How to prevent human papillomavirus infection

Asmau, 40 (not her real name) was diagnosed of cervical cancer some months ago. Doctors told her that human papillomavirus infection puts people at risk of cervical cancer.

They said the disease could have been prevented if she had taken a human papillomavirus (HPV) vaccine and other preventive measures.

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According to Dr Raymond Lawal, a general medical practitioner, HPV infection is caused by the human papillomavirus, a DNA virus from the Papilloma viridae family.

He said about 90 per cent of HPV infections cause no symptoms and resolve spontaneously within two years. However, in some cases, an HPV infection persists and results in either warts or precancerous lesions.

He said these lesions, depending on the site affected, increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth or throat.

He said, “Nearly all cervical cancer is due to HPV. Two strains — HPV16 and HPV18 — account for 70 per cent of cases. HPV6 and HPV11 are common causes of genital warts and laryngeal papillomatosis.

“There are over 100 varieties of HPV, more than 40 of which are passed through sexual contact and can affect your genitals, mouth or throat.”

Quoting data from the Centers for Disease Control and Prevention (CDC), he said HPV is the most common sexually transmitted infection (STI). It’s so common that most sexually active people will get some variety of it at some point, even if they have few sexual partners, he said.

Dr Musa said the virus that causes HPV infection is transmitted through skin-to-skin contact. Most people get a genital HPV infection through direct sexual contact, including vaginal, anal and oral sex. Because HPV is a skin-to-skin infection, intercourse isn’t required for transmission to occur.

He said, “Many people have HPV and don’t even know it, which means you can still contract it even if your partner doesn’t have any symptoms. It’s also possible to have multiple types of HPV.

“In rare cases, a mother who has HPV can transmit the virus to her baby during delivery. When this happens, the child may develop a condition called recurrent respiratory papillomatosis where they develop HPV-related warts inside their throat or airways.”

Other factors that may put someone at an increased risk for HPV infection include:

•       Increased number of sexual partners
•       Unprotected vaginal, oral, or anal sex
•       A weakened immune system
•       Having a sexual partner that has HPV

The expert said if you contract a high-risk type of HPV, some factors can make it more likely that the infection will continue and may develop into cancer. These factors include:

• A weakened immune system
• Having other STIs, such as gonorrhea, chlamydia, and herpes simplex
• Chronic inflammation
• Having many children (cervical cancer)
• Using oral contraceptives over a long period of time (cervical cancer)
• Using tobacco products (mouth or throat cancer)
• Receiving anal sex (anal cancer)

Dr Musa said in most cases (9 out of 10), HPV goes away on its own within two years without health problems. However, because the virus is still in a person’s body during this time, that person may unknowingly transmit HPV.

“When the virus doesn’t go away on its own, it can cause serious health problems. These include genital warts and warts in the throat (known as recurrent respiratory papillomatosis), cervical cancer and other cancers of the genitals, head, neck and throat.

“The types of HPV that cause warts are different from the types that cause cancer. So, having genital warts caused by HPV doesn’t mean that you’ll develop cancer.

“Cancers caused by HPV often don’t show symptoms until the cancer is in later stages of growth. Regular screenings can help diagnose HPV-related health problems earlier. This can improve outlook and increase chances of survival.

“Cancer often takes years, even decades, to develop after a person gets HPV,” he said.

Dr Musa said prevention is always better than treatment, adding that other HPV-related cancers are also more treatable when found and treated early.

According to him, the easiest ways to prevent HPV is to use condoms and to practice safe sex.

In addition, he said the Gardasil 9 vaccine is available for the prevention of genital warts and cancers caused by HPV.

The vaccine could protect against nine types of HPV known to be associated with either cancer or genital warts.

The CDC recommends the HPV vaccine for boys and girls ages 11 or 12. Two doses of the vaccine are given at least six months apart.

Women and men ages 15 to 26 can also get vaccinated on a three-dose schedule.

Dr Musa said to prevent health problems associated with HPV, it is important to get regular health checkups, screenings and Pap smears.

He said people could do the following things to lower their chances of getting HPV:

• Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups.

“Vaccination is not recommended for everyone older than age 26 years. However, some adults, aged 27 through 45 years, who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination.

“HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination,” Dr Musa said.

• Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.
• If you are sexually active:
• Use condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas the condom does not cover. So, condoms may not fully protect against getting HPV; and
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

Dr Musa said presently there is no test to find out a person’s HPV status.

“Also, there is no approved HPV test to find HPV in the mouth or throat. There are HPV tests that can screen for cervical cancer. Healthcare providers only use these tests for screening women aged 30 years and older.

HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

He said most people with HPV do not know they have the infection. They never develop symptoms or health problems from it.

However, he added that some people find out they have HPV when they get genital warts.

“Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening).

“Others may only find out once they’ve developed more serious problems from HPV, such as cancers,” he said.

There is presently no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause.

Dr Musa said, “Most cases of HPV go away on their own, so there’s no treatment for the infection itself. Instead, your doctor will likely want to have you come in for repeat testing in a year to see if the HPV infection persists and if any cell changes have developed that need further follow-up.

“Genital warts can be treated with prescription medications, burning with an electrical current, or freezing with liquid nitrogen. But, getting rid of the physical warts doesn’t treat the virus itself, and the warts may return. If left untreated, genital warts may go away, stay the same, or grow in size or number.

“Precancerous cells may be removed surgically. Cancers that develop from HPV may be treated by methods such as chemotherapy, radiation therapy, or surgery. Sometimes, multiple methods may be used.