Human Papillomavirus (HPV) infection and its impact on human health, emphasising the need for prevention.
Dr. Mehreen Aftab, Ph.D.
Background: Human Papillomavirus (HPV) comprises a group of viruses that can cause significant harm to human health. HPV is a highly contagious sexually transmitted infection that affects both men and women. It is a viral infection that spreads through skin-to-skin contact during sexual activity. Every year, an estimated 6.2 million new cases of HPV occur worldwide, making it one of the most prevalent sexually transmitted infections globally [1].
It can manifest in various forms, such as warts on the skin and even cancer, including cervical cancer in women and male infertility. The effects of this sexually transmitted infection can be severe, making it crucial to understand the risks it poses and take necessary precautions. Practising safe sex and getting vaccinated are critical steps to protect yourself and your partner from HPV’s damaging consequences. It is essential to act swiftly and prioritise you and your partner’s health and well-being by taking preventive measures against HPV. Do not wait until it is too late to take action; be proactive in safeguarding your health.
Symptoms:
Human Papillomavirus (HPV) infection can present with various symptoms depending on the strain of the virus and the individual’s immune response. However, it is worth noting that many HPV infections are asymptomatic, especially in the early stages. Here are some common symptoms associated with HPV infection:
Genital Warts: Certain strains of HPV can cause genital warts which are growths or bumps that appear in the genital area [2]. These warts can be unsightly and uncomfortable but are usually not associated with serious health problems.
Cancer: Abnormal Pap smear results can show changes in cervical cells caused by HPV infection, indicating precancerous or cancerous lesions. High-risk HPV strains like HPV 16 and 18 can lead to anogenital dysplasia or neoplasia, which may cause cancer of the cervix, anus, vulva, vagina, penis, or throat [3]. HPV infection can cause itching, discomfort, or pain in the genital or anal area and may cause bleeding, particularly after sex or during menstruation, if cervical lesions are present. HPV can also infect the mouth and throat, leading to the development of warts or lesions, although this is less common than genital infections.
Male Infertility: HPV infection in males can lead to complications that affect fertility. Genital warts may obstruct the reproductive tract, leading to difficulties with sperm transport. Additionally, in rare cases, HPV infection has been associated with reduced sperm quality, which can impact fertility. Some men may experience discomfort or pain during sexual intercourse or urination, and abnormal discharge from the penis can also occur. HPV infection can decrease the number of sperm in the semen, which can lead to infertility, and it can also cause changes in sperm shape and size, making it harder for sperm to fertilize an egg [4].
Diagnosis:
Healthcare providers often begin by visually inspecting the affected areas, such as the genital region, mouth, or throat, for any signs of warts or other abnormalities.
For cervical cancer screening, a common method is the Pap smear (Pap test) which involves collecting cells from the cervix and examining them under a microscope to detect any abnormalities, including those caused by HPV.
Another method is the HPV DNA test which checks for the presence of HPV DNA in cervical cells. This test can detect the virus even before any abnormalities are visible on a Pap smear. The test is typically recommended for women aged 30 and older, and sometimes younger women depending on specific risk factors.
If abnormal cells are detected during a Pap smear or HPV DNA test, a biopsy may be performed. During a biopsy, a small sample of tissue is collected from the affected area and examined under a microscope to confirm the presence of HPV-related abnormalities.
In cases of genital warts or lesions in other areas, healthcare providers may conduct a physical examination and inquire about the patient’s medical history to determine the likelihood of HPV infection. It is important to note that HPV can also infect the mouth and throat, in which case diagnosis may involve visual inspection or biopsy of any abnormal lesions in these areas.
Treatment:
There are tests available to detect HPV infection, primarily through molecular testing of cells collected during cervical screening (Pap smear). While there is no cure for HPV, most infections clear up on their own without causing any long-term health problems. Treatment options are available for managing symptoms such as genital warts or abnormal cell changes that may lead to cancer.
Both men and women need to be aware of HPV and its potential health impacts. Practising safe sex, getting vaccinated, and seeking regular medical care can help reduce the risk of HPV-related health problems. If you have concerns about HPV or its effects on fertility, it is important to discuss them with a healthcare provider.
Prevention:
The most effective way to prevent HPV infection is through vaccination. HPV vaccines are available for both males and females and are recommended by health authorities worldwide, typically starting in adolescence. Vaccination can protect against the most common cancer-causing HPV types as well as some types that cause genital warts [5]. Currently, the most commonly available HPV vaccines (Cervarix and Gardasil) protect against two most common HR-HPV types, -16 and -18 including HPV 9 – valent vaccine HPVs but not to other HR-HPV types. Serum Institute of India (SII) produces Cervavac, an HPV vaccine that prevents cervical cancer and other cancers caused by HPV. Cervavac is India’s first indigenous HPV vaccine. It is recommended for girls and women between the ages of 9 and 26.
HPV awareness among schools, undergraduate students and also to their parents was found to be very low in India. The level of awareness and education appears to be insignificant determinants in rural compared to urban setups. Better health education will be needed to maximize public awareness of cervical cancer prevention. International HPV Awareness Day (IHAD) is observed annually on March 4th. The day aims to raise awareness about HPV, to promote education about HPV, and to encourage governments and individuals to take action against HPV.
Our main objective was to provide awareness about HPV diagnosis using a low-cost method that could be successful in subsequent diagnostic trials.
Author:
Dr. Mehreen Aftab, Ph.D
Ph.D. from Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University, Uttar Pradesh, India.
March 01, 2024
References:
1. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209-249. https://doi.org/10.3322/caac.21660
2. Osmani, V., & Klug, S. J. (2021). [HPV vaccination and the prevention of genital warts and precancerous lesions-current evidence and evaluation]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 64(5), 590–599. https://doi.org/10.1007/S00103-021-03316-X
3. HPV and Cancer – NCI. (n.d.). Retrieved February 29, 2024, from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
4. Capra, G., Notari, T., Buttà, M., Serra, N., Rizzo, G., & Bosco, L. (2022). Human Papillomavirus (HPV) Infection and Its Impact on Male Infertility. Life, 12(11), 1919. https://doi.org/10.3390/life12111919
5. Quang, C., Chung, A. W., Frazer, I. H., Toh, Z. Q., & Licciardi, P. v. (2022). Single-dose HPV vaccine immunity: is there a role for non-neutralizing antibodies? Trends in Immunology, 43(10), 815–825. https://doi.org/10.1016/J.IT.2022.07.011