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Basic facts on HPV

HPV (human papillomavirus) is the common wart virus. It is the cause of the various kinds of warts (genital warts, plantar warts, flat warts) as well as cervical dysplasia, vaginal dysplasia, and cervical cancer. HPV has been implicated as a cause of infertility, miscarriages, vaginosis, vaginitis, vulvar vestibulitis syndrome, prostate disease, and laryngeal papillomatosis.

Common misspellings for human papilloma virus include human papillomavirus, human papilloma virus, human papiloma virus, human papaloma virus, human papalloma virus, human pipiloma virus, human pipilloma virus, and many more.

It is impossible to determine how long someone has had an HPV infection. Neither men nor women are routinely tested for HPV. Women are "indirectly" tested for HPV by a Pap smear which shows "HPV characteristics" if the HPV has damaged some cells resulting in cervical dysplasia. If the cells are not damaged, the HPV goes undetected unless a Digene Hybrid Capture® HPV DNA Test is done.

Other test methods (specific blood tests) may show that there has been HPV infection in the past, but they cannot determine if HPV is currently present. HPV is usually diagnosed because the cervical or vaginal cells obtained by Pap smear or biopsy have the "characteristic appearance of HPV-infected cells” under the microscope.

HPV is not always transmitted sexually. However, the types that cause anogenital warts (also called condylomata acuminata, venereal warts, genital warts, vaginal warts, and penile warts) and cervical dysplasia are most commonly sexually transmitted, like low risk HPV types 6, 11, 42, 43, and 44. For this reason HPV is classified as an STD (sexually transmitted disease) and can be transmitted through sexual intercourse, oral sex, anal sex, or any skin-to-skin contact.

Some women develop genital warts, cervical/vaginal dysplasia, or both, while others become carriers with no signs or symptoms, or they become immune to certain HPV types. Men generally develop genital warts, become carriers, or develop immunity.

HPV is contagious even when warts and dysplasia are not present. Some HPV types have a greater association than others with cervical dysplasia and cancer like high risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. All of the HPV types are contagious.

HPV can lie dormant in humans for an unknown period of years. However, most individuals develop immunity, after which time they are no longer contagious.

One can probably assume that immunity exists and the risk of being contagious is minimized after having genital warts and/or dysplasia when: (1) in cases of surgical removal, or when the signs and symptoms have disappeared without any treatment, there have been no recurrences for a year, or (2) in cases of immune system support, all warts and/or dysplasia disappeared.

In both of these situations one may assume, with some degree of certainty, that immunity has developed and that the HPV infection no longer exists. The advantage of immune system support is that after warts and/or dysplasia disappear, one may assume immediately that the immune system has eliminated the signs and symptoms of HPV infection. With surgery, the only way to assume that immunity has developed is if the signs and symptoms do not reappear over many months.

Nevertheless, once immunity develops, the individual is very likely no longer contagious for that HPV type and can no longer become infected by that HPV type again, barring some catastrophic failure of the immune system such as AIDS.

It is impossible to prove that someone does NOT have any HPV types. It is relatively easy to prove when someone DOES have HPV, if (1) signs or symptoms are present, or (2) the Digene Hybrid Capture® HPV DNA Test is positive.

Some feel that HPV remains in a carrier state for years; however, this is probably uncommon. There are over 70 types of HPV. This may be the reason some believe that long carrier states are common. What may be viewed as a carrier state may simply be subsequent infections by different HPV types over the years. There are over 300 rhinoviruses (cold viruses), yet no one considers a cold virus to be in a perpetual carrier state that “flares up” periodically.

There is very little cross-immunity between the different HPV types. This means that if one has immunity to one HPV type, that specific immunity is not necessarily good against another HPV type. For this reason it would be worthwhile to focus on immune support in the event of future exposure to a new HPV type.

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Cervical Dysplasia
Genital Warts
Plantar Warts
Genital Herpes
Oral Herpes
Other Conditions

Dr. Joe Glickman, Jr., M.D.

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