Medical Billing & Coding

Medical Resource: The Truth About HPV

Human Papillomavirus, or HPV, is the most common type of viral sexually transmitted infection spread through skin to skin contact. HPV is most commonly transmitted through oral, vaginal or anal sex. Symptoms of HPV can appear as cauliflower-type growths known as genital warts. In many infected individuals, no signs or symptoms of the disease are present. HPV was first discovered during the 1950s by a group of scientists from different nations. Common strains of the disease were discovered later in the 1970s and 1980s.

Signs and Symptoms

Symptoms of HPV primarily depend on the strains contracted by the individual. Strains of HPV related to cancer do not typically produce any early symptoms. A pap smear is required to detect abnormal cervical changes caused by the HPV virus before it turns cancerous. Depending on the type of HPV, genital warts can appear on or near the vulva, anus, cervix or vagina in females. In males, the cauliflower-type protrusions may appear on or near the scrotum, penis or anus.

Transmission

HPV is transmitted from person to person through direct contact. An individual runs the risk of getting infected if they touch someone or something infected by the virus and then touch their own genitals without washing their hands. Intercourse is not required to contract HPV and transmission via oral sex is not uncommon. The HPV virus can also be passed from an infected mother to her child during delivery. To prevent the transmission, a C-section is typically conducted in women with known genital warts.

Virology

HPV is a double-stranded DNA capsid virus that consists of 7900 base pairs. These pairs are arranged in a circle and include two key protein codes, L1 and L2. The virus transmits through breaks in the epidermis of skin and attaches to skin stem cells. HPV belongs to the Papovaviridae family and comprises of early and late genes that encode E1-E7 early proteins and L1-L2 late proteins.

Prevention

Abstinence from all sexual activity is the most efficient way to prevent the spread of HPV. Since abstinence is not realistic for most adults, other forms of protection can be used to reduce the risk of infection. Gardasil, the HPV vaccine, is available to females ranging in age from 9 to 26. The vaccine is given in three separate injections over a period of 3 months and remains effective for 5 years. Limiting the amount of sexual partners one has also decreases the risk of HVP. Wearing a condom provides additional protection.

Diagnosis

In many cases, no signs or symptoms are present to obtain a certain diagnosis of HPV. Therefore, an abnormal Pap smear result can suggest the virus is present. During a pap smear, the physician will obtain a sample of cells from the cervix with a swab. The cells are then studied under a microscope to look for abnormal changes. Specific testing for the HPV virus is available for women and is typically used in females over the age of 30. The test is done in the same manner as a Pap smear.

Treatment

HVP is a fairly common virus that affects more than 20 million people in the United States. While there is no cure for HPV, the infection will usually clear on its own. If the infection persists, symptoms of the infection can be treated. Regular Pap smears or colposcopies will typically be recommended by a physician. Abnormal changes in cervical tissue that could lead to cancer can be treated with crypotherapy, conizaion or LEEP. Surgery or wart-removal creams can be prescribed by a physician and applied at home to treat genital warts.

Epidemiology

There are more than 75 known types of HPV and 40 of these infect the urogenital area. HPV can affect both males and females equally but females are more likely to show symptoms of the disease. HPV is the common cause of more than 90 percent of all cases of cervical cancer. However, HPV is more commonly associated with genital warts then forms of cancer. There is still much to be learned about the HPV virus and its patterns of transmission, especially in developing countries.

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