Friday, April 1, 2011

On-Call with Dr. Rosenberg…Find out the facts on HPV

HPV will affect an estimated 75% to 80% of males and females in their lifetime. For most, HPV clears on its own. But, for others, certain HPV diseases—such as cervical, vaginal, and vulvar cancers and genital warts—can develop. There is no way to predict who will or won't clear the virus. As a parent of a pre-teen, you need to know the facts.

What is HPV?
Genital human papillomavirus is the most common sexually transmitted virus in the United States.  There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it.  HPV is spread mostly through sexual contact.

How do I know if I have HPV?  What are the signs?

Most HPV infections do not cause any signs and 90% go away spontaneously within two years. More than half of sexually active males and females are infected with HPV at some times in their lives. 

What happens to the 10% that contract the virus that do not resolve on their own?

Certain types of HPV can cause genital warts in males and females. Rarely, these types can also cause warts in the throat or upper respiratory tract.  Other HPV types can cause cervical cancer. These types can also cause other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and head and neck (tongue, tonsils and throat). 

The types of HPV that can cause genital warts are not the same as the types that can cause cancer. There is no way to know which people who get HPV will go on to develop cancer or other health problems.

How does one get HPV?

HPV is passed on by genital contact, most often during intercourse (vaginal as well as anal). HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

One can have HPV even if years have gone by since he or she had sexual contact with an infected person. Most infected people do not realize they are infected or that they are passing the virus to their partner. It is also possible to get more than one type of HPV.
Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. In these cases, the child can develop warts in their respiratory tract.

How does one prevent HPV?

Vaccines can prevent both men and women from some of the most common types of HPV.  The vaccines are administered in a three dose series over a matter of months.
Gardasil is recommended from ages 9 to 26 years of age.  The first dose is given, the second is two months later and the third is six months from the first.  It protects against two types of HPV that can cause genital warts and two types that can cause cervical cancer.  Cervarix is another type of HPV vaccine that is given in a series of three shots at dose one, one month from the first and six months from the first.  Cervarix protects against two types of HPV that can cause cervical cancer.Only Gardasil is currently available for boys between the ages of 9 to 26 years, for the revention of genital warts.  It is FDA approved, but not yet recommended by the American Academy of Pediatrics as part of the routine immunization schedule for males.It is important to complete the entire vaccine series to get the optimal protection. The vaccines are most effective when given before a person's first sexual contact, when he or she could be exposed to HPV.For those who choose to be sexually active, condoms are important to lower against the risk of HPV.  To insure optimal protection, they should be used with every sex act from beginning to end.   HPV is so virulent that it can affect areas that are not covered by a condom, and therefore even condoms are not 100% protective.  Thus, abstinence is the best way to prevent against HPV and all sexually transmitted diseases.  
Why is HPV vaccine given to such a young age group?

It is important for girls to get HPV vaccine before their first sexual contact--prior to being exposed to the disease.  For this crowd, the vaccines can prevent almost 100% of the types of HPV targeted by the vaccines.  If a woman is already infected with a type of HPV, the vaccine will not provide protection against that type.  

What are the risks from the HPV vaccine?

The HPV vaccine is an inactivated (not live) vaccine protecting against HPV.  It does not give the HPV virus.  Protection from the HPV vaccine is expected to be long lasting.

The most common side effects after the vaccine is administered are very mild:  soreness, redness and swelling at the injection site.  It can also cause mild to moderate fever and itching at the site, nausea and dizziness.  These side effects have been known to dissipate quickly.
While serious events, including death and Guillain-Barre syndrome, have been reported among women who had recently received HPV vaccine, CDC follow-up on these reports found that the events had not occurred more frequently among vaccines recipients than among the general population, and no pattern was detected that would indicate an association with the vaccine.

Who should not receive the HPV vaccine?

Anyone who has had a life-threatening allergic reaction to yeast, to any other component of the HPV vaccine, or a previous dose of the HPV vaccine should not get the vaccine.

How does one treat HPV?

There is no treatment for HPV, but the conditions it causes can be treated.  Genital warts can be treated by health care professionals and cervical cancer can be contained if diagnosed and treated early; with annual Pap smears and regular visits to the gynecologist.  The best
treatment is prevention. 
For more information on HPV, go to