Human papilloma virus (HPV) is one of the fastest growing sexually transmitted diseases (STD) in America and nobody has ever heard of it. Condoms offer only limited protection and most carriers don’t know they have it. This virus takes control of cells and changes their normal rate of cellular division. It makes the cells divide faster and faster, the cells pile up and then you have a wart: HPV causes warts. In my field, it causes genital warts and is a significant cause of abnormal pap smears.

There are more than 40 types of this virus. Each type has a tendency to cause warts of a specific kind in a specific area. Foe example, type 3 causes plain old arm, hand and facial warts. Types 6 and 11 cause genital warts, but that are less likely to become cancerous than are types 13 and 16. We can type a virus if it is a recurrent problem to see if it is a "high risk" virus and possibly be more cautious with a person infected with that one than someone with a more "benign" type.

The two ways I most frequently find out that my patient has HPV are they come in with a "bump" they never had or the virus shows up on the pap smear. I also will sometimes be asked if the infection is present because a sexual partner has been diagnosed with HPV. Unfortunately, if there are no physical signs I cannot say for sure there is no infection. This is because of the way viruses work. Just like computer viruses, they can be present and do nothing until they are triggered. What trigger HPV into action? We are not sure. Smoking, for some reason, may increase the risk.

There are several ways of treating the abnormalities caused by HPV. External warts are treated with certain chemicals that dissolve them. There are also medications for vaginal warts. If the cervix is affected, frequently close observation can be satisfactory.

If the cells begin to multiply too rapidly, this is called dysplasia and is precancerous; this needs to be treated. Dysplasia can usually be treated in an office visit with freezing or with an electrical device that removes the abnormal area. There are those that consider cervical cancer to be as STD.

Treatment must be individualized to the degree of abnormality, patient desires and option for follow-up. At this time a certain cure can not be offered for this virus. We can only be observant and try not to allow the problem to get severe.