New Mexico
AIDS
InfoNet Fact
Sheet Number 506
and Cervical Dysplasia)
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PrintNOTE: Trained counselors provide counseling and
referrals on a national human papillomavirus (HPV) hotline. Call
toll-free at 877- HPV-5868 (877-478-5868) from 2 p.m. to 7 p.m.
Eastern Standard Time Monday through Friday.
There are over 100 viruses known as human papilloma
viruses (HPVs.) They are common. One study found HPVs in 77% of
HIV-positive women. HPVs can be transmitted easily during sexual
activity. Condoms do not totally prevent transmission of HPVs:
the virus can be transmitted from person to person by direct contact
with infected areas.
There is no easy way to tell if someone is infected with an
HPV. People who don’t have any signs or symptoms of HPV infection
can transmit the infection.
Several types of HPV cause warts in the genital area or in
the mouth. Genital warts can occur on the penis, vagina, and rectum.
HPV can also cause problems in the mouth or on the tongue or lips.
Other types of HPV can cause abnormal cell growth known as
dysplasia. Dysplasia can develop into several kinds of cancer.
These include cancers of the penis and anus, and cervical cancer
in women.
Dysplasia around the anus is called anal intraepithelial
neoplasia (AIN). The epithelium is the layer of cells that
cover organs or openings in the body. Neoplasia means the new
development of abnormal cells. Anal intraepithelial neoplasia
is the new development of abnormal cells in the lining of the
anus.
Dysplasia in the cervical region is called cervical intraepithelial
neoplasia (CIN). One study found AIN or CIN in over 10% of
HIV-positive men and women. Another study showed that women with
HIV infection have a much higher rate of CIN than HIV-negative
women.
Doctors look first for the problems HPVs cause: dysplasia or genital
warts.
Dysplasia can be detected by Pap smears. They are usually
used to check a woman’s cervix, but can also be used to check
the anus in men and women. A swab is rubbed on the area being
checked. The swab picks up some cells, which are smeared on a
glass slide and examined under a microscope. If the Pap smear
results are not clear, an HPV test can indicate who needs treatment.
Some researchers believe that anal and cervical smears should
be checked each year for some people with HIV:
- People who have had receptive anal intercourse, or
- Women who have had cervical intraepithelial neoplasia (CIN),
or
- Anyone with under 500 T-cells.
Genital warts can appear anywhere from a few weeks to
a few months after you are exposed to HPV. The warts might look
like small bumps. They can also be more fleshy, and might look
like small cauliflowers. They can get bigger over time.
Your doctor can usually tell if you have genital warts by looking
at them. Sometimes a tool called an anoscope is used to look at
the anal area. If necessary, a sample of the suspected wart will
be cut off and examined under a microscope. This procedure is
called a biopsy.
TREATED?
There is no direct treatment for HPV infection. However, dysplasias
and warts can be removed. There are several ways to do this:
- Burning them with an electric needle (electrocautery) or
a laser
- Freezing them with liquid nitrogen
- Cutting them out
- Treating them with chemicals like Trichloroacetic Acid (TCA),
Podophyllin or Podofilox.
Other, less common treatments for warts include the drugs 5-FU
(5-fluorouracil) and Interferon-alpha. 5-FU exists in a cream
form, but interferon must be injected into the warts. A new drug,
imiquimod (Aldara®), has been approved for treatment of genital
warts. A drug called cidofovir (Vistide®), originally developed
to fight cytomegalovirus (CMV), might also help fight HPV.
HPV infection can last for a long time, especially in people
who are HIV-positive. Dysplasia and warts can return. They should
be treated as soon as they are found to reduce the chances of
the problem spreading or returning.
Human papilloma viruses (HPVs) are fairly common sexually transmitted
viruses. Different HPVs cause genital or oral warts, or abnormal
cell growth (dysplasia) near the anus or cervix. This abnormal
cell growth can range from mild to severe (cervical or anal cancer).
HPV infection can last a long time, especially in people with
HIV.
A Pap smear can detect abnormal cell growth in the cervix.
It can also be used to check the anus of men and women. Many researchers
believe that men who have had receptive anal sex, women who have
had cervical intraepithelial neoplasia, and everyone with fewer
than 500 T-cells should get a smear each year to test for HPV
and abnormal cell growth.
The signs of HPV infection – warts or dysplasia – should be
treated as soon as they show up. Otherwise, the problem could
spread and be more likely to return after treatment.
Revised February 28, 2001
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