Genital Warts | HPV Virus

Dr. Panagiotis Polyzos MD PhD MSc

Obstetrician Gynaecologist
Doctor of Medicine, University of Athens Medical School

Panagiotis Polyzos, Gynaecologist Obstetrician, is active at the Institute of Life - IVF Unit of Iaso Maternity Hospital.

Contents

Κονδυλώματα και ιός HPV – διάγνωση και θεραπεία

Genital Warts | HPV Virus

What is HPV?

Human papillomavirus (HPV) is one of the most common causes of sexually transmitted infections (STIs). There are many different types of the virus, classified as higher-risk or lower-risk. Some types are transmitted through sexual contact, and some cause genital warts (single or multiple lesions that develop in the genital area in both men and women).

Can someone have HPV without symptoms?

Many people who are infected with HPV do not develop any symptoms. In others, the incubation period may last for a prolonged period of time before any clinical signs become apparent.

High-Risk and Low-Risk HPV

High-risk HPV infection may cause abnormal changes in the cervical smear (Pap test), increasing the likelihood of developing cancer of the cervix, vulva, vagina, anus, or penis.

Low-risk HPV infection may cause abnormal findings in the cervical smear (Pap test) or genital warts, which, although usually harmless, are highly contagious.

What are genital warts?

Genital warts are soft, moist lesions that appear in the genital area several weeks or months after infection. They may be single or multiple. However, many people may have genital HPV infection without developing visible warts. Genital warts are highly contagious and are transmitted through oral, vaginal, and anal sexual contact with a partner who is already infected. They occur more frequently in women and may be located on the vulva, inside the vagina, at the cervical opening, or around the anus. In men, they may be found on the glans penis, along the penile shaft, on the scrotum, or around the anus.

Genital warts have been known to the medical community since the time of Hippocrates. Human papillomavirus (HPV) is an epitheliotropic virus with more than 100 genotypes identified to date, of which approximately 35 affect the genital area.

What is the link between HPV and cervical cancer?

Today, the role of HPV in cervical carcinogenesis has been clearly established. The risk of developing cervical intraepithelial neoplasia (precancerous lesions of the cervix) or invasive squamous cell carcinoma of the cervix is directly associated with the specific type of HPV involved.

Low-risk types include 6, 11, 34, 40, 42, 43, 44, 53, 54, 57, and 66. High-risk types include 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 64, and 70. Notably, HPV types 16 and 18 are currently considered responsible for approximately 70% of all cervical cancer cases.

HPV viruses cause two main types of cervical lesions: exophytic (raised) genital warts and flat lesions.

Infection occurs through sexual contact, and viral entry is facilitated by some degree of disruption of tissue integrity (microtrauma to the area during intercourse).

What are the predisposing factors?

Predisposing factors for HPV infection include inadequate sexual education, age over 30 years, various immunosuppressive conditions such as HIV/AIDS infection, pregnancy, diabetes mellitus, chemotherapy, corticosteroid therapy, smoking, and multiple pregnancies.

The incubation period ranges from one week to nine months.

Despite the high rate of HPV infection among young women, only a small percentage will develop neoplasia. This is because HPV requires cofactors, such as smoking or a particular hormonal environment, to promote the development of precancerous changes. Many women will become infected with HPV at some point in their lives, but in the majority of cases, the infection resolves spontaneously.

How can we protect ourselves from high-risk HPV types?

HPV types 16 and 18 are responsible for approximately 70% of cervical cancer cases. The quadrivalent vaccine, which includes components from HPV types 16, 18, 6, and 11, has been made available. The period just before the onset of sexual activity appears to be the most appropriate time for vaccination. It is self-evident that vaccinated women are not exempt from the need for regular cervical cytological screening, namely the widely known pap test.

How is the correct diagnosis made?

Diagnosis is made through clinical examination of the lesions by a gynecologist. In women, the cervix should also be examined, and a cervical smear (Pap test) should be performed, which may reveal abnormal cells and/or HPV infection.

There is no way to predict whether the lesions will progress or regress. There are many different treatment methods available for genital warts.

If you believe, or if a doctor has informed you, that you have genital warts or HPV infection, or if you wish to learn more about the risks associated with this infection—particularly the risk of developing cervical cancer—please register on our secure website and complete the structured questionnaire, the contents of which remain confidential. You will receive detailed, evidence-based information specifically addressing your questions and concerns. The information will be provided to you personally by a specialist medical professional with many years of experience in this field.

What is the appropriate treatment?

Genital warts are small benign tumors that appear mainly on the genital organs of both women and men and usually around the anal ring. They are pink or brown in color and resemble miniature cauliflower-like growths. They are most commonly caused by HPV infection.

Genital warts are a condition that may appear even in the absence of sexual intercourse. However, once present, they can be transmitted to a sexual partner if one of the two partners has developed them. Treatment depends on the type of lesion and may include either cauterization (destruction of the lesions) or the use of specialized topical medications.

If you have genital warts, avoid sexual intercourse or use a condom, as transmission is possible. Consult your doctor for appropriate treatment.

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