Introduction of HPV

Human papillomavirus (HPV) is a virus that can be spread through direct skin-to-skin contact or sexual intercourse, and lead to different infections to the body. HPV that is caused by sexual intercourse can be divided into the groups of low-risk and high risk. Most people who become infected with HPV do not know they have it as they do not develop symptoms. Both male and female can receive HPV vaccine to prevent diseases caused by the virus. (Please refer to 9-in-1 HPV Vaccine / Quadrivalent HPV Vaccine for more details)

What is low-risk and high-risk HPV?

HPV that is caused by sexual intercourse (Genital HPV) can be divided into the groups of low-risk and high risk：

• • Low-risk HPV: does not cause cancer but can cause skin warts on or around the genitals or anus. For example, HPV types 6 and 11 cause 90% of all genital warts.
  • High-risk HPV: causes cancer. At least a dozen high-risk HPV types have been identified. HPV types 16 and 18, are responsible for the majority of HPV-caused cancers such as cervical cancer (female), penile cancer (male) etc.

Symptoms

[Symptoms of Infected Men]

Some men who get HPV never develop any symptoms or lead to serious health problems. Patients who are infected with low-risk types (i.e. types 6 and 11) will probably have genital warts. They will feel irritated in the infected area, but this is not a threat to health. For patients who are infected with high-risk types (i.e. types 16, 18), they may have cancers of the penis, anus, or oropharynx3 (back of the throat, including base of the tongue and tonsils.) but this rarely happens.

Below are some of the signs and symptoms for HPV-related diseases:

Low-risk HPV

Genital warts

• • You may notice small, fleshy growths, bumps or skin changes on the penis, scrotum, urethra, testicles, groin, upper thighs, or in/around the anus.
  • They can be flat or smooth small bumps or quite large, pink cauliflower-like lumps.
  • Warts can appear on their own or in groups.
  • They are usually painless but may occasionally itch and cause some inflammation.
  • Warts may appear from three weeks to many months or even years after coming into contact with the virus.
  • They may cause bleeding from the anus or the urethra.

High-risk HPV

Anal cancer

• • Anal bleeding, pain, itching, or discharge.
  • Swollen lymph nodes in the anal or groin area.
  • Changes in bowel habits or the shape of your stool.

Penile cancer

• • First signs: changes in color, skin thickening, or a build-up of tissue on the penis.
  • Later signs: a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful  and bleed.

Cancers of the oropharynx

• • Sore throat or ear pain that does not go away
  • Constant coughing
  • Pain or trouble swallowing or breathing
  • Weight loss
  • Hoarseness or voice changes that last more than 2 weeks
  • Lump or mass in the neck

*People can get infected with high-risk HPV without any symptoms

[Symptoms of Infected Women]

Low-risk HPV

Genital warts

• • commonly found in vagina, cervix, vulva, penis, anus, rectum or urethra
  • Less commonly, mother may pass the virus to newborn baby during labor.

Warts in the throat

• • this is a rare condition called recurrent respiratory papillomatosis, or RRP4. When this occurs in children it is called juvenile-onset RRP (JORRP) and can cause tumor in the throat.

High-risk HPV

• • Cervical cancer : For women, precancerous cervical lesions will be developed if the high-risk HPV cannot be cleared by the immune system. If the condition worsens, the first stage of Cervical Intraepithelial Neoplasia (CIN1) will be developed in five years, and cervical cancer might eventually be developed.
  • Other uncommon but serious cancers: vulva, vaginal anal and oropharyngeal cancer (rear throat, meaning the parts nearby the base of the tongue and the tonsils)

How is HPV passed on

Both men and women can have the virus and pass it on upon sexual intercourse:

• • HPV is easily passed from one person to another through genital contact, most often during vaginal and anal sex. It may also be passed on during oral sex.
  • HPV can be passed on between straight and same-sex partners, even when the infected partner has no signs or symptoms or with only one lifetime sex partner can get HPV.
  • HPV will not pass through a condom but as condoms do not cover all of the genital area, it is possible for unprotected skin to be infected.
  • HPV can develop even years after sexual contact with an infected person.
  • Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.
  • Rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. Very rarely, the child can develop juvenile-onset recurrent respiratory papillomatosis (JORRP) and develop tumor in the throat 2.

If HPV is developed into warts, it can be infected as follows:

• • Infection is likely when warts are present but it is still possible to infect someone after warts have disappeared.
  • It is possible, but very rare, to develop warts in the mouth or throat, or on the lips from oral sex.
  • Warts can be spreaded from the genital area to the area around the anus without having anal sex.
  • It is possible for warts on the hand to be passed to the genitals but this is very rare.

Who are at a higher risk of developing HPV-related disease?

Men who are at a higher risk of developing HPV-related diseases if they are:

• • Gay and bisexual
  • Having weak immune systems, especially for those who have HIV, are more likely to develop anal cancer. Men with HIV are also more likely to get severe cases of genital warts that are harder to treat.

HPV tests

HPVs can be detected with HPV DNA Genotyping by testing cells sample to see if they contain viral DNA. The tests can identify the type of HPV is whether high-risk or low-risk and sometimes detect HPV even before cell abnormalities are evident.

How soon after sex can I be checked for genital warts?
You can be checked as soon as you think you might have been in contact with the virus.

Do I need to have a check-up to see if the warts have gone?
If you are having treatment at a clinic, it is important to return regularly for treatment. This way, the doctor can check whether the treatments are working or advise any change of treatment. Consult the doctor If you have any questions about the matter.