HPV: What We Know Now and How to Address it With Your Patients

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. In fact it’s so common that most sexually active people will contract it at one time or another in their lives. Many people are unaware of the dangers of HPV because the majority of those who contract it never show symptoms and do not know that they’ve been infected. In many cases, the body will fight off the virus on its own without causing any major health problems. However, for some, the consequences can be very serious and even life-threatening.

What Patients Need to Know

There are about 100 different types of HPV, with 13 of them considered to be “high risk” and 40 of them causing genital warts. Although there is no known treatment for HPV, there are treatments available for the conditions it causes, including genital warts. Treating the warts will not necessarily lower a patient’s risk of transmitting the infection to his or her sexual partners, and it is common for warts to recur after treatment.

Warts that are left untreated might go away on their own, remain unchanged, or grow in size and number. However, it is important to note that these warts will not turn into cancer. It is possible for pregnant women with genital warts to infect their children at the time of delivery, even if the delivery is done by cesarean section. Babies who are infected with this type of HPV can develop warts in their throat or voice box.

HPV is associated with anogenital cancers as well as oropharyngeal cancer. According to the American College of Obstetricians and Gynecologists, 12,000 women in the United States are diagnosed with cervical cancer each year , and 4,000 die from the disease. HPV genotypes 16 and 18 now account for 66 percent of the cases of cervical cancer, while genotypes 31, 33, 45, 52 and 58 account for another 15 percent of cases of cervical cancer.

How the HVP Vaccine Can Help

HPV is passed from one person to another through vaginal, oral and anal sex. Although the use of condoms can help prevent STIs, they can not completely prevent HPV. The HPV vaccination can significantly reduce the incidence of anogenital cancer, genital warts, oropharyngeal cancer and the maternal passage of HPV to infants.

The Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists now recommend routine vaccination for both girls and boys, with the target age for vaccination being between age 11 and 12. The vaccine has even been added to the Advisory Committee on Immunization Practices recommendations. Administering the vaccine at this early age gives doctors the greatest chance of preventing cases of cancer and warts. Catch-up vaccination is recommended for women and men up to age 26 if they are not vaccinated in the target age.

Despite their recommendations, the CDC reports that 50 percent of girls between the ages of 13 and 17 in the U.S. have received one dose of the HPV vaccine, and only 33 percent have received all three doses. Doctors who educate patients on the benefits of the HPV vaccine and who recommend that patients receive the vaccine can have a strong influence on the patient’s decision to receive the HPV vaccine. The CDC has reported that if 80 percent of patients are vaccinated against HPV, it is believed up to 53,000 cases of cervical cancer could be prevented during the lifetime of patients currently younger than 12 years of age.

Talking To Patients

Patients infected with HPV may express concerns about passing the infection on to their sexual partners, or that their partner will think they have been unfaithful. It is important to let your patients know that if they have been with their partner for some time that it is likely they have HPV too, but that there is no way to know if their partner gave them HPV or the other way around. The disease can live inside a person for many years before it’s found, with little to no symptoms showing.

If infected with HPV, condoms can lower patients’ risks of passing it to their partner if used correctly. However, since HPV can infect areas that are not covered by condoms, the only guaranteed way to prevent passing HPV is to abstain from having sex.

When talking about HPV with patients who are not infected, it is vital that you stress the importance of vaccination to them. Reassure patients that the HPV vaccine is safe and that few serious side effects have been reported. Minor side effects include injection site pain, low-grade fever, nausea, dizziness or fainting.