Human Papillomavirus (HPV)
Human Papillomavirus (HPV) is a virus that can infect several different parts of the body in both men and women. It can be transmitted through non-sexual and sexual contact. HPV is the most common sexually transmitted infection (STI). 75 per cent of Canadians are infected at some point in their lifetime. There are more than 100 types of HPV. Some can cause plantar warts on the skin. Others can lead to more serious illnesses such as cervical, penile and anal cancers. Persistent infection of high risk HPV types is the cause of over 99 per cent of cervical cancers.
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A majority of people infected with HPV will not develop health problems. In most cases, they clear the virus naturally within two years. When symptoms occur, they vary depending upon what type of HPV infection the person has. They include the development of plantar warts, genital warts and cancer.
Low risk types of HPV can lead to skin warts in the infected area. A sign of a sexually transmitted HPV infection is the development of genital warts. These can appear weeks or months after sexual contact with an infected partner, even if the infected partner has no signs of genital warts.
Persistent infection of high-risk HPV types can cause changes in the cells on the cervix, vulva, vagina, penis, anus, mouth or throat. Over time, if these changes remain and are not treated, cancer can develop. These cancers usually do not have symptoms until they are quite advanced. In Manitoba, approximately 45 women are diagnosed with cervical cancer each year, and about 15 women die annually from the disease.
HPV is estimated to be one of the most common sexually transmitted infections (STIs) in Canada and around the world. Most people who are sexually active will have at least one HPV infection in their lifetime. People in their late teens or early 20s are the age groups most commonly infected with HPV.
HPV infections can occur without any symptoms; it is easy for people who are infected to pass it onto others without knowing it. It is possible to have more than one type of HPV at a time. A person can have HPV even if years have passed since he or she had sexual contact with an infected person.
HPV can be spread during genital contact and oral sex with a person who is already infected. Genital contact includes skin-to-skin contact with the vagina, vulva (the outside parts of a woman’s genitals), penis, scrotum or anus. Any person who has genital contact or oral sex with an infected person can get the virus. Symptoms don’t have to be visible for HPV to spread. In rare cases, a pregnant woman with HPV can pass the virus to her baby during delivery. The child may then develop a condition that results in obstruction of the airway.
There is no cure for HPV. In most cases, the body’s immune system will clear HPV without any treatment.
When treatment is required, it will depend on the type of HPV virus one has. Low risk virus types can cause genital warts. These can be removed with treatments at home or at a health care provider’s office. High risk types can cause cancer of the cervix, vulva, vagina, anus, penis, mouth and throat. These will require treatment based on the stage of development at the time of diagnosis.
The most common and most high-risk types of HPV can be prevented through immunization. Manitoba has a provincial immunization program. It provides free, publicly-funded HPV vaccine to those who are eligible.
There are two HPV vaccines that are available for use in Canada. When either vaccine is given prior to HPV exposure, it is highly effective in preventing infection from two of the high-risk HPV types (Type 16 and Type18), which account for about 70% of cervical cancers. One of the two HPV vaccines (Gardasil®) also provides protection against two low-risk HPV types (Type 6 and Type 11), which cause about 90% of all genital warts. The vaccine does not treat existing HPV infections.
Since the vaccine does not protect against all types of HPV that cause cancer, women who receive the vaccine and become sexually active should have regular Pap tests.
Using condoms may lower the risk of getting HPV and developing HPV-related diseases (e.g. genital warts and cervical cancer). To be most effective, they should be used with every sex act, from start to finish. However, HPV can infect areas that are not covered by a condom; therefore, condoms may not fully protect against HPV.
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