1. Minnesota Department of Health
Human Papillomavirus (HPV)

2. Minnesota Department of Health
What is HPV Infection?
Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection in the United States.
There are more than 40 HPV types that can infect the genital areas of males and females.
These HPV types can also infect the mouth and throat.
Source CDC, 2011

3. Minnesota Department of Health
What is HPV Infection?
Most people who become infected with HPV do not even know they have it.
At least 50% of sexually active people will have genital HPV at some time in their lives.
HPV is not the same as herpes or HIV (the virus that causes AIDS) even though it is sexually transmitted.
Source CDC, 2011

4. Minnesota Department of Health
HPV

5. Minnesota Department of Health
Symptoms and Pathogenesis
Source : CDC

6. Minnesota Department of Health
Most people with HPV do not develop symptoms or health problems from it.
In 90% of cases, the body’s immune system clears HPV naturally within two years. 
The types of HPV that can cause genital warts are not the same as the types that can cause cancers.
Source CDC

7. Minnesota Department of Health
There is no way to know which people who get HPV will go on to develop cancer or other health problems.
Source CDC

8. Minnesota Department of Health
But, sometimes, HPV infections are not cleared and can cause:
Genital warts
Rarely, warts in the throat
Cervical cancer and other, less common but serious cancers( cancers of the vulva, vagina, penis, anus, and back of throat).
Source CDC

9. Minnesota Department of Health
Genital warts usually appear as a small bump or group of bumps in the genital area.
Warts can appear within weeks or months after sexual contact with an infected partner (even with asymptomatic infected partner).
Untreated genital warts might go away, remain unchanged, or increase in size or number.
They will not turn into cancer.
Source CDC

10. Minnesota Department of Health
Cervical cancer usually does not have symptoms until it is quite advanced.
It is therefore important for women to get regular screening for cervical cancer.
Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.
Source CDC

11. Minnesota Department of Health
Recurrent Respiratory Papillomatosis (RRP) is a condition in which warts grow in the throat.
When this occurs in children it is called juvenile-onset RRP (JORRP).
These growths can sometimes block the airway, causing a hoarse voice or troubled breathing.
Source CDC

12. Oral warts

13. warts

14. warts

15. Mouth Cancer from HPV

16. Minnesota Department of Health
Epidemiology

17. Minnesota Department of Health
Approximately 20 million Americans are currently infected with HPV.
6 million people become newly infected each year.
HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.
Source CDC

18. Minnesota Department of Health
Genital warts: about 1% of sexually active adults in the U.S. have genital warts at any one time.
RRP: is very rare, less than 2,000 children get juvenile-onset RRP every year in the U.S.
Cervical cancer: each year, about 12,000 women get cervical cancer in the U.S. Almost all of these cancers are HPV-associated.
Source CDC

19. Minnesota Department of Health
Other cancers that can be caused by HPV are less common than cervical cancer.
Each year in the U.S., there are about:
1,500 women who get HPV-associated vulvar cancer
500 women who get HPV-associated vaginal cancer
400 men who get HPV-associated penile cancer
Source CDC

20. Minnesota Department of Health
Each year in the U.S., there are about:
2,700 women and 1,500 men who get HPV-associated anal cancer
1,500 women and 5,600 men who get HPV-associated oropharyngeal cancers.
Source CDC

21. Minnesota Department of Health
Gay bisexual men, and people with weak immune systems (including those who have HIV/AIDS) are at higher risk for some HPV-related health problems.
Source CDC

22. Human Papillomavirus—Prevalence of High-risk and Low-risk Types Among Females Aged 14–59 Years, National Health and Nutrition Examination Survey, 2003–2006
50–59
40–49
30–39
25–29
20–24
14–19
Low-risk HPV*
Prevalence, %
High-risk HPV*
Age 10 20 30 40 50 60
* HPV = human papillomavirus.
NOTE: Error bars indicate 95% confidence intervals. Both high-risk and low-risk HPV types were detected in some females.
SOURCE: Hariri S, Unger ER, Sternberg M, Dunne EF, Swan D, Patel S, et al. Prevalence of genital HPV among females in the United States, the National Health and Nutrition Examination Survey, 2003– J Infect Dis. 2011;204(4):566-73

23. Genital Warts—Initial Visits to Physicians’ Offices, United States, 1966–2010
100
200
300
400
500
2008
2005
2002
1999
1996
1993
1990
1987
1984
1981
1978
1975
1972
1969
1966
Visits (in thousands)
Year
NOTE: The relative standard errors for genital warts estimates of more than 100,000 range from 18% to 30%.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.

