The Human Papillomavirus or HPV frequently causes genital warts and cellular changes in the uterine cervix and is probably the most common genital infection, as part of sexually transmitted diseases. It is estimated that over six million patients a year are infected with HPV. These are only reported cases.
Genital warts, known also as Venereal Warts and Condylomata acuminata, are the most common lesions caused by genital HPV infection; however, there could be an HPV infection without the presence of genital warts, at least in the beginning of the disease.
Genital warts may appear within a few weeks of virus exposure, but also, it may take months for them to become visible, usually as small and soft skin growths. They may also appear in small, irregular groups of three or more can be visible in the genital area or hidden around the uterine cervix
There are many different types of HPV viruses, but only about thirty strains may cause genital lesions, usually by sexual contact. The most serious lesions appear on the uterine cervix, which do not cause symptoms and could go undetected for a long time.
Viral lesions, including flat warts on the skin, are very contagious; the viruses are spread during oral, vaginal, or anal sex with an infected partner. After contact with an infected partner, warts may develop within sixty to ninety days and can be spread to others, even without any symptoms.
In women, warts may appear on the genital area skin, inside the vagina and on the uterine cervix.
In men, warts are less common but when they are present, they could be seen on the genital area. HPV warts may also appear in the mouth and throat and, like many sexually transmitted diseases (STDs), they do not have signs and symptoms of the disease. Some studies have shown that up to half of all infected women are not aware that they are carriers of the virus and, as noted above, it could be spread without even knowing about it.
In the presence of genital warts, women should be examined for possible HPV infection of the uterine cervix. Abnormal Pap smears may detect cancer or pre-cancerous lesions on the cervix; DNA testing for the viruses is also useful when warts or other flat lesions may be present. A simple acetic acid test [vinegar] may also be useful: its application to a suspicious area or lesion turns the cells whitish, indicating a possible infection.
How Do We Treat Genital Warts?
Some genital warts may disappear over time without treatments. At present, they are treated with Aldara Cream (Imiquimod), Podophyllin Solution, 5FU Cream (5-fluorouracil), and Trichloroacetic acid (TCA). Also freezing (cryosurgery), coagulation with electrocautery, and laser treatments.
Any form of podophyllin or 5FU is contraindicated during pregnancy, because their absorption through the skin may cause birth defects.
Surgery is indicated for large warts or for those that do not respond to other treatments. Interferon is another medication that could be used; however, by either a single type of treatment or a combination of several, the warts could be removed, it is not possible to remove the virus, and the warts may come back.
Gardasil, an HPV vaccine available since 2006, is being studied at this time for the treatment of genital warts as a secondary application. Unfortunately, the vaccine would offer protection for only three or four out of approximately thirty virus strains responsible for causing the warts and, most importantly, cervical cancer. The vaccine caused some controversy when released because it was recommended that only teenage girls should receive it.
The vaccine is a significant step forward in the prevention of cervical cancer and other lesions mentioned above. Does the vaccine really protect against cervical cancer? It offers only partial protection because is active only to a few viral strains.
Shouldn’t men also receive the vaccine? In theory, the answer is yes, because men are also HPV carriers. Furthermore, recent research has determined that HPV viruses are responsible for many cancers of the mouth and throat in men. Further studies are under way.
