HPV Infections: What Did You Think Wrong?

These are some common misconceptions about HPV infections – infections with the human papillomavirus, some of which cause cervical cancer.

 1. Only men transmit HPV

Incorrect. Both men and women can transmit human papillomaviruses to sexual partners. A man who is a carrier of HPV got HPV from someone. If he is heteronormative, it means that he was with a woman who infected him and then he transmits the virus to the next partner. 

2. Only women can get the infection

The difference is that in men it usually passes without any major problems, while in women, epithelial cell damage, if not detected and treated in time, turns into cervical cancer. Men also have HPV infection. However, it would be incorrect to say that in men, HPV infection cannot cause cancer or condylomas/warts and other problems – men are not immune to this, so HPV infections are very common, resulting in warts on the penis, and cases of cytological changes are not rare either. , and cancer of the anus and throat. The fact that someone does not have a cervix does not mean that they cannot get an HPV infection or that they cannot get malignant changes caused by HPV. 

Both men and women are at equal risk of contacting the HPV virus.

 

3. HPV cannot be acquired during the first sexual contact

Incorrect. The truth is different – HPV infections are so widespread that many of them occur during the first sexual experience, especially if a condom was not used for protection, which increases the risk. Demographically, infections are most prevalent in the teenage population. The risk of contacting the virus increases with the number of previous partners a person has had. 

 

4. Only older women, those in menopause, get cervical cancer

Incorrect. In fact, the risk decreases at that age. The risk is highest in women in their twenties and thirties.

 

5. HPV infections are rare

Incorrect. It is true that HPV is the most common sexually transmitted infection. There are more than 100 different types of HPV, and a significant percentage of men and women are exposed to at least one type of virus during early adulthood. 4 out of 5 Americans will have an infection with one of these strains during their lifetime, that’s about 80%, and we can assume that the situation is similar around the world. Besides being a very common virus, most people never develop symptoms or health problems, and unknowingly pass the virus on to their partners. However, what for one person is a subclinical infection with which the organism can fight itself and does not lead to cytological damage, for another person it may be something that will lead to cancer.

 

6. If I have HPV, I will definitely get cancer

Incorrect. There are about 150 types of HPV, and types 16 and 18 are the most risky for the development of cervical cancer. About 70% of cervical cancer cases are caused by these two types of human papillomavirus. However, cervical cancer does not develop just like that, in a few days or months. For example, Pap smears once a year are quite enough to detect malignant changes in time. That is why we have those CIN findings of varying degrees. 

CIN 1  denotes  cervical intraepithelial neoplasia of the first degree. This name indicates the presence of abnormally (dysplastic) changed cells of the cervix, which is why this change is often called dysplasia of a lower or milder degree. In other words, it is the mildest degree of abnormal cell changes caused by the HPV virus. The next stage is CIN 2 and 3, but these are not findings of cervical cancer – these are findings that someone has a precancerous change – a change that precedes cervical cancer. That is why we need regular inspections, and we must not allow neglect. It is possible to treat precancerous changes and thus prevent difficult surgical interventions.

 

7. HPV infections occur due to a decline in immunity

This is half true. Namely, in people with serious immunodeficiencies, the risk that the organism will not fight the infection on its own is greater. Let’s repeat – our immune system does not protect us from contact with the causative agent of the disease, but it helps us to fight it. This thesis about how HPV infections occur due to a decline in immunity is probably a layman’s simplified fact that it often happens that the body fights the HPV virus on its own, but this is not the case in people with immunodeficiency. Cytological changes due to HPV infection are not only due to immunodeficiency, but also due to a number of other factors that increase the risk – if one does not regularly go for Pap (and other) gynecological examinations, if the person smokes, if the person often changes partners and if the person is entered into sexual contacts early. Therefore, it is not only immunity that we rely on. 

HPV infections occur, how can I tell you – because we were intimate with someone and did something. 

 

8. HPV is curable

This is half true. It depends on how it is taken. It is true that many people fight off an infection without even knowing they had it, and it is true that if some damage to the epithelial cells has occurred, it can be treated. But this is not always the case – everyone reacts individually and some HPV infections pass without consequences and heal, without causing cytological changes, while in another person it can have consequences. We cannot know which group we belong to. Vaccines combined with regular gynecological examinations are key to combating cervical cancer and infections with several strains of this virus. We don’t have screenings – examinations that could determine the appearance of changes in the penis on some other mucous membranes – that’s why cancer of the throat and anus often pass under the radar, unfortunately. 

 

9. The HPV vaccine only protects against cervical cancer

The HPV vaccine, especially the nine-valent vaccine, protects against infection with the types of HPV virus that the vaccine contains. The most important thing is that the vaccine protects against the two high-risk types – HPV 16 and 18 (and all three HPV vaccines that exist in the world protect against exactly these strains). However, other strains contained in the vaccine also protect us from cell changes in other parts of the body, and even from warts and cancer of the throat or anus. Let’s not forget that there is also cancer of the vulva and vagina, which are also caused by HPV infections. But the vaccine does not protect us from some other types of HPV (let’s not forget that there are about 150 of them), but again – those other types are not so dangerous. The vaccine against HPV infections does not contain viruses, but only some of their parts that initiate the immune activity of our body and the production of appropriate antibodies. The more of these types of components from different virus strains a vaccine contains, the more strains it protects against.

 

10. The HPV vaccine is neither safe nor effective

This is a total lie. The three-dose series is the most effective way to prevent HPV and is designed to expose young people to antigens from these viruses before they become sexually active, so that their bodies build up immunity before contacting the virus. 

There is a lot of scientific evidence that HPV vaccines, especially Gardasil-9, which protects against 9 forms of HPV, are safe and effective. And one of the last proofs for this is the rapid practical eradication of cervical cancer in the Australian and Nordic populations, which were vaccinated thanks to comprehensive HPV vaccination programs. A study in NEJM published in October 2020 showed a substantially reduced risk of cervical cancer, and a study in Lancet , published in June 2020, is the final analysis of the effectiveness of the HPV vaccine, which showed that in 14 years of use of this vaccine, the incidence of cervical cancer has decreased. and vaccinated persons are seropositive, i.e. they have antibodies to the HPV virus. In particular, the Gardasil 9 vaccine is proof that science works.

11. Condom protects against HPV infections

The use of condoms significantly reduces the risk of infection, but does not eliminate it. There are parts of the skin that are in contact during intercourse where the virus can still get there. There are also the problems of contacting the virus during oral sex, for which, well, we don’t believe that many people use condoms, right?