Everything you need to know

dec-2.jpgA few months ago pharmaceutical giant Merck & Co. started an ad campaign called “Tell Someone,” warning women about the consequences of the human papillomavirus, more commonly known as HPV.

As a result, millions of women have heard about HPV and the fact that it can cause cervical cancer, but because the commercial is only 30 seconds long, it can’t address the many questions women have on this virus and its sometimes devastating effects.

New Orleans Living got the answers from Dr. Gregory S. Henderson, the author of Women at Risk: The HPV Epidemic and Your Cervical Health and the associate chairman of the Department of Pathology at Ochsner Health System.

What causes HPV?

According to the Centers for Disease Control and Prevention (CDC), more than 20 million Americans have one of the 100 types of HPV. Of those, about 50 are sexually transmitted. “Of these sexually transmitted types, about 30 have been shown to cause cervical, vaginal and vulvar cancers in women,” says Henderson.

The discovery that HPV can cause cancer was made over 15 years ago. This was a phenomenal discovery because, according to Henderson, it was the first time an actual infectious virus was shown to be the major cause of a type of cancer.

HPV is the most common sexually transmitted disease in the world, with studies showing that about 80% of us will be infected with one of the sexually transmitted strains in our lifetime.

“The immune system of most people eradicates the virus before they ever know they were infected and before any precancerous changes can occur,” he says. “Unfortunately, for reasons that are still unknown, about 10% of people infected are unable to eradicate the virus, and because a person can be infected with different strains over their lifetime, the best prevention is the new HPV vaccine.

A medical breakthrough
The reason we have been hearing so much about HPV recently is because of the discovery and availability of a vaccine for the most common types of the virus.

Although scientists have known about the relationship of HPV and cervical cancer for years, public health efforts to educate people about the virus have been lacking. This presented the unusual situation of a vaccine being made available for a common infection that very few people knew about—hence, the need for the “Tell Someone” campaign by Merck.

The new HPV vaccine is called Gardasil and is the first vaccine available to offer protection against infection of the four most common types of HPV—two cancer-causing types and two that cause genital warts.

“The FDA has approved the vaccine for use in girls and women between the ages of 9 and 26,” says Henderson. “The vaccine is given in three separate injections over six months and has minimal side effects.”

The good news is that most insurance companies now cover the cost of the vaccine in this age group; it’s on the same level as a flu vaccine, which is great news for women’s health. Henderson says that the best screening prior to a vaccine is an annual Pap test.

Get a yearly Pap
Henderson suggests that the best first-line “test” for HPV is the annual Pap smear. “In this test, a pathologist actually looks at the cells from the cervix to see if they show changes indicative of HPV infection or the more serious precancerous changes that the virus can cause in these cells,” he says.

However, sometimes just looking at the cells is not good enough, according to Henderson because some changes may suggest infection, but are not conclusive.

“In these cases, an actual test for HPV DNA can be performed, usually on the same sample used for the Pap smear,” he says. “This test is very sensitive and can tell whether the cellular changes are due to infection by the cancercausing types of HPV.”

A yearly Pap test is crucial because it’s the best screening prevention for HPV.

The Sex Factor

While there is no age-group risk for HPV infection, the single major risk factor for HPV is sex, therefore the group that is most affected by HPV are sexually active women—most of the time, young women.

“Whenever someone becomes sexually active they are at risk for contracting HPV, and they remain at risk throughout their life,” says Henderson. “This is why girls and women should begin to have annual Pap tests when they begin sexual activity, and have them every year thereafter.”

Symptoms of HPV
Unfortunately, HPV infection is, for the most part, asymptomatic. However, the most common symptom that can be seen is the presence of genital warts.

“The problem is that many times genital warts are too small to be seen,” says Henderson. “Furthermore, more often than not, HPV infection is localized to the cervix, and only a proper medical examination can see the cervical changes that occur in HPV infection.”

Once it has reached the stage of genital warts, HPV can be spread through sexual intercourse.