Infectious Disease Compendium

Human Papilloma Virus

Microbiology

A papilloma virus, hence the name.

Epidemiologic Risks

Sex.

"...any genital HPV prevalence among adults aged 18–59, was 42.5% in the total population, 45.2% among men and 39.9% among women; high-risk genital HPV prevalence was 22.7% in the total population, 25.1% among men and 20.4% among women. (PubMed). Frank Drebin had it right.

In heterosexual men, the prevalence of HPV was 18.7% at the penis, 13.1% at the scrotum, 7.9% at the perineal/perianal region, and 21.0% at any site (PubMed). In homosexual men it was 18.5% at the penis, 17.1% at the scrotum, 33.0% at the perineal/ perianal region, 42.4% in the anal canal, and 48.0% at any site (PubMed).

Risk of spread in discordant couples is 3.5/100 person months or a per-partnership transmission probability of 0.20 which is a number not even statisticians understand (PubMed). You want to know risk per episode of sex.

Syndromes

Venereal warts, cancer of the cervix, rectum, and oral pharyngeal cancer (I wonder how it gets to the throat?) (PubMed).

70% of HPV cervical cancers are caused by 2 strains: HPV-16 or HPV-18.


Disease & HPV type
Common warts: 2, 7, 22
Plantar warts: 1, 2, 4, 63
Flat warts: 3, 10, 8
Anogenital warts: 6, 11, 42, 44 and others
Anal dysplasia: 6, 16, 18, 31, 53, 58
Genital cancers
Highest risk: 16, 18, 31, 45
Other high-risk: 33, 35, 39, 51, 52, 56, 58, 59
Probably high-risk: 26, 53, 66, 68, 73, 82
Epidermodysplasia verruciformis: >15 types
Focal epithelial hyperplasia (oral): 13, 32
Mouth papillomas: 6, 7, 11, 16, 32
Oropharyngeal cancer: 16
Verrucous cyst: 60
Laryngeal papillomatosis: 6, 11

 

Treatment

There is a vaccine. It prevents cancer. That should be considered a good thing. It covers 7 strains that are associated with cancer and 2 strains that cause warts.

Besides females, "Advisory Committee on Immunization Practices (ACIP) recommended routine use of quadrivalent human papillomavirus (HPV) vaccine in males aged 11 or 12 years. ACIP also recommended vaccination with HPV4 for males aged 13 through 21 years who have not been vaccinated previously or who have not completed the 3-dose series; males aged 22 through 26 years may be vaccinated. (MMWR)"

The vaccine will not lead to more or risker sex: "HPV vaccine-related risk perceptions were not associated with sexual initiation or age of sexual initiation, providing further support that HPV vaccine-related risk perceptions are unlikely to lead to riskier sexual behaviors (PubMed)", although if concerned an early death from cancer will lead to less sex.

Notes

Herd immunity works. Vaccination of females leads to decreased disease in unvaccinated females and in males, the vector.

Last update: 05/05/18