What is HPV?
Human papillomavirus, or HPV, is a virus estimated to infect up to 80% of the general population over the course of your lifetime. HPV affects both women AND men and is transmitted from skin-to-skin contact usually from sexual contact. The virus can be present from the first sexual experience, though it may take much longer before it shows up on an exam. In many cases, a healthy immune system will clear the infection before it causes any problems; however, if the virus lingers it may cause complications. Consequences of HPV infection in women include, but are not limited to genital warts, abnormal pap smears, and in extreme cases genital cancers of the cervix, vulva, vagina, anus. Smoking and immunodeficiency will increase your risk of cancer in the presence of HPV infection.
Types of HPV
There are many strains of HPV and all types can affect the genital area or lead to abnormal pap smears. Typically, low risk HPV can lead to genital warts. Because the low-risk types of HPV do not typically lead to cancer, they are not screened for in routine testing. High-risk HPV (HRHPV), including Types 16 and 18 which are most commonly associated with cervical cancer in about 75% of cases, are screened for routinely at age 30 and above with the pap smear.
How can I have high-risk HPV when my paps have always been normal?
Current pap guidelines typically recommend screening for high-risk HPV at age 30 and above in addition to the routine pap smear. This is because about 5-10% of women with a normal pap smear history can still be infected with HRHPV. In this affected group, about one third of women can actually have underlying precancerous cells that need to be removed.
The Gardasil Vaccine is recommended to prevent genital warts, cervical cancers, and other diseases caused by HPV in both women and men. The vaccine series consists of 3 injections given over a 6 month period of time in females and males between the ages of 9 and 44. Currently, the vaccine is considered preventative care and typically covered by insurance if you are under the age of 27. Pregnant women and breastfeeding women should not receive the vaccine at this time.