Human Papillomavirus (HPV) Treatments

Types of HPV Infection and Treatment Options

human papillomavirus traveling in the body
How are human papillomavirus (HPV) infections treated?. Istockphoto.com/Stock Photo©Dr_Microbe

You may have heard that human HPV infections can lead to genital warts or even cancer, but how are these infections treated?

HPV Treatment Options

Before talking about treatment options, it's important to note that there are over 100 different strains of the human papillomavirus (HPV) which can affect humans, with roughly 30 of these being sexually transmitted infections.

The other important point to make is there there is no universal HPV treatment for those who are infected with one of these strains.

Treatment, instead, focuses on relieving the symptoms of the infection rather than getting rid of the infection altogether. There are three primary ways in which HPV can affect people who contract the virus:

  • Asymptomatic infection - Many people who are infected with HPV do not have any symptoms. This is important for those affected as they may develop symptoms (genital warts or cervical dysplasia) in the future, and for those who are sexually involved with someone who contracts an HPV infection and could catch the virus.
  • Genital warts
  • Abnormal cervical changes leading to cervical cancer. Other cancers such as penile cancer, head and neck cancers, vaginal cancer, and anal cancer are associated with HPV infection as well.

Let's look at each of these separately.

Treatment for Asymptomatic Infections with HPV

When HPV is asymptomatic (not causing any symptoms), and if the virus does not pose any immediate health risk, no specific treatment is recommended.

(A healthy diet and exercise are recommended, of course, as they are for everyone at risk of any condition, which means everyone.)

Leaving the virus alone because it is not causing symptoms one day does not mean that it will never cause symptoms. If symptoms, such as genital warts develop, or if a woman has an abnormal Pap smear, treatment will be needed at that time.

 

Those who are infected but asymptomatic may still pass the virus on to others, who may then become symptomatic. While no specific treatment is recommended, those between the ages of 9 and 26 should consider vaccination. There are many strains of HPV, as noted above, and immunization may prevent a person from becoming infected with another, and potentially more dangerous, strain. Physical partners should also consider immunization for the same reason.

Treatment for Genital Warts

Though unsightly and uncomfortable, genital warts do not usually cause any major health problems. It's important to note that the HPV strains which cause genital warts are different than the strains which cause cancer. Roughly 90 percent of genital warts are due to infection with HPV 6 and HPV 11.

Today, most people with genital warts can be treated with at-home topical creams that are prescribed by a doctor. There are other creams that can be purchased over the Internet that claim to cure HPV, but be cautious about medications that guarantee cures. If it's too good to be true, then it probably is. These medications are not regulated by the Food and Drug Administration and usually do not work.

Plus, there is no known cure for HPV.

Other methods of removing genital warts include cryotherapy (freezing the warts), cautery (burning the warts), applying trichloracetic acid, laser therapy and using a surgical scalpel.

Regardless of what type of treatment is used to remove genital warts, it is not curative. After removal, genital warts can return. Removal simply treats the symptoms, not the virus.

Those who develop genital warts should be monitored carefully as they may also be at risk for acquiring other types of sexually transmitted diseases.

Learn more about treatments and prevention of genital warts.

Treatment for Cervical Changes Caused By HPV

Infection with certain strains of HPV can lead to cervical dysplasia, and in some cases, cervical cancer. At the current time, roughly 70 percent of cervical cancers are caused by infection with HPV 16 and HPV 18. Another 20 percent of cervical cancers are associated with HPV 31, 33, 34, 45, 52, and 58. HPV is associated with other cancers as well, including head and neck cancers, penile cancer, anal cancer, vaginal cancer, and possibly even lung cancer. It's thought that HPV 16 is the primary culprit in most head and neck cancers associated with HPV infection.

An abnormal Pap smear is often the first indication of an HPV infection. Depending on the findings, a coloposcopy may be recommended, with cervical biopsies taken of any abnormal areas. HPV testing may also indicate an HPV infection. Cervical changes due to HPV can be treated in a number of different ways, which often depend, in turn, on the degree of abnormality.

