HPV Information

HPV Information - Human Papilloma Virus

One of the most common human infections in the world is that caused by Human Papilloma Virus (HPV). HPV, which is commonly known as "wart virus", is a microscopic virus particle that infects the skin. In the case of HPV, the infection is actually localized directly to the infected point in the skin. With HPV, the infection is actually in the skin.

Most infections with HPV are invisible. This means that the virus has entered the skin at some point and altered the DNA structure of the human cell, usually causing no visible or apparent changes in the cellular structure. This happens, literally, in tens of millions of cases. The only way to detect these infections is by performing medical sampling of the skin, either with a swab or with a biopsy, and then the performing in a laboratory of testing for the appearance of HPV DNA in these samples.

Such sampling research has been very revealing. As far back as 1991, the Journal of the American Medical Association revealed that almost 50% of sexually active females seeking evaluation for unrelated conditions at a gynecological evaluation at a University Health Center environment demonstrated positive testing for HPV DNA in the vagina. Thus, a decade ago almost half of sexually active females revealed through testing that they had HPV DNA in their vaginas. These data were an astounding revelation regarding the prevalence of this infection that had never before been noticed.

Interestingly in this study fewer than 10% of patients had actual visible, external signs of skin changes consistent with "genital warts", the most common skin manifestation of HPV. The conclusion, therefore, was that about half of sexually active females in the 20-40 age range were infected with HPV, and fewer than one in ten patients were aware of it.

In the intervening years it has become apparent that the same sort of data applies to males as well. Penile skin can become infected and yet have no outward signs of infection. Only DNA testing for HPV, often on a random basis on the penis, might show such an infection. To accurately find any virus might require multiple samples, and even then the testing might miss the infection.

It is safe to say, therefore, that patients may be carrying HPV infections without any evidence of signs or symptoms and that only comprehensive testing of the genital skin may show it. Even then, the testing may miss it.

Testing for HPV is essentially limited to taking swabs or samples from potentially infected skin area. No truly, consistently effective blood test is available for the infection. Testing includes examination of the specimen of interest for the presence of viral DNA.

With an infection so prevalent in the population, the reader might wonder if the virus is actually very dangerous. After all, if possibly a hundred million people in America alone carry such a chronic infection and apparently have little if any symptoms, does the infection really present any real problem?

The most correct answer to this question is a careful "no". HPV generally presents little problem. The occasional patients who develop warts on their extremities or elsewhere are usually treated with some sort of chemical or cautery device that destroys the outward sign of the virus. The visible wart is a condition where the DNA of the human skin has been changed by the virus, allowing the skin to develop a tumor-like growth in that area. The growth is generally felt to be "benign" - that is, not a cancer - since it apparently does not spread throughout the body, except possibly to other areas of the skin.

Evidence is beginning to accumulate, however, that HPV may be associated with various other cancers, including cancers of the head and neck. Spreading of these cancers may be due to actual particles of HPV spreading through the bloodstream.¹

Evidence has also been shown that infants born to mothers with HPV may, in fact, have contamination of their mouth area with the virus. This study also showed, though, that virtually all of the infants cleared this virus spontaneously over a relatively brief period of time.

Once removed by chemicals or cautery, the wart usually goes away and remains gone. However, the skin surrounding the area from which the wart came usually remains infected with wart virus and may be contagious. The fact that the surrounding skin may still be contagious even though the wart has been destroyed applies to warts on the fingers as well as warts on the genitalia.

Recent published evidence, though, does suggest that many, possibly even most, patients will spontaneously clear up and eliminate HPV infections. This is encouraging, new information for many millions of HPV sufferers. Clinicians have noticed for years that infections with warts on the hands, for example, might spontaneously clear away. Apparently this same sort of clearance of the virus by the immune system happens to many genital HPV sufferers.

However, what is also clear is that many of the strains of HPV, especially some of the ones associated with cervical cancer, are much less likely to clear spontaneously. So, ALL patients who have experienced HPV and/or genital warts must be periodically re-examined to make sure that the affected area is cleared, especially females.

HPV Information - Prevention of HPV Infections

This discussion will make a distinction between non-genital and genital infections for the purpose of covering the aspects of prevention.

HPV is transmitted to another area of the body or to another person through the contact by an infected piece of skin with a non-infected piece of skin. The presumption is that the non-infected area has to have a small, perhaps microscopic, break in the skin that allows a tiny amount of tissue from the infected area to get into the non-infected area, allowing an infection to set up.

It is easy to imagine that someone with a wart on a finger might scratch an itch elsewhere on the body and transmit the virus to that area. This is a common way in which warts are spread around on different areas of the same person.

Sadly, most areas of skin that possess HPV infection have no outward signs. Thus, the infection may be transmitted to the uninfected area of a partner without any knowledge of this fact by either partner. This is the manner in which almost all HPV infections are apparently transmitted. So, practically, if partners choose to have direct skin-to-skin contact between genitalia, then it may be impossible to know if HPV virus is being transmitted or not.

Latex condoms are ineffective in preventing transmission of HPV to partners. The condom must cover potentially infected areas completely. If a partner has no outward signs of infection on an area high on the penis near the scrotum, for example, the partner may in fact spread HPV to a partner even while wearing a condom. Thus, it is reasonable to use latex condoms, but no assurance can ever be given that the condom will be completely protective.

Various plastic membranes are available for females now which may be somewhat helpful at preventing transmission of most STD's, not just HPV. Such devices must be of an appropriate size for the female, even perhaps requiring proper fitting by a medical provider such as a gynecologist for maximum protection and comfort.
As mentioned above vaccines are not yet available that can provide protection for people who do not yet carry the virus.

Exciting new research is ongoing suggesting that perhaps "chemical condoms" for females, and/or "Intravaginal Release" medications may be very effective in preventing transmission of a broad range of STD's, including HPV. While no final information is yet available at the time of the posting of this article regarding the potential release date for this material, we have found through our research that exciting trials are beginning in Europe this year. We will continue the regular monitoring of ongoing research to determine when or if such materials or devices will become available.

HPV Information - Common Misspellings and Alternate Names for HPV