Epidemiology

HPVs are readily spread by sexual intercourse; a single sexual exposure to an infected person transfers the infection 60% of the time. Asymptomatic individuals infected with HPV can transfer the virus to others. Forty-six percent of women university students seeking routine gynecological examinations were found to be infected

25.7 Viral STDs 655

Table 25.14 Papillomavirus STDs

Symptoms

Many have no symptoms. Warts of the external and internal genitalia the most common symptom

Incubation period

Usually 3 months (range, 3 weeks to 8 months)

Causative agents

Human papillomaviruses, many types, small, non-enveloped double-stranded DNA viruses of the papovavirus family. Different types infect different tissues and produce different lesions

Pathogenesis

Virus enters epithelium through abrasions, infects deep layer of epithelium; establishes latency; cycles of replication occur when host cell begins maturation; cancer-associated viral types can integrate into the host cell chromosome, cause precancerous lesions

Epidemiology

Asymptomatic individuals can transmit the disease; 60% transmission with a single sexual contact; multiple sex partners the greatest risk factor; warts can be transmitted to the mouth with oral sex, and to newborn babies

Prevention and treatment

Latex condoms advised to minimize transmission. Avoidance of sexual contact with those having multiple sex partners. Pap tests at least yearly for sexually active women. Wart removal by multiple techniques, does not cure the infection. Imiquimod useful in treating multiple warts about anus and external genitalia

with HPV in one study. HPV infection is the most common reason for an abnormal Papanicolaou test in teenage women. A history of having multiple sex partners is the most important risk factor for acquiring genital HPV infection. Warts can develop in the mouth from HPV infection transferred by oral sex.

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