Human Papilloma Virus (HPV) FAQ
What is HPV?
Human papilloma virus (HPV) is a common virus that most people are exposed to at some point in their lives. There are over 100 types of HPV, and the majority of them don’t cause harm.
It is estimated that about 40 of the 100 viral types affect the genital area and can be split into two groups: low-risk and high-risk. A few of the high-risk types have been proven to be important for the development of cervical cancer. Low-risk types are not associated with cervical cancer.
How do you get HPV?
The genital human papilloma viruses are spread from person to person through sexual or intimate skin-to-skin contact.
PLEASE NOTE: Condoms provide some protection. They do not prevent all transfers because they do not cover all areas of the genital region.
Having more than one sexual partner may increase the risk of getting HPV, but it is possible to get the virus even if you have only had sexual relations with one person.
YES, men carry the HPV virus although they typically show no symptoms of the virus. There has been some link between penile and anal cancer and HPV.
How common is HPV?
In the United States, HPV is the most common sexually transmitted disease. The Centers for Disease Control and Prevention (CDC) reported that as many as 80% of adults will get a genital type of HPV by the age of 50. Of these people, only 90% will clear the virus by themselves.
Who should have an HPV evaluation done?
The American Society for Colposcopy and Cervical Pathology (ASCCP), along with 24 other professional and governmental partners, suggest the following guidelines for HPV testing:
- No HPV testing for women under the age of 21.
- After a Pap test result of Atypical Squamous Cells of Undetermined Significance (ASC-US) for women 25 and older.
- Recent guidelines (2012) suggest a split in HPV reflex testing for women ages 21-24. HPV reflex testing is acceptable, but not recommended. It is important for a woman to discuss HPV reflex testing with her clinician.
- Cotesting with the Pap test for women 30 and older.
How is the HPV test done?
The cytologic material needed for an HPV test is often collected at the same time as the Pap test. The collected material is submitted to the laboratory for processing and evaluation.
The WSLH cytology section currently uses the cobas® 4800 HPV test that has been approved by the Food and Drug Administration (FDA). It is a qualitative multiplex assay that provides detection of 14 high-risk HPV types, as well as specific genotyping information for HPV Types 16 and 18.
There are other FDA approved HPV testing methods available. After careful evaluation, the WSLH selected the cobas® 4800 system based on
- having a “housekeeping” probe that tells us there is an adequate sample;
- the ability to provide specific HPV 16/18 genotyping at the same time as the 12 other high-risk viral types; and
- being able to move to an automated platform.
How is the HPV test evaluated?
The cobas® 4800 HPV method is a molecular test that looks for certain HPV DNA patterns using probes and primers. After a series of cycles, these attachments are amplified. The amplification reaction causes light to be emitted and then measured. If there is enough “light,” the test is positive.
What does the HPV diagnosis mean?
A positive HPV test means that the patient has been exposed to one or more of the high-risk viral types. A positive HPV test DOES NOT mean that the patient has cervical cancer or will develop cervical cancer. It does mean that the risk for developing a precancerous/cancerous lesion is increased. Most women exposed to high-risk HPV viral types clear the infection within two years. The test is used to identify women who may require close follow-up using Pap and HPV tests. Depending on age and clinical history, patients with a positive HPV test and abnormal cytology may be followed yearly, or referred to colposcopy for evaluation and treatment.
What is the difference between LOW-risk HPV and HIGH-risk HPV?
The 40 HPV types that affect the genital area are divided into two groups:
- Low-risk HPV has not been linked to cervical cancer. However, low-risk HPV can cause genital warts and abnormal cervical changes. These changes most often go away on their own within two years of exposure. There is no need for low-risk HPV testing.
- High-risk HPV can cause changes in the cervix that are potentially more dangerous. They have been linked to both squamous cell carcinoma and endocervical adenocarcinoma. The Pap test and high-risk HPV test work best together to identify risk and extent of disease. Final diagnoses are made by biopsy.
According to the CDC, about 70% of new HPV infections (both low- and high-risk) go away within one year of contracting the virus. About 91% of infections dissipate within 2 years.
When the body’s immune system cannot fight off the virus, high-risk HPV contributes to abnormal cell changes called dysplasia and if left untreated may gradually develop into cervical cancer. Patients need to know that the usual progression to cervical cancer often takes 15-20 years. In this way, periodic screening is the best way to monitor patients and their cervical health.