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Understanding Human Papilloma Virus

Human papilloma viruses (HPV ) are one of the most common sexually transmitted diseases. They are related to the cause of several malignancies including those of the cervix, anus, and throat. There are vaccines available to prevent HPV but sadly many people are not receiving these vaccines.

There are many strains of HPV but in particular types 16, 18, 31, and 52 are associated with causing cancer of the female genital tract. Infection with type 16 is present in 50% of the invasive cervical cancers, and 18 is present in 20% of cervical cancers. Anal cancer and throat cancer is associated with type 16.

HPV infections can be acquired through touching such as hand to genital, intercourse, or oral sex. Most infections are transient and are cleared without sequela (a condition that is the consequence of a previous disease or injury). Those who fail to rapidly clear the infection, and in whom it becomes chronic , have an increased risk for development of cancer. 

We see increased risk of HPV infection again at menopause possibly due to a reactivation of an earlier infection rather than a new exposure. This reactivation is more common in people who smoke, have chronic illnesses, or require use of steroids, all of which lower ones resistance.

Prevention of HPV virus is possible with vaccination. The newer 9 valent vaccine protects against many of these serious strains of HPV. Many young people were vaccinated with the 4 valent vaccine and should be offered an additional vaccine with the newer 9 valent product. In my practice, HPV 9 valent vaccine is offered to any female who may potentially find herself exposed to new partners and serious virus exposure.

HPV , in most instances, causes a virus that results without serious sequelae. If the virus is not easily cleared from the genital tract, anus or throat, it can result in invasive carcinoma. Sadly we are seeing a large increase in throat cancer in young adults from oral sex. Luckily there are vaccines that can prevent this occurrence. Yearly examinations, including Pap smears, can help to detect early viral changes that can result in early treatment and prevention of cancer.

Karie McMurray, RNMN, MD, FACOG