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What is HPV?

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HPV stands for human papilloma virus. It is a sexually transmitted virus that is extremely common - with four in five people exposed to the virus at some point in their lives.

What can HPV infection do?

HPV infection can cause changes to the cells of the cervix creating abnormalities in some women. HPV attacks the basal cells of the cervix (these are specific cells found in skin that reproduce new skin cells) which can affect the DNA in the cells causing new cells to be abnormal.

These abnormalities can result in the production of damaged and disorganised cervical cells that cannot function correctly. Once these abnormalities become severe, they can develop into cancer which is why cervical screening and HPV vaccination are important in helping to prevent cancer.

Key facts

  • HPV can infect men and women. In women it may lead to cervical cancer and for men and women it may lead to cancer of the anus or mouth cancer.
  • 99.7% of cervical cancers are caused by HPV.
  • Anyone who is sexually active can be infected with HPV at some time. The body’s immune system will usually clear the virus on its own, with most people not even knowing they have contracted the virus.
  • A small percentage of women do not clear the infection and it can remain ‘dormant’ (inactive) or persistent in their bodies, sometimes for many years.
  • For the 10% to 15% that do not clear the HPV virus automatically, infection may become persistent.
  • It is still not understood why some women are able to clear the infection while in others, the virus may lead to the development of abnormal cells and possibly cervical cancer.
  • Abnormal cells found through cervical screening are not cancerous, but over time they may go on to develop into cancer.
  • Over 10-15 years a small number of women with abnormal cells will progress to CIN 2 & 3, which are referred to as “pre-cancerous”
  • Even at this pre-cancerous stage, treatment is very successful and prevents the progression to cancer. If not treated, the cells will go onto develop into a cervical cancer. If diagnosed at this late stage, very aggressive treatment in the form of radical surgery with chemo and radiotherapy is required.
  • Around 13 high-risk types of HPV are responsible for causing cervical cancers. Within the high–risk group types 16, 18 and 45 are the most prevalent, causing over 70% of cervical cancers.
  • For younger women, the HPV vaccination can help prevent seven out of ten cervical cancers.

Testing for HPV

HPV testing has been introduced in some parts of the UK as part of the National Cervical Screening Programme. The HPV test is carried out using the same sample of cells taken during a cervical screening test. In the NHS laboratory the cells are analysed for current HPV infection.

In the laboratory, the sample of cells is analysed for high risk HPV infection. If the cells have been infected with high-risk HPV, the test will give a positive result for high-risk HPV types.

There are 13 types of high risk HPV that cause cervical cancer. Our test reports on all 13 types, with HPV 16 & 18 being reported individually because they cause approximately 70% of all cervical cancers, and all other types of HPV (31, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68) reported as a group. The reason that subtypes 16 & 18 are reported separately is that they cause the majority of cervical cancers and, if they are absent, then HPV vaccination to prevent future infection with HPV 16 or 18 is possible. If diagnosed with a high-risk subtype other than 16 or 18, the report will not identify exactly which one of these subtypes is present as the management is similar for all high-risk subtypes.

A publication from Sargent et al shows that in women, persistent infection with the virus becomes less common as women get older. It is very common in younger women, and this is the main reason that HPV testing is not recommended in women under 25 years of age.

The best time to test for HPV is 1 week or more after last menstruation. This is when the most accurate HPV concentration is found.

The importance of testing for HPV

The HPV test is important because it identifies women with a high-risk type of HPV. If a woman contracts high risk HPV and this becomes a persistent infection then she has a higher possibility of developing abnormal cells and thus should be monitored more closely to reduce her risk of developing cervical abnormalities and cervical cancer.

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