THE HPV VIRUS

  • Fact: HPV is the most frequently sexually transmitted disease in the world. [1] According to the Center for Disease Control (CDC), approximately 45.2% of men and 39.9% of women, age 18–59, have genital HPV. [2]
    [1] Steinbach A, Riemer AB, Immune evasion mechanisms of human papillomavirus: An update. Int J Cancer. 2017 Sep 2. doi: 10.1002/ijc.31027. [Epub ahead of print]
    [2] Studer L, Cardoza-Favarato G  Human Papillomavirus. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017-2017 Aug 1.

  • Fact: The majority of HPV infections are temporary. The virus is cleared naturally by the immune system within a couple of years after exposure. Only 10-20% of infections stay in the body in a latent (hidden) state. These latent viruses can become active and cause symptoms, such as the development of abnormal growths and cancer. [1]

    [1] Shanmugasundaram S, You J. Targeting Persistent Human Papillomavirus Infection. Viruses. 2017 Aug 18;9(8). pii: E229.

  • Fact: HPV lives in thin, flat cells called epithelial cells. Epithelial cells are found on the surface of the skin. They are also found on the surface of the vagina, anus, vulva, cervix and head of the penis. They are also found inside the mouth and throat. [1]

    [1]http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-virus-information-about-human-papillomavirus#1

  • Fact: There are over 180 known subtypes of HPV.

    • Subtypes 6 and 11 cause most of the genital warts. They are called low-risk HPV, which means having a low-risk of becoming cancerous.
    • Subtypes 16 and 18 cause most of the pre-cancerous and cancer lesions of the cervix, male and female genital areas, and oropharynx area. They are called high-risk HPV, which means having a high-risk of becoming cancerous.
    • Subtypes 31, 33, 35, 45, 52, and 58 are also high-risk HPV.
    • Warts of the hands and feet are most commonly caused by HPV subtypes 1, 2, 4, 27, or 57. [1]

    [1] Studer L, Cardoza-Favarato G Human Papillomavirus. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017-2017 Aug 1.

  • Fact: Almost all people acquire a genital HPV infection at some point in their life. Oral infections are also common. The majority of the infections appear without symptoms, and are cleared naturally by the immune system. [1]

    [1] Syrjänen S,Rautava J. [HPV and cancer].Duodecim. 2015;131(19):1765-74.

HPV, GENITAL WARTS AND CANCER

  • Fact: HPV infection is very common among sexually active men, and can lead to more serious outcomes, including cancer. [1] Overall, 42.2% of US males, age 14-59 years, have genital HPV infections. [2]

    [1] Ventimiglia E , Horenblas S, Muneer A,Salonia A.Human Papillomavirus Infection and Vaccination in Males.Eur Urol Focus. 2016 Oct;2(4):355-362. doi: 10.1016/j.euf.2016.08.012. Epub 2016 Sep 12.

    [2] Gargano JW, Unger ER, Liu G, Steinau M, Meites E, Dunne E, Markowitz LE. Prevalence of Genital Human Papillomavirus in Males, United States, 2013-2014. J Infect Dis. 2017 Apr 1;215(7):1070-1079.

  • Fact: Genital warts are a very common disease. They appear as growths in the areas where friction has occurred in the genital region. They are caused mostly by low-risk HPV 6 and 11. [1] This means that HPV’s caused by genital warts generally have a low-risk of turning into cervical or other cancers.

    [1] Steben M , Garland SM .Genital warts.Best Pract Res Clin Obstet Gynaecol. 2014 Oct;28(7):1063-73. doi: 10.1016/j.bpobgyn.2014.07.002. Epub 2014 Jul 17.

  • An abnormal Pap test result does not necessarily mean you have cancer. Normally the abnormal cell changes, detected by the test, are caused by certain types of HPV, go away on their own. Also, at times, those cell changes may be due to infections caused by other organisms, such as bacteria or yeast. These infections should be treated, but they don’t cause cancer. [1]

    [1] http://www.webmd.com/women/tc/abnormal-pap-test-topic-overview#1

  • Fact: Cervical cancer is primarily caused by an infection with HPV. But other factors, such as smoking, co-infections, and genetic background, can increase the risk that the HPV infection will turn into cancer. [1] For instance, if you smoke, you weaken the immune system around the cells of the cervix, and make it easier for the virus to turn normal cell into cancer cells.  Smoking, therefore, is a major risk factor for developing cervical cancer.

    [1] Cardoso MFS, Castelletti CHM, Lima-Filho JL, Martins DBG, Teixeira JAC.Putative biomarkers for cervical cancer: SNVs, methylation and expression profiles.Mutat Res. 2017 Jul;773:161-173.

HPV TRANSMISSION

  • Fact: Both low and high-risk HPVs are generally considered to be sexually transmitted.  However, HPV may be spread by other forms of intimate contact, such as oral sex [1].  

    [1] Studer L, Cardoza-Favarato G Human Papillomavirus. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017-2017 Aug 1.

  • When condoms are used all the time, they appear to offer a relatively good protection from HPV infections. [1] However, HPV spreads through skin-to-skin contact. As condoms do not cover the entire genital area of either sex, they do not provide full protection. 

    [1] Lam JU , Rebolj M, Dugué PA, Bonde J, von Euler-Chelpin M, Lynge E. Condom use in prevention of Human Papillomavirus infections and cervical neoplasia: systematic review of longitudinal studies.J Med Screen. 2014 Mar;21(1):38-50. doi: 10.1177/0969141314522454. Epub 2014 Jan 31.

