An HPV infection is caused by human papillomavirus, a DNA virus from the papillomavirus family, of which over 170 types are known. More than 40 types are transmitted through sexual contact and infect the anus and genitals. Risk factors for persistent HPV infections include early age of first sexual intercourse, multiple partners, smoking, and poor immune function. HPV is typically spread by sustained direct skin-to-skin contact with vaginal and anal sex being the most common methods. Occasionally, it can spread from a mother to her baby during pregnancy.
Most HPV infections cause no symptoms and resolve spontaneously. In some people, an HPV infection persists and results in warts or precancerous lesions. The precancerous lesions increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth, or throat.
Here are some key points about human papillomavirus :-
- Most sexually active men and women will contract the HPV virus at some pointduring their lifetime.
- HPV can be spread through oral, vaginal, or anal sex.
- It can result in genital warts and some types of cancer.
- Sometimes, HPV can be transmitted during birth to an infant causing genital or respiratory system infections.
- There is no cure for HPV but safe and effective vaccinations are recommended at the age of 11 to 12 years.
Symptoms and Treatment for HPV During Pregnancy
Sign and Symptoms
HPV may not cause symptoms at once, but they can appear years later. Some types can lead to warts, while others can cause cancer.
Common symptoms of some types of HPV are warts, especially genital warts. Genital warts may appear as a small bump, cluster of bumps, or stem-like protrusions. They commonly affect the vulva in women, or possibly the cervix, and the penis or scrotum in men. They may also appear around the anus and in the groin. They can range in size and appearance and be large, small, flat, or cauliflower shaped, and may be white or flesh tone. Other warts associated with HPV include common warts, plantar, and flat warts.
Common warts – rough, raised bumps most commonly found on the hands, fingers, and elbows.
Plantar warts – described as hard, grainy growths on the feet; they most commonly appear on the heels or balls of the feet.
Flat warts – generally affect children, adolescents, and young adults; they appear as flat-topped, slightly raised lesions that are darker than normal skin color and are most commonly found on the face, neck, or areas that have been scratched.
Cancer
Other types of HPV can increase the risk of developing cancer. These cancers include cancer of the cervix, vulva, vagina, penis, anus, and oropharynx, or the base of the tongue and tonsils. It may take years or decades for cancer to develop.
Pregnant With HPV
No link has been found between HPV and miscarriage, premature delivery, or other pregnancy complications.
Also, the risk of transmitting the virus to the baby is considered very low.
In some pregnant women with HPV, the tissue changes may increase during pregnancy. If possible, doctors postpone treatment, because it may lead to premature labour.
If a pregnant woman has genital warts, the doctor will monitor to see if the warts get larger. Hormone changes during pregnancy can cause the warts to multiply or get larger. Sometimes the warts will bleed.
Depending on the extent of the warts, the doctor may postpone treatment until after childbirth. But if the warts get so big that they might cause an obstruction in the vagina, they may need to be removed before childbirth.
Genital warts can be removed surgically, with chemical treatment, or with electric current.
HPV and Childbirth
Most of the time, a baby born to a woman with genital warts does not have HPV-related complications. In very rare cases, a baby born to a woman who has genital warts will develop warts in the throat. This serious condition is called respiratory papillomatosis and requires frequent laser surgery to prevent the warts from blocking the baby’s breathing passages.
Diagnosis
Diagnostic tests for HPV are not a part of the routine check-up during pregnancy. However, genital warts can be diagnosed during serological examinations (blood tests which look for antibodies in the blood). The doctor can also identify external warts through careful physical examination. After that, a biopsy is suggested to confirm vaginal lesions.
The doctor will also advise a few other tests to confirm the presence of HPV and possible cancer cells.
Pap smear test involves scraping of the cervical lining cells and examining them under a microscope.
Colposcopy is done for further evaluation and involves the application of vinegar (acetic acid) over the cervix. Vinegar changes the color of the abnormal cells, which are then tested for HPV.
DNA test on a sample of cells from the cervix checks for DNA of HPV to analyze the presence of cancerous cells.
If the tests result positive for HPV, the doctor will suggest the necessary course of treatment.
Treatment
Most HPV infections go away on their own. Treatment is required only when there are visible warts and abnormal cervical cells. Treatment options include:
Cryosurgery:Freezing or destroying warts using liquid nitrogen
Electrocautery:Burning of warts using electric current
Loop electrosurgical excision procedure (LEEP):Removing abnormal cervical tissue using electrically charged wire loop
Cone biopsy:Removing a cone-shaped portion from the affected cervical tissue
Laser therapy:Destroying warts using a laser beam
Prescription creams:Medicated cream can be applied directly to warts. However, over-use is dangerous
Prevention
Measures that can reduce the risk of contracting HPV include:
- having the HPV vaccine
- practicing safe sex
- practicing abstinence or being in a monogamous sexual relationship
- not having sex while there are visible genital warts.
Vaccination
Currently, there are three HPV vaccines on the market: Gardasil, Cervarix, and Gardasil 9.
The Centers for Disease Control and Prevention (CDC) recommend vaccination at the age of 11 to 12 years, to reduce the risk of cervical and other cancers developing in future.
The vaccine is given in two doses, 6 to 12 months apart. Catch-up vaccines are recommended for males up to the age of 21 years and females up to 26 years who did not receive the vaccination at a younger age. Gay and bisexual men are encouraged to have the vaccination up to the ages of 26 years.
