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Human Papillomavirus (HPV)

Human Papillomavirus (HPV). What is HPV Infection?. Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection in the United States. There are more than 40 HPV types that can infect the genital areas of males and females.

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Human Papillomavirus (HPV)

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  1. Human Papillomavirus (HPV)

  2. What is HPV Infection? • Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection in the United States. • There are more than 40 HPV types that can infect the genital areas of males and females. • These HPV types can also infect the mouth and throat. Source CDC, 2011

  3. What is HPV Infection? • Most people who become infected with HPV do not even know they have it. • At least 50% of sexually active people will have genital HPV at some time in their lives. • HPV is not the same as herpes or HIV (the virus that causes AIDS) even though it is sexually transmitted. Source CDC, 2011

  4. HPV

  5. Symptoms and Pathogenesis Source : CDC

  6. Most people with HPV do not develop symptoms or health problems from it. • In 90% of cases, the body’s immune system clears HPV naturally within two years.  • The types of HPV that can cause genital warts are not the same as the types that can cause cancers. Source CDC

  7. There is no way to know which people who get HPV will go on to develop cancer or other health problems. Source CDC

  8. But, sometimes, HPV infections are not cleared and can cause: • Genital warts • Rarely, warts in the throat • Cervical cancer and other, less common but serious cancers( cancers of the vulva, vagina, penis, anus, and back of throat). Source CDC

  9. Genital warts usually appear as a small bump or group of bumps in the genital area. • Warts can appear within weeks or months after sexual contact with an infected partner (even with asymptomatic infected partner). • Untreated genital warts might go away, remain unchanged, or increase in size or number. • They will not turn into cancer. Source CDC

  10. Cervical cancer usually does not have symptoms until it is quite advanced. • It is therefore important for women to get regular screening for cervical cancer. • Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer. Source CDC

  11. Recurrent Respiratory Papillomatosis (RRP) is a condition in which warts grow in the throat. • When this occurs in children it is called juvenile-onset RRP (JORRP). • These growths can sometimes block the airway, causing a hoarse voice or troubled breathing. Source CDC

  12. Oral warts

  13. warts

  14. warts

  15. Mouth Cancer from HPV

  16. Epidemiology

  17. Approximately 20 million Americans are currently infected with HPV. • 6 million people become newly infected each year. • HPV is so common that at least 50% of sexually active men and women get it at some point in their lives. Source CDC

  18. Genital warts: about 1% of sexually active adults in the U.S. have genital warts at any one time. • RRP: is very rare, less than 2,000 children get juvenile-onset RRP every year in the U.S. • Cervical cancer: each year, about 12,000 women get cervical cancer in the U.S. Almost all of these cancers are HPV-associated. Source CDC

  19. Other cancers that can be caused by HPV are less common than cervical cancer. • Each year in the U.S., there are about: • 1,500 women who get HPV-associated vulvar cancer • 500 women who get HPV-associated vaginal cancer • 400 men who get HPV-associated penile cancer Source CDC

  20. Each year in the U.S., there are about: • 2,700 women and 1,500 men who get HPV-associated anal cancer • 1,500 women and 5,600 men who get HPV-associated oropharyngealcancers. Source CDC

  21. Gay bisexual men, and people with weak immune systems (including those who have HIV/AIDS) are at higher risk for some HPV-related health problems. Source CDC

  22. Human Papillomavirus—Prevalence of High-risk and Low-risk Types Among Females Aged 14–59 Years, National Health and Nutrition Examination Survey, 2003–2006 Prevalence, % 60 Low-risk HPV* High-risk HPV* 50 40 30 20 10 0 14–19 20–24 25–29 30–39 40–49 50–59 Age * HPV = human papillomavirus. NOTE: Error bars indicate 95% confidence intervals. Both high-risk and low-risk HPV types were detected in some females. SOURCE: Hariri S, Unger ER, Sternberg M, Dunne EF, Swan D, Patel S, et al. Prevalence of genital HPV among females in the United States, the National Health and Nutrition Examination Survey, 2003–2006. J Infect Dis. 2011;204(4):566-73

  23. Genital Warts—Initial Visits to Physicians’ Offices, United States, 1966–2010 Visits (in thousands) 500 400 300 200 100 0 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 Year NOTE:The relative standard errors for genital warts estimates of more than 100,000 range from 18% to 30%. SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.

  24. STD Surveillance Network (SSuN)—Genital Warts—Prevalence Among Sexually Transmitted Disease (STD) Clinic Patients by Sex, Sex of Partners, and Site, 2010 Percentage 15 MSM* MSW* Women 12 9 6 3 0 San Francisco Los Angeles Seattle Denver Chicago New Orleans Birmingham Baltimore New York City Hartford/New Haven Richmond Philadelphia * MSM = men who have sex with men; MSW = men who have sex with women only.

  25. Genital Herpes—Initial Visits to Physicians’ Offices, United States, 1966–2010 Visits (in thousands) 400 350 300 250 200 150 100 50 0 1966 1969 1972 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005 2008 Year NOTE: The relative standard errors for genital herpes estimates of more than 100,000 range from 18% to 30%. SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.

  26. Herpes Simplex Virus Type 2—Seroprevalence in Non-Hispanic Whites and Non-Hispanic Blacks by Age Group, National Health and Nutrition Examination Survey, 1976–1980, 1988–1994, 1999–2004, 2005–2008 Percentage Percentage 100 100 Non-Hispanic Whites Non-Hispanic Blacks 80 80 60 60 40 40 20 20 0 0 14–19 20–29 30–39 40–49 All Ages* 14–19 20–29 30–39 40–49 All Ages* Age Age 1976–1980 1988–1994 1999–2004 2005–2008 * Age-adjusted by using the 2000 U.S. Census civilian, non-institutionalized population aged 14–49 years as the standard. NOTE: Error bars indicate 95% confidence intervals.

  27. Risk factors

  28. Transmission • HPV is passed on through genital contact, most often during vaginal and anal sex. • HPV may also be passed on during oral sex and genital-to-genital contact. • HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms. Source CDC

  29. Transmission • A person can have HPV even if years have passed since he or she had sexual contact with an infected person. • Most infected persons are unaware of their infectiousness and capacity to infect their sex partner. • It is also possible to get more than one type of HPV. Source CDC

  30. Transmission • Rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. • Very rarely, the child can develop symptoms Source CDC

  31. Prevention

  32. Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer. • These vaccines are given in three shots. It is important to get all three doses to get the best protection. • The vaccines are most effective when given at 11 or 12 years of age. Source CDC

  33. Girls and women:Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. • Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. • These vaccines can also be given to girls beginning at 9 years of age. Source CDC

  34. Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers. • This vaccine is available for boys and men, 9 through 26 years of age. Source CDC

  35. For sexually active individuals: condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. • Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. • But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV. Source CDC

  36. People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. • But even people with only one lifetime sex partner can get HPV. • That's why the only sure way to prevent HPV is to avoid all sexual activity. Source CDC

  37. Treatment

  38. There is no treatment for the virus itself, but there are treatments for the diseases that HPV can cause: • Visible genital warts:  can be removed by the patient him or herself with prescribed medications. • Cervical cancer:  is most treatable when it is diagnosed and treated early. But women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Source CDC

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