  • Most sexually active people will be infected with a sexually transmitted infection (STI) at some point in their lives. People who have casual sex are not the only ones who get STIs. In 2008, there were about 110 million people; women and men, in the United States who had an STI. More than 20% of infections (22.1 million) were seen in women and men age 15 to 24. Approximately 19.7 million new infections occurred in the United States in 2008. Nearly 50% (9.8 million) were seen in young women and men age 15 to 24. [1]

    [1]Satterwhite, Catherine Lindsey PhD, et al. Sexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2008, Sexually Transmitted Diseases: March 2013 – Volume 40 – Issue 3 – p 187–193

  • Fact: This is a common myth that cause a lot of heartbreaks. This myth, however, is not true.  HPV infections can be subclinical or latent in both skin and mucosa (a mucous membrane) for years. [1]  Being subclinical means being nearly or completely asymptomatic, that is, having no signs or symptoms. Begin latent also means having no symptoms. The virus can therefore remain in the body for years, or even a lifetime, without the infected individual being aware of its existence. Since lesions can occur after a long subclinical or latent period, the infection could have occurred before you met each other.

    [1]Cubie HA.Diseases associated with human papillomavirus infection.Virology. 2013 Oct;445(1-2):21-34.

  • Fact: HPV infections are very common, and HPV is the most frequently sexually transmitted disease in the world. [1] The only way you can avoid getting HPV is avoiding all types of sexual behavior (including oral sex). This, however, is probably not a popular option for most people.

    [1] Steinbach A, Riemer AB, Immune evasion mechanisms of human papillomavirus: An update. Int J Cancer. 2017 Sep 2. doi: 10.1002/ijc.31027. [Epub ahead of print]

  • Fact: You can get HPV through skin to skin contact of the genital area. So any person who has ever been sexually active can have HPV.  Today, the guidelines suggest to stop pap screenings at the age of 65. However, some European studies show that the percentage of invasive cervical cancer in the oldest patients is still high and these cancers are detected at a more advanced stage. [1]

    [1] Enderle I, Le Baccon FA, Pinsard M, Joueidi Y, Lavoué V, Levêque J, Timoh KN. Pap Smear after 65 years. Gynecol Obstet Fertil Senol. 2017 Sep;45(9):478-485.

THE HPV VACCINE

  • Fact: Three vaccines are approved by the FDA to prevent HPV infection: Gardasil, Gardasil 9, and Cervarix.

    • Cervarix prevent infections with HPV types 16 and 18, two high-risk HPVs that cause about 70% of cervical cancers.
    • Gardasil prevents infection with HPV types 16, 18, 6 and 11, which cause 90% of genital warts.
    • Gardasil 9 prevents infection with 9 HPV types: 16, 18, 6, 11, plus five additional high-risk HPV types 31, 33, 45, 52, and 58.

    However, no vaccine protects against all types of HPV. [1]

    [1] National Cancer Institute, https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet

  • Fact: Women who have the HPV vaccine should still visit an OB/GYN provider for cervical cancer screening since the vaccine does not cover all types of HPV that can cause cancer. Cervical cancer screening in the United States has seen a great decrease in cancer incidences and mortality over the last half century. [1]

    [1] Sawaya GF, Huchko MJ Cervical Cancer Screening. Med Clin North Am. 2017 Jul;101(4):743-753. doi: 10.1016/j.mcna.2017.03.006. Epub 2017 Apr 21.

  • Fact: According to the CDC, the vaccine does not protect against all types of HPV: so they will not prevent all cases of HPV, or all cases of cervical cancer. [1] Also, the HPV vaccines can only be used to prevent HPV, and are not effective in individuals who already have HPV. [2]
    [1] https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm

    [2] Shanmugasundaram S,You J. Targeting Persistent Human Papillomavirus Infection.Viruses. 2017 Aug 18;9(8). pii: E229.

  • Fact: The vaccine has been used for only the past 10 years. The CDC states “research suggests that vaccine protection is long-lasting.” Current studies have watched vaccinated individuals for ten years, and show that there is no evidence of the vaccination becoming weaker. [1]

    [1] https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm

HPV AND PREGNANCY

  • Fact: A study found that the rate of preterm birth (premature birth) was not significantly different in women with HPV and women without HPV. The rates of pregnancy-related hypertension (high blood pressure) also were not significantly different between women with HPV and women without HPV. [1] The authors concluded that being pregnant with the HPV infection does not make someone more likely to have a preterm birth, or pregnancy-related hypertension. [1]

    [1] Subramaniam A, Lees BF, Becker DA, Tang Y, Khan MJ, Edwards RK.Evaluation of Human Papillomavirus as a Risk Factor for Preterm Birth or Pregnancy-Related Hypertension.Obstet Gynecol. 2016 Feb;127(2):233-40.

HPV TREATMENTS

  • Fact: A clinical study showed that the herbal Gene-Eden-VIR/Novirin safely clears the Human Papillomavirus (HPV) after one year of treatment without side effects. [1]

    [1] Polansky H,Itzkovitz E,Javaherian A.Human papillomavirus (HPV): systemic treatment with Gene-Eden-VIR/Novirin safely and effectively clears virus.Drug Des Devel Ther. 2017 Mar 3;11:575-583