What is HPV & what can you do about it

Written by:

Dr Tan Kok Kuan

Dr Tan Kok Kuan

Dr Tan is a medical doctor in private practice focusing on men's health, and a contributing author of the Singapore HIV PrEP prescribing guidelines and the Blueprint to end AIDS and HIV transmission in Singapore by 2030. Read more of his articles at http://drtanmenshealthblog.com.

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Human Papillomavirus or HPV is a sexually transmitted disease that can cause cancer and genital warts in both men and women. HPV is not HIV (Human Immunodeficiency Virus) and not HSV (Herpes Simplex Virus). While all the above are sexually transmitted diseases, HPV is one that is often overlooked and misunderstood. Let’s break it down for you:

Is it really an STD? Yes it is an STD.

HPV is a DNA virus with over 200 subtypes. The virus is passed from one person to another through physical contact and is considered a sexually transmitted disease as sexual intercourse is the primary source of exposure to the virus.

Studies have shown that men or women with a higher number of sexual partners, regardless of sexual orientation, are at higher risk of HPV infection. That said, because HPV is so common and so contagious, even people who have only had one sexual partner are considered to be at risk and will benefit from screening and vaccination.

Does it cause warts or cancer? It causes both warts and cancer.

The large number of subtypes of the virus means different subtypes of the virus affect the body differently:

Warts can occur on any skin surface that came into contact with wart-causing subtypes. The resulting warts can either be flat or raised bumps (papules) that cluster together and grow larger as the HPV replicates within the tissue. Warts are commonly described as looking like “cauliflowers”. They commonly grow on or around the genitals and anus. Conditions that weaken the immune system can cause more warts to grow and to grow faster and larger. These include diabetes, smoking and HIV.

HPV infection has also been linked to a variety of cancers including cervical cancer, anal cancer, penile cancer, vulvar and vaginal cancer.

What are the treatments for HPV warts?

Warts are easily removed with either creams, freezing or laser. The idea is to destroy any tissue that contains the virus. Warts can be very stubborn and sometimes multiple treatment sessions are necessary.

Getting rid of warts is only the first step. Preventing them from recurring and avoiding getting re-infected is probably more important. This is why getting the HPV vaccine is so crucial even if you have already developed HPV warts.

How does HPV cause cancer?

Once the virus has infected an area of tissue such as the cervix or anus, it starts to use the cells in the area to replicate. As the virus replicates it causes damage to the cells and makes the body’s repair of the area inefficient.

The result is the original healthy and well organised tissue loses its ability to produce normal cells. This is known as dysplasia and is regarded as a pre-cancerous change. Given enough time, the HPV drives more dysplasia in the area and eventually the area becomes so damaged the cells become cancerous.

What can I do to prevent HPV-related cancers?

Regular screening combined with vaccination reduces the risks of HPV infection and consequently HPV warts and cancer. Regular screening allows doctors to detect pre-cancerous changes at an early stage. Very often, doctors will just keep a close eye on this while the body fixes itself.

If the pre-cancerous lesion is found at a late stage or progresses onto a more advnaced stage, the pre-cancerous cells can be removed thus preventing the development of cancer altogether.  

Vaccination creates antibodies against several subtypes of HPV thus reducing the chances of HPV remaining in the body. It also protects you against infection by other HPV strains.  Vaccination can also reduce the risk of warts recurring. HPV screening is done by doing a swab in the affected area. For bottoms, this is done with an anal swabs. Penile swabs can be done for tops and heterosexual men.

Do I need to get vaccinated against HPV? Yes! You absolutely do!

Current HPV vaccines are recommended for men from age 9 to 45 years old. The latest vaccine is called Gardasil 9. It directly protects against nine strains of HPV and gives cross protection against many other strains. Getting vaccinated against HPV will reduce your risk of developing genital warts as well as penile and anal cancer, and protects your partners against a HPV infection.

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