HPV: An Updated Guide to Treatment and Prevention

Jennifer A. Wilson, PharmD, BCACP; Rashi C. Waghel, PharmD, BCACP

Disclosures

US Pharmacist. 2015;40(9):HS-22--24. 

In This Article

Abstract and Introduction

Abstract

Human papillomavirus (HPV) infection, a prevalent issue that affects both males and females, presents in many forms (e.g., plantar warts, anogenital warts, dysplasia/neoplasms) based on location and genotype. Sexually transmitted HPV infections are typically self-limiting; however, treatment options do exist for patients experiencing bothersome symptoms. Some genotypes are responsible for the development of various cancers, most commonly cervical cancer. Current screening recommendations are intended to help with early identification of cervical cancer. Strategies aimed at reducing HPV transmission and infection include vaccination and safe sexual practices.

Introduction

Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) in the United States. According to the CDC, most of the sexually active population are infected with HPV at some point in their lives.[1] However, most individuals who are infected with HPV are asymptomatic, as <1% present with active lesions.[2] There are many different genotypes of HPV (>100 types), which can manifest differently after infecting the epithelium of the skin and mucous membranes. Location also affects presentation of the infection. Common manifestations of HPV include plantar warts, anogenital warts, and dysplasia/neoplasms.[3] Dysplasia, along with additional risk factors, can potentially result in cancer.[2,3]

HPV types 16 and 18 are associated with multiple types of cancer including cervical, anogenital (penile, vulvar, vaginal, anal), and oropharyngeal.[4] Types 16 and 18 are responsible for 70% of cervical cancers, whereas types 6 and 11 are responsible for 90% of anogenital warts.[3] This review will focus specifically on sexually transmitted HPV manifestations.

Most HPV infections and resulting lesions are self-limiting and resolve on their own in 1 to 2 years; therefore, treatment is often not required.[2] The CDC does not recommend any specific antiviral therapy for asymptomatic or subclinical infection.[4] However, there are a number of treatments available for symptomatic or bothersome lesions, none of which are curative in nature.[3] Current treatment methods vary depending on manifestation and location. Selection of therapy can also be dependent on patient preference, cost, and failure of previous therapies.

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