases.
Many HPV infections are harmless and resolve on their own. However, some strains can lead to more severe health issues such as genital warts, cervical cancer and other human papillomavirus HPV-related cancers, emphasizing the importance of awareness, prevention, and treatment.
HPV Types and Health Effects
HPV infection can be broadly categorized into high-risk and low-risk strains, each associated with different health outcomes.
High-Risk HPV
Certain strains of Human papillomavirus (HPV) are considered high-risk because they have the potential to cause severe health complications. These strains are primarily linked to cancers such as cervical, anal, oropharyngeal cancers, penile cancer, vulvar cancer, and vaginal cancers and other anogenital cancers. Among the high-risk strains, HPV types 16 and 18 are the most notorious, accounting for the majority of HPV-related cancers.
Individuals infected with high-risk HPV have an increased risk of developing certain cancers, especially cervical cancers — HPV infection causes 95% of cervical cancers.
Regular screening and early detection help manage and prevent cervical cancer from progressing. Pap smears and HPV tests play a vital role in identifying precancerous changes in the cervix, allowing for timely intervention and treatment. This allows it to be caught early before it cervical disease progresses.
Early detection of high-risk HPV can significantly improve health outcomes and reduce cancer-related complications, highlighting the importance of regular health checks and awareness. This is why all women are required to go for regular pap test to detect abnormal cells early. HPV DNA test and HPV testing is also now recommended for women 30 years old and above.
Low-Risk HPV
Conversely, low-risk strains of HPV are generally not associated with long-term health risks. These types may cause conditions like genital warts, anogenital warts which, while bothersome, do not lead to cancer. HPV types 6 and 11 are common low-risk types that cause most of the genital warts cases. These are caused by warts hpv strains.
HPV Symptoms
HPV infections can manifest with a variety of symptoms, which often depend on whether the virus is a high-risk or low-risk strain. It could be genital warts that are raised, flat, small, or large and sometimes have a cauliflower-like appearance.
For high-risk HPV strains, symptoms can be less obvious and more insidious. Abnormal vaginal bleeding, particularly after sexual intercourse, pelvic pain, and unusual discharge can be signs of more serious conditions like cervical cancer. Because these symptoms can be subtle or mistaken for other conditions, it is crucial to consult a healthcare professional for an accurate diagnosis.
*we can link this page to the symptoms page for more detailed discussions regarding symptoms
HPV Prevention
Preventing human papillomavirus infections reduces the risk of associated health complications, including various forms of cancer. There is currently no cure for HPV itself; hence, prevention efforts focus on managing symptoms and preventing complications through various strategies.
Vaccination
Vaccination can help prevent HPV infection and related cancers. An HPV vaccine is recommended for preteens and young adults before they become sexually active. However, they can also be administered to older teens and young adults who did not receive the HPV vaccine earlier. Gardasil 9 is now approved for women from 9 up to 45 years of age.
There are several HPV vaccines available, with the latest one called Gardasil 9. Its schedule typically involves two to three doses, depending on the age at which the first dose is administered.
HPV vaccinations reduce the risk of developing cancers caused by high-risk HPV types as well as a decrease in the occurrence of genital warts caused by low-risk strains.
Safe Sexual Practices
Engaging in safe sexual contact is essential for reducing the transmission risk of HPV. Regular use of condoms can significantly lower the chance of HPV transmission during sexual activity. Also, limiting the number of sexual partners can decrease the likelihood of encountering an HPV carrier.
Regular Screening
Regular cervical cancer screening can help detect and manage potential complications arising from human papillomavirus infection. The HPV test can detect human papillomavirus, and a Pap test can help identify cervical abnormalities.
Screening recommendations vary based on age and risk factors. 21 to 29-year-old women should have a Pap smear every three years, while those between 30 and 65 should have a Pap smear with an HPV test every five years or a Pap smear alone every three years.
HPV Treatment Options
While there is no cure for HPV itself, the body’s immune system can often clear the infection over time. Therefore, treatment focuses on managing symptoms and preventing complications arising from HPV-related conditions. Here are some key treatment options for common HPV-related issues:
Medical Treatments
There are several medical treatment options to address the common warts caused by most HPV infections:
Cryotherapy freezes and destroys warts using liquid nitrogen so that the wart can blister and fall off.
