Persistent HPV explained

Human papillomavirus (HPV) is one of the most prevalent sexually transmitted infections (STIs) worldwide. While most HPV infections will resolve on their own, some types can lead to chronic infections.

Dr Karin Hellner, leading consultant gynaecologist, provides an expert insight into the key aspects of persistent HPV, discussing its symptoms and treatment.

What is persistent HPV?

HPV is a group of over 200 related viruses, some of which can cause genital warts, while others can lead to various cancers, including cervical cancer. Persistent infections with HPV refers to the maintenance or reactivation of the virus in people who have previously been infected.

When you are infected with HPV, the virus may remain dormant in your body, particularly within the skin or mucous membranes. While your immune system can sometimes suppress the virus, it’s possible for it to reactive later.

The symptoms of persistent HPV largely depend on the specific type of HPV present. Certain strains of HPV can lead to genital warts, which may recur after a period of dormancy. On the other hand, if the virus causes abnormal cell changes, this may lead to serious conditions, such as precancerous lesions or cervical cancer.

How is persistent HPV detected?

Several methods are involved, primarily focused on identifying symptoms and conducting appropriate screening tests. If you notice the return of genital warts or other unusual symptoms, you should seek medical advice from a specialist, such as a gynaecologist.

A gynaecologist will perform a physical exam to identify visible warts or lesions. In cases where there is suspicion of cervical changes, a cervical smear will typically be performed, which involves collecting cells from the cervix to check for abnormalities.

If abnormal cells are detected, further testing may be conducted, such as a colposcopy. This is a procedure which involves using a specialised magnifying instrument to closely examine the cervix for any indications of abnormality. If necessary, a biopsy may be performed to collect tissue samples for additional analysis.

What are the treatment options for persistent HPV?

Treatment options largely depend on the symptoms and the type of HPV involved. If you experience genital warts, several effective treatment methods are available to remove them, including:

• Topical treatments: Prescription medications like Imiquimod, Podophyllin, or Trichloroacetic Acid work by stimulating the immune system or directly destroying the wart tissue.
• Cryotherapy: This method involves applying liquid nitrogen to freeze the warts.
• Laser therapy: For larger or more resistant warts, laser treatment may be recommended to vaporise the wart tissue.
• Surgery: In cases where warts are extensive or recurrent, surgical excision may be necessary.

If abnormal cells are detected during a cervical smear, your gynaecologist may recommend a loop excision (LLETZ) to remove the affected tissue from the cervix to prevent the progression to cervical cancer.

Can HPV be prevented?

Preventing persistent HPV is challenging, as the virus may remain dormant in the body. However, there are various ways to lower the risk.

The HPV vaccine is among the most effective methods for preventing infection. The vaccine is most effective when administered before exposure to the virus, typically to adolescents, but it can still offer protection for adults against certain high-risk strains of HPV.

Practising safe sex is another important step. Consistently using condoms during sexual activity can help lower the risk of transmitting or contracting new strains of HPV.

Finally, maintaining a strong immune system can help the body control the virus and reduce the likelihood of recurrence. Regular exercise, a balanced diet, not smoking, and managing stress can all contribute to better immune function.

If you would like to book an appointment with Dr Karin Hellner, head on over to her Top Doctors profile today.