Human papillomavirus, genital warts and anogenital cancer

Human papillomavirus (HPV) is a double stranded DNA virus. It is associated with both genital warts and anogenital cancers, and some cancers of the head and neck. 

Genital Warts 

HPV 6 and HPV 11 caused >90% of genital warts.  Warts appear between 3 weeks to 8 months from infection. 

Treatment: 

Soft, non-keratinised warts: podophyllin 

Keratinised warts: cryotherapy 

Either: imiquimod 

Patients with a small number of either type of warts are best treated with cryotherapy from the outset. 

Anogenital cancer 

The 2 main types of HPV associated with cervical cancer are HPV 16 (50% of cases) and HPV 18 (15% of cases). 

HPV 16 and 18 are also associated with up to 90% of all anal squamous cell carcinomas and around 40% of penile cancers. 

Vaccination

Girls aged 12/13 are given 3 doses of either 

• cervarix – active against HPV 16 and 18 or
• gardasil – active against HPV 6,11, 16 and 18 

References:

British Association for Sexual Health and HIV. Guidelines on management of genital warts. 2007. Available at http://www.bashh.org/guidelines 

 Department of Health. Human papillomavirus. The Green Book. 2007. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079917