Human Papillomavirus (HPV)

Human papillomavirus (HPV) is a virus that can infect several parts of the body in both males and females. HPV is the most common sexually transmitted infection (STI); 75 per cent of Canadians are infected at some point in their lifetime. In some people, HPV can cause cells within the body to change which can cause genital warts, cervical and genital cancers, as well as certain cancers of the head and neck.

Video © 2012 Michael Evans and Mercury Films Inc.

Please note: the above YouTube video, “Should you get the HPV vaccine?” was developed in 2012 and therefore, does not reflect the new vaccine, Gardasil┬«9, that is available and offered free-of-charge in Manitoba to girls and boys in grade 6 and to others who meet Manitoba’s eligibility criteria. Gardasil┬«9 protects against five more types of HPV than the previously used vaccine in Manitoba, Gardasil┬«4, and is equivalent in terms of safety.


Symptoms

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 and can include the development of genital warts and cancer. However, many cancers that are caused by HPV do not have symptoms until they are quite advanced.

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/symptoms 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 each year, approximately:

  • 50 females are diagnosed with cervical cancer, and about 20 die from it.
  • 15 males are diagnosed with penile cancer.
  • 23 people are diagnosed with anal cancer.
  • 1,500 people reportedly get genital warts. 
Causes

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 do not 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 (recurrent respiratory papillomatosis) that results in obstruction of the airway.

Treatment

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.

Prevention

The most common 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.

The HPV vaccine used in Manitoba and across Canada, provides protection against 9 types of HPV (types 6, 11, 16, 18, 31, 33, 45, 52, 58). When the vaccine is given before exposure to the virus, it is very effective in preventing infection from the most common types of HPV, which cause approximately:

  • 90% of all cervical cancers
  • 90% of all anal cancers
  • 90% of all genital warts
  • 60% of all penile cancers
  • Other genital cancers (vulva, vagina)
  • Cancers of the head and neck

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 and see a doctor for regular health examinations. Men should continue to see their physician for regular health examinations.

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 sexual encounter, 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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