For women who have low-grade cervical dysplasia, the treatment is often no treatment at all. The "watch and wait" approach alleviates unnecessary medical treatments. Research shows that in cases of low-grade dysplasia, the condition usually resolves on its own without medical intervention. Women are advised to undergo regular screenings to ensure the dysplasia has not worsened, which would require treatment. These follow-ups are vital for cervical health.

High-grade cervical dysplasia requires treatment to prevent it from progressing into cervical cancer. Removing the affected tissue can be accomplished by LEEP, laser therapy, cryotherapy and other surgical methods, if necessary.

Treating cervical dysplasia and CIN, however, only treats the abnormal cells and does not rid the body of the infection. People who have developed cervical changes due to HPV will need to be monitored closely for recurrence of changes.

HPV Infections and Head and Neck, Vaginal, Penile, and Anal Cancers

Abnormal cells in the mouth or throat, vagina, penis, or anal region due to HPV infection are treated in a similar way to those found in cervical dysplasia, and may include cryotherapy, cautery, or surgical removal of abnormal regions. For example, laryngeal papillomas caused by HPV may progress to laryngeal cancer if not treated.

Including cervical cancers, anal cancers, and head and neck cancer associated with HPV, it's thought that HPV is responsible for around five percent of cancers worldwide.

Partners of Those Infected with HPV

There is a small increased risk of HPV associated cancer in partners of those who have had an HPV related cancer. For example, there may be a small increase in men with tongue cancer and cancer of the tonsils who have a partner with cervical dysplasia or cervical cancer. It's thought that this risk is between one and three percent, but may be higher.

Is There Any Way to Get Rid of an HPV Infection?

As we noted at the beginning, the focus of treatment with HPV infections is treating the symptoms of the infection, whether that be genital warts or dyplasia of the cervix (or other region of the body.) At the current time we may be able to prevent an infection (with the vaccine) but there is not a specific treatment for removing the virus from the body.

Most HPV infections go away in time. In fact, most people who are infected with the strains which can cause genital warts or cancer never go on to develop these conditions and the body fights off the virus before it can cause these changes. It's likely that taking care of yourself—eating healthily, exercising, and avoiding tobacco—can hasten the bodies removal of these viruses. We know that smoking works together with HPV to increase the risk of cervical cancer. Some studies have looked at specific foods that may accelerate the resolution of the infection, but for the present time, the best approach is to simply be healthy, both to lessen your risk that an HPV infection will take hold, and to keep your body as healthy as possible in many other ways as well.

HPV Infection Prevention

The ideal "treatment" for HPV infection is preventing the infection in the first place. Practicing safe sex comes foremost, and reduces your risk of other sexually transmitted infections as well. Immunization is recommended for those between the age of nine and 26. Even if a person has had an infection with one strain of HPV, immunization may prevent infection with other strains.

The three currently vaccinations are:

  • Gardisil (which was approved in 2006) offers protection against HPV 6, 11, 16, and 18
  • Cervarix (approved in 2009) offers protection against HPV 16 and 18
  • Gardisil 9 (approved in 2014) offers protection against strains 6, 11, 16, 31, 33, 45, 52, and 58

Sources:

Berman, T., and J. Schiller. Human Papillomavirus in Cervical Cancer and Oropharyngeal Cancer: One Cause, Two Diseases. Cancer. 2017 Mar 27. (Epub ahead of print).

Egawa, N., and J. Doorbar. The Low-Risk Papillomaviruses. Virus Research. 2017. 231:119-127.

Hellner, K., and L. Dorrell. Recent Advances in Understanding and Preventing Human Papillomavirus-Related Disease. F1000Research. 2017 Mar 14. (Epub ahead of print).

Hoffman, S., Le, T., Lockhart, A. et al. Patterns of Persistent HPV Infection After Treatment for Cervical Intraepithelial Neoplasia (CIN): A Systematic Review. International Journal of Cancer. 2017 Jan 25. (Epub ahead of print).

Mirghani, H., Sturgis, E., Auperin, A., Monsonego, J., and P. Blanchard. Is There an Increased Risk of Cancer Among Spouses of Patients with an HPV-Related Cancer: A Systematic Review. Oral Oncology. 2017. 67:138-145.

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