Genital Warts – Human Papillomavirus
What are Genital Warts?
The human papillomavirus (HPV) is a virus that infects the epithelial (skin or mucosal) cells.
There are many types of the virus which are numbered in order of their discovery. The majority of types cause no symptoms, some cause warts (verrucae) while others can, in a minority of cases, lead to cancer. Warts which appear in the genital region, penis, vulva, vagina or anus, are termed genital warts.
How does one get Genital Warts?
HPV is believed to be the most common sexually transmitted infection in the developed world, and many sexually active men and women will be infected with the virus at some time in their lives.
More than 30 to 40 types of HPV are transmitted through sexual contact. By the end of the third quarter of 2011, up to the end of September, there were 360 cases of genital warts reported in Ireland. 90% of genital warts are caused by HPV types 6 or 11. These are very common and highly infectious. Penetrative sex is not required, and skin-to-skin genital (e.g. penile-vulval) contact is a recognised mode of transmission. Not everyone who is infected with the virus develops warts, and the HPV genotype 6 and 11 that cause genital warts tend to run a benign course and do not usually cause cancer.
It has been estimated that HPV causes almost 100% of cancer of the cervix, 90% of anal cancer and 40% of cancers of the external genitalia (vulva, vagina, and penis). HPV can also cause cancer of the mouth and throat. HPV infection of the cervix usually clears after a few months, but persistent infection beyond 12 months, as occurs in 5-10% of women, is associated with changes in the cells of the cervix. These changes can progress to cancer, a process which usually takes 15-20 years. Cervical cancer is rare in women under 30 years of age. Factors believed to contribute to the progression to cervical cancer include immune suppression, as in advanced HIV infection, cigarette smoking, long-term uninterrupted use of hormonal contraceptives and coinfection with Chlamydia trachomatis or Herpes simplex. 70% of cervical cancer is caused by the high-risk HPV genotypes 16 and 18.
How are Genital Warts diagnosed?
Genital warts type 6 and 11 are diagnosed by inspection.
Warts can be flat or on a stalk, and are ‘cauliflower like’. Cancer-causing warts can be identified on cervical screening, or in anal screening, where appropriate. Warts can often be mixed up with molluscum contagiosum.
How are Genital Warts treated?
Warts are treated by several methods, freezing with liquid nitrogen, surgical removal, laser removal and topical treatments available on prescription.
Do not try this at home!!
Is there any aftercare for Genital Warts?
Warts may need regular treatment until they have gone.
They may also recur but usually do not. If they recur, it can be very frustrating for the person.
How are Genital Warts prevented?
Condoms offer some protection from genital wart infection, but not always. Warts may be in areas not covered by the condoms. A vaccine has been developed against genital warts.