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      The Wart Virus
  Thomas Ind, Gynaecological Surgeon.   thomas ind
    Gynaecological Surgeon Royal Marsden and
St George’s Hospitals
51 Sloane Street, London SW1X 9SW
Tel: 020 7201 2666; Fax 020 7823 1499
  Sloane Street Gynaecology Clinic  
The Wart Virus
The wart virus is also called the human papilloma virus (HPV). It is a common virus. Over 100 different types of HPV have been identified and each is known by a number. Each type affects certain parts of the body: for example HPV types 1, 2 and 4 are associated with the common warts that can arise on the hands and feet. Types 6 and 11 can cause genital warts (warty growths in the genital area) in some women.

Some HPV types, most commonly types 16 and 18, can lead to abnormal changes in the cells of the cervix (neck of the womb or uterus) known as CIN. Not all women with these types of HPV develop changes in the cells of the cervix, but this information is about how HPV can affect the cervix in some women.

It should be noted that the HPV types which cause genital warts are not the same as the HPV types that can cause CIN.

Why is HPV important?
When certain types of HPV affect the cervix they can lead to cell changes called cervical intra-epithelial neoplasia (CIN). This is not a cancer, but in some women can develop into cancer over a number of years if it is left untreated.
Treatment for CIN is very effective, and the risk of CIN coming back after treatment is low.

For many people HPV infection is temporary and most people affected will not have any lasting cell changes.

How is HPV spread?

HPV in the genital area is spread through skin contact, mainly during sexual contact. The virus can affect both men and women. Many people do not have any symptoms and are unaware that they have HPV. For some people, with particular types of HPV, visible warts occur. The virus may be inactive for weeks, months and, for some people, possibly even years after infection.

Often, exactly how a person gets the virus is uncertain; and it is not always possible to find a sexual explanation. Some people believe that there may be other ways of spreading the virus that have not yet been identified

How is HPV diagnosed?
A woman may be told that she has HPV when she receives her cervical smear result. If a HPV infection is present, changes in the appearance of the cells can sometimes be seen when they are looked at under a microscope after a smear.

Some women with particular types of HPV may notice visible warts, which appear as flat smooth small bumps, or larger `cauliflower' like lumps. Warts do not lead to cancer and may appear on their own or in groups. They may itch, but are usually painless. HPV only produces visible warts in around 30% of people, leaving 70% of people with HPV who have no signs of the infection.

Three main tests exist for the HPV types that cause abnormal smears. One of these is called ‘PCR’ and looks at the genetics of the HPV virus for individual types. One test currently looks at 35 different types. Another is called ‘hybrid capture 2’ which tests for a group of high risk type wart viruses. Another test looks at something called mRNA expression which is the production of the cancer promoting protein of the HPV virus.

Most women with a positive wart virus test need no treatment at all. The HPV virus usually goes way on it’s own. If you need treatment following colposcopy you will usually be treated without a night stay and usually in the clinic setting.

Treatment is 95% successful in the first instance and nearly 100% successful in total.

After treatment you will need regular check-ups to make sure that the cervix is healthy again. You may need annual smears for up to ten years afterwards.

HPV and cancer
HPV is most commonly contracted through sexual contact. However, it is not always possible to find a sexual explanation. Sometimes a diagnosis relates back to sexual contact over fifteen years earlier. It is extremely common with over 80% of women having contacted it at some time in their life. Most women do not get cancer and the development of cancer from HPV involves a series of genetic and immunological processes that are not fully understood.

The future
Vaccines are currently being developed for HPV and one has recently been released. This is available at the Sloane Street Clinic. Please see the link to the vaccine.

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Colposcopy, colposcopic treatment, the colposcopy examination, wart virus, and HPV are discussed on this page.



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