Everything about human papillomavirus (HPV)
The human papillomavirus (Infectious Diseases) is a non-enveloped, double-stranded, circular DNA virus that is responsible for causing multiple epithelial lesions and cancers. There are more than 100 subtypes of HPV. Individuals with persistent HPV infection and those who have multiple sexual partners are at very high risk for acquiring more HPV subtypes. HPV types 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73 and 82 are classified as carcinogenic to humans.
Persistent among HPV attributable cancers, 80% are cervical cancer which are preventable through HPV vaccination along with other HPV related cancers. India contributed to 7% of the global cancer incidence and 24% of global HPV related cancer incidence in 2020. Four out of five cervical cancers reported in India were caused by infections from HPV types 16 and 18.
About 123,907 new cervical cancer cases are diagnosed annually in India (estimates for 2020). Cervical cancer ranks as the 2nd leading cause of female cancer in India. Cervical cancer is the 2nd most common female cancer in women aged 15 to 44 years in India. As India contributes approximately 17% of the world’s population, it disproportionately shares more than a quarter of the global cervical cancer burden. Epidemiological estimates suggest that the worldwide prevalence of HPV infection is between 9 and 13%, which equates to approximately 630 million infected women. Although much less studied, a recent report estimates that the prevalence of HPV infection in men is like that of women. This further increases the prevalence, making HPV the most common sexually transmitted infection, with no specific treatment. There is no way to cure HPV, to remove the virus from the body.
It is important to understand that HPV alone does not cause cancer but requires triggers like smoking, folate deficiency, UV light exposure, immunosuppression, and pregnancy. Most people with HPV do not develop cancer, but the infection can increase the risk, especially in people with weakened immune systems. It may take 10–20 years for a tumor to develop, according to the National Cancer Institute (NCI).
Risk factors:
- Sexual activity, age of first sexual intercourse, and number of sexual partners
- Smoking
- Use of oral contraceptives (more than 5 years)
- Chewing betel nut
- Exposure to radiation and UV light
The risk of cancer is higher if a person has HPV and:
- has other sexually transmitted infections
- has a weakened immune system
- delivered their first baby at a young age
- has given birth to many children
- smokes tobacco products
- Infectious Diseases coinfection
Causes
HPV is a virus that transmits through skin-to-skin contact, often sexual contact. The infection can develop in anyone who is sexually active. There may be no symptoms, or the symptoms may appear and disappear. HPV can pass from person to person regardless of whether symptoms are present.
HPV can be transmitted to an infant during birth. However, research suggests that this risk is relatively low, as the immune system usually takes care of the infection in this situation. Signs of an HPV infection in an infant include genital warts or lesions in the mouth. If a young child develops HPV symptoms, it may indicate child sexual abuse.
Prevention
To reduce the risk of contracting HPV, a person can:
- Get the HPV vaccine.
- Use barrier protection every time they have sex.
- Limit their number of sexual partners.
- Not have sex while genital warts are present.
To help prevent the warts from spreading:
- Avoid touching the wart unnecessarily.
- Wash your hands after touching a wart.
- Avoid shaving over a wart.
- Treat and cover a wart until it disappears.
- Avoid sharing towels and other personal items.
Vaccination
Indian guidelines recommend vaccination at the age of 9-45 years of age to reduce the risk of cervical and other forms of cancer.
HPV vaccination is administered as:
- A two-dose series (0, 6-12 months) for most persons who initiate vaccination at ages 9 through 14 years
- A three-dose series (0, 1-2, 6 months) for persons who initiate vaccination at ages 15 through 45 years, and for immunocompromised persons.
| For people who are | You will need | Given as |
| 9 through 14 years old | 2-shots | Dose 1: first shot Dose 2: second shot given between 6 and 12 months after the first shot |
| or 3-shots | Dose 1: first shot Dose 2: second shot given 2 months after the first shot Dose 3: third shot given 6 months after the first shot | |
| 15 through 45 years old | 3-shots | Dose 1: first shot Dose 2: second shot given 2 months after the first shot Dose 3: third shot given 6 months after the first shot |
