HPV Types 6 and 11… leading to genital warts.
As we have discussed in the two previous blog entries, HPV is a cutaneous virus, or a skin-to-skin virus that is predominately transmitted through sexual contact via vaginal/penile penetration, digital penetration, oral sex, and shared devices. Although sexual contact is the primary route of transmission, also as mentioned previously there are studies that show the HPV virus may be spread in other ways.
HPV types 6 and 11 account for greater than 90% of all external genital warts with an infection rate of anywhere between 40-80% when there is a visible lesion or wart. There is very little data on the transmission of genital warts in the absence of a current visible outbreak. However, many women have no idea that they currently have an outbreak, which makes it more difficult to reduce transmission to others. Obvious signs of genital warts typically appear approximately 6-8 weeks from exposure but data shows that as many as 2/3 of women exposed to HPV will have their first clinical symptoms anywhere between 3-36 months.
Prevention of contracting genital warts resulting from HPV types 6 &11 is obtained in two ways. The first way is to receive the full three injection series of Gardasil® vaccine prior to any sexual activity and the second being a reduction in sexual partners as well as using barrier methods during any sexual contact, such as condoms. Condoms are not able to completely prevent the spread of HPV, especially if the warts on you or your partner are in an area that a condom is not able to cover.
There are a couple of different ways to treat external genital warts; treatments provided by the physician and/or the patient. Patients are often prescribed a cream to apply to the affected area either a couple of times a day or a couple of times a week, depending on the brand. The nice thing about patients having access to treatment is that it reduces the number of office visits and reduces the need for surgical procedures. The location, severity, and compliance of the patient all play a role in the efficacy of the treatment. The treatment course is typically 1-4 months depending on the brand and is 30-75% effective. There is a potential for genital warts to not respond to these therapies or to develop a recurrence of the warts in the future.
Treatments performed by the health care provider are either topical therapies applied to the warts in the office approximately every week for on average of 4 weeks or can be as extensive as outpatient surgery. Again this all depends on the location and the severity of the outbreak. There are also times in which a patient administered treatment is initially prescribed and then follow-up with a therapy from the health care provider is performed to reduce the size or quantity of the warts or sometimes cost plays a role in determining the best method of treatment. The decision on treatment should be made between the patient and the health care provider on an individual basis.
One other important bit of information regarding external genital warts is that not all warts found in the genital tract are a result of HPV and that being said, not all growths in the genital area are warts. It is necessary for a thorough evaluation to be performed by a health care provider to rule out other benign or possibly cancerous conditions.
The following websites are excellent resources for HPV and I encourage you to educate yourself about the virus and ways of prevention.
Ashastd.org
cdc.gov/std/hpv
arhp.org
acs.org
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