24. STD Surveillance Network (SSuN)—Genital Warts—Prevalence Among Sexually Transmitted Disease (STD) Clinic Patients by Sex, Sex of Partners, and Site, 2010
Philadelphia
Baltimore
Richmond
New
Orleans
Chicago
Denver
Seattle
Los
Angeles
San
Francisco
MSW*
MSM*
Percentage
Women 3 6 9 12 15
Birmingham
New York City
Hartford/ New Haven
* MSM = men who have sex with men; MSW = men who have sex with women only.

25. Genital Herpes—Initial Visits to Physicians’ Offices, United States, 1966–201050
100
150
200
250
300
350
400
Visits (in thousands)
Year
2008
2005
2002
1999
1996
1993
1990
1987
1984
1981
1978
1975
1972
1969
1966
NOTE: The relative standard errors for genital herpes estimates of more than 100,000 range from 18% to 30%.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.

26. Herpes Simplex Virus Type 2—Seroprevalence in Non-Hispanic Whites and Non-Hispanic Blacks by Age Group, National Health and Nutrition Examination Survey, 1976–1980, 1988–1994, 1999–2004, 2005–2008
1976–1980
1988–1994
1999–2004
2005–2008 20 40 60 80
100
40–49
30–39
20–29
14–19
All Ages*
Percentage
Non-Hispanic Whites
Age
Non-Hispanic Blacks
* Age-adjusted by using the 2000 U.S. Census civilian, non-institutionalized population aged 14–49 years as the standard.
NOTE: Error bars indicate 95% confidence intervals.

27. Minnesota Department of Health
Risk factors

28. Transmission
HPV is passed on through genital contact, most often during vaginal and anal sex.
HPV may also be passed on during oral sex and genital-to-genital contact.
HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.
Source CDC

29. Transmission
A person can have HPV even if years have passed since he or she had sexual contact with an infected person.
Most infected persons are unaware of their infectiousness and capacity to infect their sex partner.
It is also possible to get more than one type of HPV.
Source CDC

30. Transmission
Rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery.
Very rarely, the child can develop symptoms
Source CDC

31. Minnesota Department of Health
Prevention

32. The vaccines are most effective when given at 11 or 12 years of age.
Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer.
These vaccines are given in three shots. It is important to get all three doses to get the best protection.
The vaccines are most effective when given at 11 or 12 years of age.
Source CDC

33. These vaccines can also be given to girls beginning at 9 years of age.
Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers.
Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger.
These vaccines can also be given to girls beginning at 9 years of age.
Source CDC

34. This vaccine is available for boys and men, 9 through 26 years of age.
Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers.
This vaccine is available for boys and men, 9 through 26 years of age.
Source CDC

35. For sexually active individuals: condoms may lower the risk of HPV
For sexually active individuals: condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish.
Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer.
But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.
Source CDC

36. But even people with only one lifetime sex partner can get HPV.
People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners.
But even people with only one lifetime sex partner can get HPV.
That's why the only sure way to prevent HPV is to avoid all sexual activity.
Source CDC

37. Minnesota Department of Health
Treatment

38. Minnesota Department of Health
There is no treatment for the virus itself, but there are treatments for the diseases that HPV can cause:
Visible genital warts:  can be removed by the patient him or herself with prescribed medications.
Cervical cancer:  is most treatable when it is diagnosed and treated early. But women who get routine Pap tests and follow up as needed can identify problems before cancer develops.
Source CDC