Laser treatment destroys the wart tissue using a concentrated beam of light.
Surgical removal is typically reserved for warts that do not respond to other treatments. It involves cutting out the wart and surrounding skin.
For warts in the genital area, prescription creams or ointments, such as podophyllotoxin and imiquimod, are applied directly to the warts, aside from cryotherapy.
Managing Symptoms
Another symptom of HPV is the abnormal cells that can be found through Pap smear. Women should start getting regular Pap smear screening at age 21, as long as they have ever had sexual intercourse in their lives. This will help monitor abnormal changes that could lead to cervical cancer.
If abnormal cells are found, further testing, such as a colposcopy, may be recommended. It helps identify the severity and location of any precancerous changes that can develop cancer. It can also diagnose conditions such as cervical intraepithelial neoplasia.
The combination of Pap smears and colposcopies allows healthcare providers to monitor the progression or regression of precancerous changes and determine the appropriate treatment or management plan for the patient.
Effectiveness of HPV Treatments
In the short term, treatments like cryotherapy, laser treatment, and surgical removal of warts can effectively eliminate visible warts and offer rapid relief from symptoms. However, these treatments do not cure the HPV infection itself, meaning that new warts can potentially emerge later. This is due to the ability of HPV to remain latent in the basal layer of the skin, leading to the reactivation and regrowth of lesions over time.
Several factors can impact the long-term success of HPV treatments, including:
Lesion Type and Location: Treatments tend to be more effective for external genital warts compared to internal or recurrent lesions.
Immune Status: Patients with weakened immune systems, such as those with human immunodeficiency virus, are more prone to HPV persistence and treatment failure.
Adherence: For patient-applied topical treatments, proper and consistent application is crucial for efficacy.
Viral Factors: Certain types of HPV, like HPV 16 and 18, are more resistant to treatment.
Potential Side Effects of HPV Treatments
The potential side effects of HPV (human papillomavirus) vaccine include:
Pain, swelling, redness, itching, bruising, bleeding, and a lump at the injection site
Headache
Fever
Nausea
Dizziness
Tiredness
Diarrhea
The side effects are typically mild and temporary.
Cost of HPV Treatments
The cost of HPV treatments in Singapore varies depending on the specific procedure or vaccine. The price for HPV vaccines like Gardasil 9 can range from SGD 270 plus to SGD 350 plus for each dose.
Medical treatments for HPV-related issues, such as cryotherapy, laser treatment, or surgical removal of warts, also fluctuate in cost. These procedures may typically range from SGD 200 to SGD 500, depending on the location of treatment and its complexity.
Living with HPV
While HPV infections can sometimes clear on their own, some types can lead to more serious health issues if left untreated. Living with HPV requires ongoing management and care to maintain good health and prevent complications.
Long-term Management
It’s important to schedule regular check-ups with your healthcare provider to monitor any potential complications or changes related to your HPV infection. This may include:
Pap tests or HPV tests to check for cervical cancer, anal cancer, or other HPV-related changes
Physical exams to inspect for genital HPV infection or other visible signs of HPV
Discussions about your overall health and any new symptoms
Psychological Impact
Receiving an HPV diagnosis can be stressful and have a significant psychological impact. Coping with the diagnosis and any necessary treatment can be challenging. It’s important to seek support and resources to help manage the emotional aspects of living with HPV.
Some ways to cope with an HPV diagnosis and any related treatment include:
Talk to your healthcare provider for concerns and questions
Joining a support group to connect with others in similar situations
Practising stress management techniques
Conclusion
HPV is a common STI, but it can be managed with effective treatment and prevention strategies. HPV vaccination remains the best way to prevent HPV infection and related cancers. HPV vaccines have proven effective in preventing infections from the high-risk HPV types that are most commonly associated with cancer.
Additionally, regular screening and early detection are key for the successful treatment of HPV-related cancers. Pap smears, HPV tests, and other recommended screenings can detect precancerous changes early, allowing for timely and effective intervention.
By staying informed and proactive about HPV prevention and management, individuals can significantly reduce their risk of serious complications associated with the virus.
