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How do we prevent HPV infections?

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Over the last few weeks I have been discussing the human papilloma or warts virus. I said that the virus usually causes warts soon after an infection, but years later, especially with continued trauma, it might cause cancers. That’s why these viruses, are called slow viruses because they can cause cancers many years after the initial infection.{{more}}

The principles of treatment are to prevent the infections, treat the infections if they occur, treat the warts or treat the cancers caused by the warts. Obviously, we would prefer not to treat the cancer, but prevent it, so most of the discussion on treatment of cancers caused by the warts virus will concentrate on early detection.

How do we prevent HPV infections? The principle is the same as in all sexually transmitted infections; first, abstain, especially if you are under age or not ready for sexual intercourse. Secondly, if you must have sex, especially with someone whom you do not know well, use a condom or other effective barrier method, e.g. a femidom. Thirdly, if for the sake of pregnancy or in a long-term relationship with someone whom you trust, then please, be faithful. Multiple partners, especially people whom you do not know well, increase your risk of all STIs, including HPV.

How do you know that you have the infection? Unfortunately, you do not know when you have just caught the infection, because the virus unlike other viruses, does not cause any symptoms, because it does not get into the blood stream on initial infection. Instead, it infects the superficial layers of the skin to cause warts. If your partner has warts, you can be tested for the virus by doing a special examination on your genital organ skin. Women who have been exposed to the virus should be immunized against the virus. All sexually active young women, especially those with a history of multiple partners, should be vaccinated, as it is impossible to know when you have “caught the virus”. The transformation from warts to cancer is not clear, but a significant number of patients who develop cancer of the penis or the cervix would have been treated for genital warts in the years prior to developing a cancer.

How do we treat genital warts? Unlike skin warts genital warts do not usually regress. Because they occur in moist dark areas (under the foreskin or in the vulva or vagina), they tend to get bigger or remain the same. Because of the potential for spreading the virus or inability to have sexual intercourse or to infect the unborn child, genital warts should be treated. The usual treatment is laser or electrocautery of the lesions. Smaller warts can be treated with creams and ointments, but care must be taken not to damage the surrounding normal skin. Even when the wart has been treated, the person is still potentially infective, because treatment does not cure all the infected cells that you cannot see with the naked eye. Besides, very few patients are encouraged to apply a topical preparation to kill all the infected skin cells after they have had electrocautery or laser.

So, how do we prevent cancers arising from HPV? The best way is to detect the precancerous changes early in its course and hence prevent the development of the cancer. For women that means the use of the PAP smear, once they become sexually active. Other tests like colposcopy, can detect the extent of the precancerous changes and effect treatment. The treatment of precancerous changes of the cervix involves the use of cryotherapy or surgery to remove the precancerous cells. In men, it is not that that simple, because it is very difficult to detect precancerous cells on the surface of the penis. Unless there are other precancerous lesions not related to HPV, most men will develop primary penile cancer from the outset, without going through a precancerous stage. This is usually more than 20 years after becoming infected from the virus and not knowing it.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: [email protected]

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