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  Human papilloma viruses

Human papilloma viruses (HPV) are a group of viruses which are DNA-based that infect the skin and mucous membranes. There are over than 100 types of human papilloma virus (HPV) that have been classified. Some HPV types are causing the benign skin warts or verrucae known as papillomas. These groups of HPV are transmitted environmentally or via casual direct skin-to-skin contact and manifests as coarse papules over skin surfaces. The following are some of the several types of skin warts: 1. common warts caused by the \"cutaneous\" HPV-1 and HPV-2 most often found on the hands and feet but can occasionally occur in the elbows or knees with a characteristic mildly raised, cauliflower-like surface appearance. 2. Plantar warts resembling common warts but are found on the soles of the feet. 3. Subungual or periungual warts which are formed under or around the fingernails or on the cuticle. 4. Flat warts which are most commonly found on areas such as the arms, face or forehead.

Human papilloma viruses Skin diseases
Human papilloma viruses


The other group of around 30 varieties of HPV strains is typically transmitted through sexual contact. The condition is known as genital HPV infection causing genital or anal warts otherwise known as condyloma acuminata or venereal warts which is a very common sexually transmitted disease. The strains commonly transmitted through sexual contact are the HPV types 6 and 11 causing genital warts and a rare condition known as recurrent respiratory papillomatosis, warts involving the larynx (voice box) or other areas of the respiratory tract. Although the genital HPV types are sometimes transmitted from mother to child during delivery, genital HPV-related diseases in neonates is quite rare.

Certain HPV types 16, 18, 31 and 45 are considered to be belonging to the \"high-risk\" sexually transmitted HPVs. These high risk HPVs can lead to the development of cervical cancer as well as anal, vulvar, penile and sometimes head and neck cancers. A higher incidence rate of genital HPV infection has been found among those individuals who begin to engage in sexual activity. Those HPV types that tend to cause genital warts are not coming from the same group that can cause cervical cancer.

Papanicolaou smear (Pap smear or Pap test) is an effective screening test to detect HPV-induced abnormalities in the cells of the cervix that can lead to invasive cervical cancer. This will allow surgical removal of pre-malignant lesions even prior to the development of cervical cancer thereby reducing the incidence and fatality rate. If these pre-cancerous lesions are left untreated and not diagnosed early, around 1% of women with genital HPV will eventually progress to the development of cervical cancer. In some cases, a more detailed inspection of the cervix by colposcopy is indicated especially if abnormal cells are found to be present basing on the results of Pap smear.

According to the American Cancer Society (ACS), a previous history of infection with either a single or multiple high-risk HPV types (mentioned above) for a long period of time is believed to be a predisposing factor for the development of cervical cancer. Those women without any history whatsoever of the aforementioned high-risk virus do not develop particularly this type of cancer. Suggested preventive measures to reduce the risk of cutaneous HPV infection is by avoidance of contact with potentially contaminated surfaces as well as treating common warts as soon as after they first appear to halt its spread to additional sites. Other advices to prevent genital HPV infection includes: avoidance of smoking and risky sexual behavior such as having multiple sexual partners. The use of physical barriers (e.g. condom, topical microbicides) as a practice of safer sex and as a method of contraception at the same time is up to 70% effective in one study in preventing genital HPV infection.

Recently, a prophylactic HPV vaccine has been approved by the FDA (on June 8, 2006), namely, Gardasil which showed protection against initial infection with HPV types 16 and 18 (causes 70% of cervical cancers) and HPV types 6 and 11 (causes 90% of genital warts). This anti-cancer vaccine is found to be more effective if given at an early age, around 9 years to 22 years of age.

Genital warts may or may not warrant any treatment. Most of the time, people may want their warts removed if they particularly cause itchiness, burning, and discomfort. The doctor may treat genital warts by applying a chemical while you are in the clinic or may prescribe a topical cream which you can apply at home. Another option is surgical which include: 1. Electrocautery uses an electric current to burn away the warts 2. Laser treatment employs light to destroy it. 3. Cryosurgery freezes the warts off 4. Cutting them away. It is not very clear though that if genital warts are treated, it reduces the person\'s chance of infecting his or her sexual partner because the genital HPV still remain in the affected areas despite treatment. However, if left untreated, genital warts may eventually disappear, remain unchanged, or increase in size or number but definitely they will not develop into cancerous lesions.

If abnormal cervical cells are found on Pap smear, a close follow up with your doctor is necessary. Any of the following treatment options may be suggested by the physician to remove the abnormal tissue namely: 1. Cryosurgery which utilizes liquid nitrogen to freeze off the abnormal tissues. 2. Loop electrosurgical excision procedure (LEEP), removes the abnormal tissues by using a hot wire loop. 3. Laser treatment uses a beam of light in destroying the abnormal cervical tissues 4. Cone biopsy, performed by removing a cone-shaped sample of tissue.

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