Human papillomavirus infection
Human papillomavirus infection
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Human papillomavirus infection

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Human papillomavirus infection

Human papillomavirus infection (HPV infection) is an infection caused by a DNA virus from the Papillomaviridae family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. Sometimes an HPV infection persists and results in warts or precancerous lesions. Many warts are caused by HPV. These lesions, depending on the site affected, increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth, tonsils, or throat. Nearly all cervical cancer is due to HPV and two strains, HPV16 and HPV18, account for 70% of all cases. HPV16 is responsible for almost 90% of HPV-related cancers of the mouth, throat, or tonsils. Between 60% and 90% of the other cancers listed above are also linked to HPV. HPV6 and HPV11 are common causes of genital warts and laryngeal papillomatosis.

Over 200 types of HPV have been described. An individual can become infected with more than one type of HPV and the disease is only known to affect humans. More than 40 types may be spread through sexual contact and infect the anus and genitals. Risk factors for persistent infection by sexually transmitted types include early age of first sexual intercourse, multiple sexual partners, smoking and poor immune function. These types are typically spread by direct skin-to-skin contact, with vaginal and anal sex being the most common methods. HPV infection can spread from a mother to baby during pregnancy. There is limited evidence that HPV can spread indirectly, but some studies suggest it is theoretically possible to spread via contact with contaminated surfaces. HPV is not killed by common hand sanitizers or disinfectants, increasing the possibility of the virus being transferred via non-living infectious agents called fomites.

HPV vaccines can prevent the most common types of infection. Many public health organisations now test directly for HPV. Screening allows for early treatment, which results in better outcomes. Nearly every sexually active individual is infected with HPV at some point in their lives. HPV is the most common sexually transmitted infection (STI), globally.

High-risk HPVs cause about 5% of all cancers worldwide and about 37,300 cases of cancer in the United States each year. Cervical cancer is among the most common cancers worldwide, causing an estimated 604,000 new cases and 342,000 deaths in 2020. About 90% of these new cases and deaths of cervical cancer occurred in low and middle income countries. Roughly 1% of sexually active adults have genital warts.

HPV is a group of more than 200 viruses, which are designated by a number for each virus type. Some HPV types, such as HPV5, may establish infections that persist for the lifetime of the individual, without manifesting any clinical symptoms. HPV types 1 and 2 can cause warts in some infected individuals. HPV types 6 and 11 can cause genital warts and laryngeal papillomatosis.

Many HPV types are carcinogenic. About twelve HPV types (including types 16, 18, 31, and 45) are called "high-risk" types because persistent infection has been linked to cancer of the oropharynx, larynx, vulva, vagina, cervix, penis, and anus. These cancers all involve sexually transmitted infection of HPV to the stratified epithelial tissue. HPV type 16 is the strain most likely to cause cancer and is present in about 47% of all cervical cancers, and in many vaginal and vulvar cancers, penile cancers, anal cancers and cancers of the head and neck.

The table below lists common symptoms of HPV infection and the associated types of HPV.

Skin infection ("cutaneous" infection) with HPV is common and can cause noncancerous skin growths called warts (verrucae). Warts are caused by the rapid growth of cells on the outer layer of the skin.

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