HPV is the most common sexually transmitted infection worldwide. It is estimated that 70-80% of the sexually active population will be infected with HPV during their lifetime. Although most infections are asymptomatic and resolve spontaneously, some can persist and lead to serious complications, including cancer.
HPV transmission
HPV is mainly transmitted by direct skin-to-skin or mucous membrane-to-mucous membrane contact during sexual relations, including oral and anal sex. It is important to note that penetration is not necessary for transmission of the virus. The virus can affect both men and women. The frequent absence of visible symptoms facilitates transmission of the virus, as infected people may be unaware of their condition. Young adults, particularly those aged 16-25, are the most affected. Although condoms reduce the risk of transmission, they do not fully protect against HPV, which may be present in areas of the skin not covered by a condom.
HPV symptoms
In most cases, HPV infection is asymptomatic. Infected people show no visible signs, and can unknowingly transmit the virus. This lack of symptoms makes HPV detection and prevention particularly difficult.
Clinical symptoms
When symptoms do appear, they can take different forms depending on the type of HPV involved.
Genital warts
Also known as condylomas, these painless, cauliflower-shaped growths appear on the external genitalia, anus or perianal area.
Precancerous lesions and cancers
These lesions, often asymptomatic, can be detected during a routine gynecological examination ("Pap smear"). They can develop into cancers of the cervix, vagina, anus, throat or penis. In advanced stages, symptoms can include bleeding and pain.
Risk factors
Certain behaviors increase the risk of contracting HPV, such as having multiple sexual partners, starting sex at a young age, or not using protection such as condoms. Smoking, immunosuppression (e.g. due to HIV), and long-term use of oral contraceptives can also increase the risk of developing HPV-related cancers.
Preventing HPV
HPV prevention is based on several complementary strategies:
Vaccination
HPV vaccination is the most effective method of prevention. It is recommended for :
- Girls and boys aged 11 to 14 (basic vaccination)
- Adolescents and young adults aged 15 to 26 (catch-up vaccination)
Current vaccines protect against the HPV types responsible for 70-90% of cervical cancers and genital warts. The vaccination schedule generally includes two doses given six months apart for 11-14 year-olds, and three doses for those aged 15 and over. They are considered safe, with generally mild and transient side effects (pain at the injection site, fatigue, headaches).
Safe sexual practices
The systematic use of condoms during intercourse can reduce HPV transmission. However, it does not fully protect against HPV, which may be present in areas of the skin not covered by the condom. Limiting the number of sexual partners and regular screening also help to prevent HPV. For women, regular screening for cervical cancer is recommended (cervical smear or pap smear).
Treating HPV
There is no specific curative treatment to eliminate the HPV virus; it disappears on its own in the majority of cases. However, symptoms and complications can be treated: genital warts can be treated by various methods such as cryotherapy, or the application of topical medications (creams). Precancerous lesions can be treated by surgery, laser or conization (removal of a portion of the cervix).
HPV and cancer
HPV is responsible for several types of cancer, including cervical cancer. Around 90% of cervical cancers are caused by high-risk HPV. In Switzerland, it affects 250 women every year and causes 80 deaths. It is a cancer that can be prevented by screening examinations (regular cervical smears).
HPV is also implicated in the development of cancers of the anus (240 new cases per year in Switzerland, 70% of which occur in women), penis, vagina and throat. Although less frequent than cervical cancer, they remain significant and underline the importance of prevention and vaccination. In at least 80% of cases, these are HPV viruses against which the vaccine is effective.
The development of HPV-related cancer is a slow process, which can take several years. This slow progression offers a window of opportunity for early detection and treatment of precancerous lesions.
Conclusion
Human papillomavirus (HPV) represents a major public health issue, due to its high prevalence and the associated risk of cancer. Although most infections are transient and asymptomatic, some can lead to serious complications, including cancer. Prevention plays a crucial role in the fight against HPV. Vaccination, combined with safer sex practices and regular screening, is the most effective strategy for reducing the risk of HPV.
FAQ on HPV
What is human papillomavirus (HPV)?
HPV (Human Papillomavirus) is a very common virus with over 100 types, of which around 40 can infect the genital area. Some types can cause genital warts or progress to cancer.
How is human papillomavirus (HPV) transmitted?
HPV is transmitted mainly by direct skin-to-skin or mucous membrane contact, often during sexual intercourse, including vaginal, anal and oral sex. It can also be transmitted without penetration.
What are the symptoms of human papillomavirus (HPV)?
Most HPV infections are asymptomatic. However, some types can cause visible genital warts. High-risk types can cause precancerous lesions, which are often detected during routine cervical smears.
Can I be infected several times with the same HPV type?
In general, once you've been infected with one type of HPV and the body has cleared it, you develop immunity to that specific type. However, you can still be infected by other types of HPV (there are around 40 that can infect the genital area).
What is the most effective prevention method?
Vaccination remains the most effective method, followed by condom use.
What is the recommended age for vaccination?
From age 11 to 14 (basic vaccination for girls and boys). From 15 to 26 (catch-up vaccination for adolescents and young adults).
Can men be tested for HPV?
There is no routine test for HPV in men. However, men can benefit from vaccination and should consult their doctor if they develop any visible symptoms.
Is vaccination effective if I've already had sexual relations?
Yes, vaccination can still be beneficial, even after sexual activity has begun. It will protect against HPV types with which you have not yet been infected.
Does the condom provide complete protection against HPV?
No, condoms reduce the risk of transmission by around 70%, but do not protect completely, as the virus can still be present in uncovered areas.