Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Genital warts are caused by infection with a subgroup of the human papillomaviruses (HPVs).
Another subgroup of the HPVs that infect the anogenital tract can lead to precancerous changes in the uterine cervix and cause cervical cancer.
HPV infection is now considered to be the most common sexually-transmitted infection (sexually transmitted disease, STD) in the U.S., and it is believed that at least 75% of the reproductive-age population has been infected with sexually-transmitted HPV at some point in life.
HPV infection is common and does not usually lead to the development of warts, cancers, or even symptoms.
HPV infection of the genital tract is transmitted through sexual contact, although non-sexual transmission is also possible.
In many cases genital warts do not cause any symptoms, but they are sometimes associated with itching, burning, or tenderness.
Condom use seems to decrease the risk of transmission of HPV during sexual activity but does not completely prevent HPV infection.
What are human papillomaviruses (HPVs)?
There are over 100 types of human papillomaviruses (HPVs) that infect humans. Of these, more than 40 types can infect the genital tract and anus (anogenital tract) of men and women. Sometimes, they cause genital lesions known as condylomata acuminata or venereal warts. A subgroup of the HPVs that infect the anogenital tract can lead to precancerous changes in the uterine cervix and cervical cancer. HPV infection is also associated with the development of other anogenital cancers. The HPV types that cause cervical cancer have also been linked with both anal and penile cancer in men as well as a subgroup of head and neck cancers in both women and men. Genital warts and HPV infection are transmitted primarily by sexual intimacy, and the risk of infection increases as the number of sexual partners increases.
The most common HPV types that infect the anogenital tract are HPV types 6, 11, 16, and 18 (HPV-6, HPV-11, HPV-16, and HPV-18), although other HPV types can also cause infection. Among these, HPV-6 and HPV-11 are most commonly associated with benign lesions such as genital warts are termed "low-risk" HPV types. In contrast, HPV-16 and HPV-18 are the types found most commonly in cervical and anogenital cancers as well as severe dysplasia of the cervix. These belong to the so-called "high-risk" group of HPVs.
Other HPV types infect the skin and cause common warts elsewhere on the body. Some types of HPVs (for example, HPV 5 and 8) frequently cause skin cancers in people who have a condition known as epidermodysplasia verruciformis (EV).
Gardasil is a human papillomavirus (HPV) vaccine. Gardasil is a sterile preparation for intramuscular injection and contains purified inactive proteins from HPV types 6, 11, 16, and 18. The proteins in Gardasil are structural, virus-like proteins (VLP) that resemble the HPV virus. The proteins can activate the immune system but cannot give rise to replicating virus. Viral proteins used in Gardasil are manufactured in yeast cells (S. cerevisiae) using recombinant technology. Once released from yeast cells, the VLPs are purified, combined with a catalyst (amorphous aluminum hydroxyphosphate sulfate) and a purification buffer. Human papillomavirus causes:
genital warts, and
Gardasil works by stimulating the immune system to attack HPV types 6, 11, 16, and 18.