Table of contents:
- Human papilloma virus (HPV, genital warts)
- Transmission path
- Diagnosis & Therapy
- Pregnancy & breastfeeding
Human papilloma virus (HPV, genital warts)
More than 30 types of the human papilloma virus (HPV) infect the genital tract, the main triggers of genital warts (also called genital warts, condylomata acuminata, anogenital warts) are types 6 and 11. Approximately half of all sexually active people are infected with at least detectable with one HPV type. The majority of these infections go unnoticed without symptoms and are benign. Only five percent of all infections can be diagnosed using cytology (cell culture) and colposcopy (viewing the vagina and the cervix under magnifying glass). In some women, an HPV infection leads to the development of cervical cancer after a period of one to several decades, in men to the development of penile cancer. However, other types of HPV are responsible for this…
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- Transmission path
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It is most commonly transmitted through sexual contact. Human papilloma viruses can also be transmitted through simple (skin) contact (smear infection), as well as through transmission from mother to child during birth. HPV transmission can occur both with the presence of warts and without visible warts.
The risk of HPV infection can be reduced by using condoms during sex. Several HPV vaccines are available in Austria. You can prevent cervical cancer and its precursors as well as genital warts, cancer precursors of the vulva and the anal region. The Austrian vaccination plan of the Federal Ministry for Health and Women recommends the vaccination of all girls and women between nine and 40 years of age. The Austrian Cancer Aid, the Austrian Society for Gynecology and Obstetrics and the Working Group on Sexually Transmitted Diseases of the Austrian Society for Dermatology also recommend vaccinations.
Boys between the ages of nine and 15 can also be vaccinated to prevent genital warts (condylomata acuminata), which affect men and women alike.
Ideally, the HPV vaccination should be given before the start of sexual activity, as this can prevent infection from the outset and the vaccination is most effective in young people. However, vaccination also makes sense in adulthood. Vaccination of people of both sexes is effective in breaking the chain of infection. A full vaccination consists of three parts, each given in the upper arm.
See HPV vaccination for more information.
Genital warts are flat, smooth to velvety, skin-colored or whitish-brownish nodules (papules) in the genital area that can affect men and women equally. In most cases they do not cause any symptoms; they are rarely associated with itching, burning, bleeding, pain or sexual dysfunction (dyspareunia).
HPV infection usually heals on its own. However, some women can become chronically infected with HP viruses, which over time can lead to cell changes and subsequently to cancer precursors. An infection with HPV 16 and 18 in particular favors the development of cervical cancer (cervical carcinoma).
Note Cancer precursors can be detected by a cancer smear carried out annually by a specialist in gynecology and obstetrics as part of the preventive examination. This annual check-up plays an important role in the early detection of cervical cancer. Every year in Austria at least 400 women develop such cervical cancer, and ten times more have to undergo surgery for precancerous stages.
Diagnosis & Therapy
The diagnosis is based on the typical symptoms. In addition, histology, PCR and hybridization techniques are available. The aim of every treatment is to remove the visible genital warts and improve the uncomfortable symptoms. None of the available therapies will eliminate the virus from the body. Basically, the earlier the therapy starts, the more effective it is. Smoking can negatively affect the success of therapy. Various treatment options for genital warts are available, depending on the extent and location (and the patient's wishes). Some are done in a clinic or doctor's office, others are local prescription remedies that need to be used at home for several weeks:
Therapy by a doctor (can lead to faster healing of the warts):
- Surgical removal (electrosurgery, scissors cutting, curettage, laser),
- Local application of trichloroacetic acid to the wart
- Cryotherapy (freezing with liquid nitrogen).
Therapy at home ( must not be used during pregnancy):
- Podophyllotoxin cream or solution: about six weeks,
- Imiquimod crème: up to 16 weeks,
- Green tea leaf extract ointment: up to 16 weeks.
Note While you have warts, it is advisable to always use condoms to avoid infecting a new partner. It is recommended to use condoms for at least three months after therapy to reduce the risk of HPV infection.
Pregnancy & breastfeeding
Local therapy with podophyllotoxin is not recommended during pregnancy. Surgical local therapy is not recommended during pregnancy. Surgical removal is recommended during pregnancy weeks 33 to 35 or during breastfeeding under local or regional anesthesia using a laser. Very small, isolated lesions have a high probability of spontaneous healing after childbirth. In principle, spontaneous delivery is the first choice of delivery mode after surgical rehabilitation, as the risk of infection for the newborn is extremely low. Most children are born healthy even though the mother had genital warts. Very rarely, newborns who have been exposed to HPV during birth may develop warts in the throat or genital area.This is rare, so women with genital warts do not need a caesarean section.