HPV: Human Papillomavirus

How is HPV treated?

HPV itself is never treated; however, symptoms and signs of the virus are. Patients should discuss all treatment options with their provider before deciding on one treatment.

Genital warts

For students who have an HPV infection resulting in genital warts, there are several methods of treatment most of which can be done during an office visit at Student Health. Treatment depends on the size and location of the wart and may include any of the following:

• Podofilox or imiquimod prescriptions– a prescription medication applied to the surface of the warts.
• Podophyllin– a chemical applied to the surface of warts by a health care provider.
• Trichloroacetic acid (TCA) – an acid that is applied to the wart and surrounding tissue to destroy wart tissue. This procedure burns slightly and the skin will turn white as it is applied resulting in a sore that quickly heals.
• Cryosurgery – a procedure in which liquid nitrogen is placed on the wart and a small area of surrounding skin. The liquid nitrogen freezes the skin causing ice crystals, which results in sloughing of the wart.
• Interferon – an antiviral drug which is injected into the warts (not available at Student Health).
• Laser therapy – uses an intense light energy to destroy warts in complicated cases. It is the most costly method of treatment and not available at Student Health.

• While each approach has certain advantages, none is 100% effective in curing HPV. The goal of treatment is to remove the major sites of infection by destroying skin cells where the HPV is found. Treatment cannot destroy all infected cells because the HPV inhabits a wider area of skin than the actual location of the warts. In fact new warts may appear weeks or months after successful treatment. Treatment should be sought as soon as possible if there is a recurrence. Your sexual partner(s) should be simultaneously treated to diminish the potential of transmitting the disease to each other. If you do have sex, use condoms which have been shown to decrease (but not eliminate) the risk of re-infection.

  Cell change - subclinical HPV infection>

  
  

  (HPV infection without warts)

  Many researchers disagree on whether or not treatment of HPV without warts is beneficial. Providers usually do not treat minor Pap test abnormalities because most will go away on their own. However, it is important that regular Pap smears be conducted to watch for precancerous changes on the cervix.

  If the HPV infection is treated, the two most common forms are trichloroacetic acid (TCA) and cryotherapy. Laser therapy is used for problems that cannot be treated by those methods. Occasionally a cone biopsy is used when the abnormal cells (dysplasia) extend up into the cervical canal where they cannot be reached by cryotherapy or laser.

  Will I always have HPV?

  A healthy immune system can supress the HPV virus.  However, it is difficult to predict when HPV is no longer contagious. Experts disagree on whether the virus is eliminated from the body or whether it is reduced to undetectable levels.

  What are the risks if HPV is not treated?

  There is an increased risk of cancer of the cervix, vulva, penis, or anus among people who are infected with particular strains of HPV. The types of HPV that typically cause genital warts are not the types linked to cervical, penile and anal cancer.

  The best defense against cancer is early detection and treatment.

  Women should have Pap smears once a year, especially if they have genital warts, or if they are at a high risk for them (because they have multiple sexual partners and/or a history of sexually transmitted infections). If detected early, these cervical changes are relatively easy to treat. However, if dysplasia occurs and remains untreated, it my later develop into cancer. If a treatment plan is followed, the risk of cancer is greatly reduced.

  For anyone with a histor of receptive anal sex, an anal Pap test can be done to detect cellular changes in or around the anus, which may be precursors to anal cancer.

  Does HPV cause cancer?

  There is an increased risk of cancer of the cervix, vulva, penis, or anus among people who are infected with particular strains of HPV. Regular screening and appropriate follow-up treatment prevent most women in the United States from getting cervical cancer. Vulvar, penile, and anal cancer are rather uncommon. Other factors such as strength of the immune system, history of other sexually transmitted infections, smoking, genetics, number of sexual partners, and hormonal contraceptive use, might also increase the risk of cancer.

  Want to know more?

  Read about:
  HPV transmission
  HPV diagnosis
  HPV prevention
  HPV resources

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  Reviewed by the Office of Health Promotion, August 2007.