Human papillomavirus (HPV)

Introduction

Human papillomavirus (HPV) is a common virus, spread through sexual contact. Most people do not experience any HPV symptoms and the virus often goes away by itself. When HPV does not go away, it can cause further health problems which are outlined below. HPV can affect anyone who is/has been sexually active. It is common to be infected with one/more types of HPV shortly after sexual activity starts. There are more than 200 strains of HPV - around 40 types can affect the genital area.

HPV is usually spread by skin-to-skin contact during sex including:

• genital-to-genital contact
• vaginal, anal and oral sex
• sharing sex toys

Many people with HPV do not experience symptoms. The virus can clear from your body without your knowledge. Although symptoms can be vague, see your doctor or sexual health clinic if you have:

• unusual vaginal/anal bleeding
• pain during sex
• lumps, pain or itching in your genital area.

HPV can cause:

• genital warts: a common sexually transmissible infection (STI)
• certain types of cancer, including cervical cancer, cancer in the genital areas, mouth cancer and throat cancer (high-risk infection)

Around 14 HPV strains can infect the cervix. They can cause abnormal cell changes if the virus does not clear naturally from the body, which can then lead to cancer cell formation. This usually takes more than 10 years to occur.

See a doctor and/or nurse if you, or your child, notice any unusual changes to the skin around the genital area

Diagnosis may include:

• physical examination
• blood test
• cervical screening test (CST) (for people with a cervix, over the age of 25).

Symptoms for HPV can be treated, but there is no cure for the disease.

Medications to eliminate warts are typically applied directly and usually take many applications before they're successful. Examples include:

• salicylic acid: over-the-counter treatments that contain salicylic acid work by removing layers of a wart a little at a time.
• imiquimod: this prescription cream might enhance your immune system's ability to fight HPV. Common side effects include redness and swelling at the application site.
• podofilox: a topical prescription, podofilox works by destroying genital wart tissue. Podofilox may cause burning and itching where it's applied.
• trichloroacetic acid: this chemical treatment burns off warts. It might cause local irritation.

If medication doesn't work, you or your child's doctor might suggest removing warts by one of these methods:

• freezing with liquid nitrogen (cryotherapy)
• burning with an electrical current (electrocautery)
• surgical removal
• laser surgery.

If you have an abnormal HPV or CST, your gynaecologist will perform a procedure called a colposcopy. Using an instrument that provides a magnified view of the cervix (colposcope), your doctor will look closely at the cervix and take samples of any areas that look abnormal. Any precancerous lesions need to be removed. Options for removal include freezing, laser, surgical removal, loop electrosurgical excision procedure and cold knife conization. 

Practising safe sex helps stop the spread and infection of HPV. Always use barrier protection (condoms and dental dams) during sex, and have regular sexual health checks, including testing annually for STIs if you are sexually active.

The HPV vaccine protects against nine strains of HPV that cause more than 90% of cervical cancers and more than 95% of HPV-related cancers. The vaccine also protects against HPV that causes more than 90% of genital warts.

HPV protection is expected to be long-lasting and is probably life-long. If booster shots are ever needed, people will be contacted by the Australian Immunisation Register, which keeps records of everyone who has received the vaccine.