Human Papillomavirus (HPV)

Another virus that is sexually transmitted is the human papillomavirus (HPV), which causes genital warts, also called condylomata acuminala. These genital warts may occur in the urogenital, perineal, or anal areas, and may be either external or internal. The population at risk seems to be teenage girls or young women in their twenties. In the United States, it is estimated that there are approximately 1 million new cases of genital warts identified every year, and as many as 24 million already infected with HPV (NIAID and NIH, July 1998b). The incubation period for genital warts appears to be approximawly 1 to 2 months, but may be up to 6 months. Unlike genital herpes, genital warts are usually painless, soft fleshy growths appearing most commonly in the genital area. Sometimes many warts may grow together to form a large cauliflower-shaped growth. The greatest health threat that HPV poses to a female client is the predisposition to the development of cervical cancer. Although there are over 60 different types of HPV, only 6 of those have been associated with the development of cervical cancer. Cigarette smoking has been linked to the development of cancerous cervical changes in women with HPV. Women who have HPV should be advised not to smoke. HPV appears to play a role in the development of cervical cancer, along with many other factors. An abnormal Pap test may be the first indication of HPV. Genital warts are less common in men. If seen, they are usually on the lip of the penis.

hpv-genital-warts

 

Medical—Surgical Management
Since genital warts are caused by a virus, there is no cure for the disease. The focus is on preventing the spread of the disease to sexual partners, and reducing the possibility of cancer. Use of a condom during sexual intercourse may provide some protection. Once the genital warts disappear, the disease may lie dormant for many years until there is a recurrence of the outbreak.

Surgical
The warts may be removed under local anesthesia. This is especially recommended if the warts have formed a large fleshy cauliflower-like growth. Freezing the warts off with cryosurgery, or surgical use of extreme cold, is the treatment of choice for small warts. The warts may also be removed with laser surgery, or cauterized. Whatever treatment is recommended, it mu.st be remembered that the treatment will not cure HPV, but only provide a palliative effect. The warts may recur after any treatment.

Pharmacological
A topical solution of podophyllum resin (Poddoen) may be applied to the genital warts. It is only recommended for treatment of I or 2 lesions at a time, since it can be toxic if applied to too large an area at one time. Most people report experiencing a good deal of pain from the treatment. After the solution has been in contact with the genital warts for a period of 4 to 6 hours, it is then washed off with soap and water. If not thoroughly washed off, podophyllum may cause
chemical burns that 1w-al very slowly and are very painful. This therapy must not be used on a diabetic client, a client with poor circulation, or a pregnant client.