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Human Papilloma Virus (HPV)

What Is It?

Human Papilloma Virus (HPV) is a virus which is spread by sexual contact from one person to another, usually through intercourse with a person who is a carrier. Another name for this infection is Condyloma. There are many types of this virus. Some of the types of HPV can cause vaginal or venereal warts, which present as multiple small bumps on the vulva (outside of the vagina) or in the vagina. Other types of HPV cause infection in the cells of the cervix and have no symptoms except for abnormal Pap smears.

How Did I Get It?

HPV infection is considered a sexually-transmitted disease but can exist in a man or a woman for months or years without symptoms before it is transmitted to another person. It is impossible to tell how long someone has had an HPV infection, or from whom they have contracted the virus if they have had more than one sexual partner in their life.

How Does HPV Cause Abnormal Pap Smears?

HPV infection occurs in the nucleus of the cell of the cervix and causes a characteristic pattern that can be seen on Pap smears or biopsies of these cells. We now believe that this virus can cause infected cells to undergo changes, which can eventually result in cancer of the cervix. Pap smears will pick-up these changes (called dysplasia) in early stages well before they actually become cancer.

What Is Cervical Dysplasia?

Cervical Dysplasia (also called Cervical Intraepithelial Neoplasia or CIN) is the name for the abnormal appearance of the cells of the cervix caused by HPV infection. It is described as mild, moderate, or severe according to the degree of abnormality. Cervical Dysplasia is the intermediate stage between initial HPV infection of the cervix and cancer of the cervix. If properly treated, it is almost always completely cured and should not turn into cancer. The time interval between initial HPV infection and the development of cancer is variable in each woman but is thought to average 5 - 7 years. Not all Cervical Dysplasia will eventually turn into cervical cancer, but it is not possible to tell which cases will at this time. We therefore recommend that all HPV infection or Cervical Dysplasia be treated as soon as reasonable in the early stages.

How Is HPV Infection Of The Cervix Evaluated?

The first step is to determine the degree and extent of the problem with an examination called Colposcopy. This is an office procedure to study a magnified view of the cervix and to take samples or biopsies of any abnormal areas. The appearance of the cervix at colposcopy and the pathology report of the biopsies will determine the proper treatment.

How Is It Treated?

HPV infection and Cervical Dysplasia can be successfully treated in a number of different ways. Many women can be treated with an office procedure called Cryotherapy (freezing of the cervix). Some women are treated with Laser surgery or an office excision procedure called L.E.E.P. More complicated and advanced disease can rarely require surgical treatment including hysterectomy. The great majority of women can be treated with a simple procedure which will not affect their menstrual periods or future fertility.

What About My Partner?

It is very important that your partner be examined by a physician experienced in the treatment of HPV infection. Recent studies have shown that the male sexual partner of a woman with HPV or Cervical Dysplasia has a 60% chance of having HPV infection of the penis. This infection most frequently can only be detected with magnification or "male colposcopy" as the lesions are very tiny. Male HPV infection must be treated in order to prevent re-infection of the female partner. In addition, there are now studies to suggest that untreated male HPV may eventually lead to cancer of the penis in some cases.

How Can I Prevent HPV Infection?

Since it is not always possible to accurately test for this infection and because most carriers of the virus have no symptoms, only strict use of condoms can prevent transmission of HPV. Other barrier methods of contraception such as the diaphragm or cervical cap do not adequately protect against viral infections such as HPV.