HPV is likely one of the most common sexually transmitted infections (STIs) in Canada. It is estimated that 75 percent of Canadians will have at least one HPV infection in their lifetime. Some types of HPV can cause genital warts while other types can lead to cancer.

Many types of HPV have been identified. The virus can be transmitted during vaginal, oral or anal sex or close skin-to-skin contact with someone who is infected. Different types of HPV cause different problems. Some types can lead to genital warts while other types can lead to cervical cancer (cancer of the opening of the uterus), and other cancers (cancer of the penis or anus). It is possible to have more than one type of HPV. Although treatments are available to remove warts caused by HPV, they do not treat the underlying HPV infection in the surrounding area and the warts may recur. There is no known cure for HPV infections but many people will eventually clear the infection from their bodies. However, some infections do persist. Practising safer sex can help reduce the risk of getting or transmitting the infection.

Symptoms of HPV

Genital warts, (also called Condylomata) are one symptom of HPV infection. Genital warts may look like a small cauliflower or they may be flat. In women, the warts may appear on the vulva, cervix, rectum or thigh area. In men, they may appear on the penis, scrotum, rectum or thigh area. The types of HPV that cause genital warts do not cause cancer but it is possible to be infected with more than one type of HPV.

HPV is often a 'silent' infection, in that many people with HPV will have no obvious signs of infection. However, the infection can cause changes that can be seen under a microscope.

For women, the majority of HPV infections affect the cells of the cervix. This infection can be either active or inactive. With an inactive infection, the cells appear normal under a microscope and the woman may never know she was infected. The body fights the virus in a way that isn't clearly understood.

However, with an active infection, changes can be seen in the cervical cells under a microscope. An active infection can follow one of two courses:

• The abnormal cells become normal again and the infection becomes inactive. However, there is always the chance that an inactive infection can become active again, for reasons that aren't clearly understood.
• The abnormal cells slowly progress to cervical cancer.

Regular Pap smear testing can help to identify changes in the cells of the cervix, allowing these to be treated. If these changes are not identified, they can progress to cancer. HPV testing, to identify the presence of a high-risk HPV infection, may also be used.

The Health Risks of HPV

By far the most serious risk of HPV is cancer, one of the most common being cervical cancer in women. Almost all cervical cancers are caused by HPV.

HPV can also lead to other types of cancer in both men and women, such as cancer of the penis, anus or vulva.

Genital warts can be uncomfortable and can also lead to emotional and social problems for those who are infected. Genital warts can be treated by applying a medicated gel to the warts in the doctor's office or at home. Several treatments are usually needed to be effective. In some cases, other methods such as cryotherapy, electrosurgery, laser surgery or surgery may be used. However, the removal of visible warts does not always eliminate HPV infection. Sometimes the warts recur.

HPV does not appear to affect a woman's ability to become pregnant. For a woman who is pregnant, it is not certain what effect HPV can have on her baby. The baby may be at risk of getting an HPV infection in the throat, but experts don't believe that the infection is passed on to the baby very often.

Minimizing Your Risk

These measures can help protect you against HPV and its consequences.

• Anyone who has had sex is at risk of HPV, even without symptoms. If you are a woman, see your doctor regularly for a Pap test or other form of cervical screening.
• Learn about safer sex methods and practise them.
• Make informed decisions about your sexual health. Talk to your partner(s) about their STI status and the use of protection.
• Condom use may reduce the risk of getting HPV. However, remember that the areas of skin not covered by the condom are not protected.
• If you have had multiple sexual partners, talk to your doctor about HPV and have yourself tested for STIs.

Government of Canada's Role

The Sexual Health and Sexually Transmitted Infections Section of the Public Health Agency of Canada provides national leadership and coordination through programs that develop and support surveillance and targeted research studies. Working with the provinces and territorial governments, non-governmental organizations and health care providers, the Section develops evidence-based national standards and policies, promotes the exchange of information, and engages in prevention and promotion activities.

Tags: Sexually Transmitted Diseases (STDs)

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