Human Papilloma Virus (HPV) is the most common sexually transmitteddisease in the United States. It is also harder to understand thanother STDs. It is actually a group of common viruses which cause wartson different parts of the body. There are particular strains of thatcause genital warts and some are linked cervical cancer. The medicalterm for warts in the genital area is condyloma acuminatum. It isusually spread by genital to genital contact. This can include penilepenetration, but skin to skin contact is all that is necessary. It canalso spread within the genital area after contact; anal lesions aresometimes found in women and men who have had no anal intercourse.Infection after oral sex is rare but has been reported (in some caseslesions were found on vocal cords). Warts on the hand or foot are adifferent strain of and are not transmissible to someone’s genitals.Symptoms: The incubation period is one month to many years. Palpable lump or irregularity of the skin surface (feels rough)
Soft, moist, pink or red swellings, raised or flat a sometimes cauliflower-like
Painful intercourse if the lesions are rubbedNO SYMPTOMS: The virus is often asymptomatic, especially women becausethe warts can be located within the vagina and on the cervix. This iswhy annual Pap smears for sexually active women are so importantGenital warts on the penis and the vulva are usually diagnosed byvisual inspection. is harder to diagnose on the vagina and cervix.Biopsies (tissue samples) and/or magnification with a specialinstrument called a colposcope are sometimes used. Acetic acid(vinegar) may be applied to lesions because this will make them turnwhite so they are easier to identify. For women, can be detected with aPap smear, and often this is the only way that the diagnosis can bemade. Newer Pap smears such as “Thin Prep” are wet smears, and can beused to determine which strains of a person has. Often people wonderwhy there is no blood test for . A blood test looking for antibodies isavailable, but it is expensive and the information it provides is notparticularly useful. is so common that many people will have theantibodies, and then it would be back to a visual exam to decide thenext course of action. Regular Pap smears would be important, but theyare already recommended once a year for all women regardless ofdiagnosis.At present, there is no cure for . For cosmetic purposes, the lesionscan be treated by applying Podophyllin (done by a health carepractitioner). This treatment must be reapplied over several visits toa clinic, and cannot be used on some lesions. Liquid nitrogen,electrocautery, and lasers can also be used to destroy the warts.Recurrence is common and often related to stress.HPV has been strongly linked to cervical cancer in women. All types ofcan cause mild Pap smear abnormalities that do not have seriousconsequences, but 15 of the 30-40 identified genital types can lead tothe development of cervical cancer. Three of these strains areconsidered high risk. Cervical cancer is detected through the Papsmear, and is the most compelling reason for women to receive an annualpelvic exam which includes a Pap smear. When caught and treated,cervical cancer, or often pre-cancerous cells of the cervix do not leadto further health complications. Persistent infection with is the keyrisk for cervical cancer (most women with do not have persistentinfections after the first two years).Since HPV can be transmitted skin to skin and because it is the most common STD around, prevention is particularly difficult. Barrier methods (condoms, dental dams) always help, but are not totally effective due to skin contact beyond the barrier.
Regular testing, especially testing within a monogamous relationshipcan be effective, though symptoms are not always obvious, and testingfor is more complex than just peeing in a cup or getting a blood test.
The virus can be present and transmissible even if not apparent, so barrier methods are still a good idea
Women should have yearly Pap smears to screen for cervical cancer and other precancerous conditions.
Avoid sexual contact with people who have visible symptoms of an STDSince is treatable, but not curable, people with should communicatewith their partners about prevention. Risk of transmission can bereduced by avoiding sexual contact when lesions are present.Additional Info: The most common type of in the US is type 16, which handily enough isalso one of the two strains most likely to cause cancer. (The otheris 18). Currently a vaccine for type 16 is in the later stages ofdevelopment.
At this point, the best way to prevent cervical cancer is to test forthe group of high-cancer-risk strains. This is why Thin Prep or otherwet smears are so coolathey can tell you exactly which strain(s) youhave and thus approximately how much you should worry.
Multiple infection (one or more strains is common) and that almosteveryone will get of some kind in their lifetime. Cervical cancer isdangerous. Worldwide, half the women diagnosed will die. In the US, athird die. Fortunately cervical cancer is extremely slow growing.
The average abnormality takes 10 years to develop into cancer (though afew strains can cause cancer in as little as one year inimmuno-compromised individuals), but if treated early is usually notdeadly.
Vaden has decided to start offering a “wet-preparation” Pap smear. They’re doing the final logistical checks now.
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