About HPV
What is HPV?
HPV is a common virus which affects people of all genders. Around four in five Australians will get HPV at some point in their lives. HPV is named by the warts (papillomas) some HPV types can cause.[1] Some other HPV types can lead to cancer. These cancers include cervical cancer (cancer of the cervix which is the lower part of the womb), and cancers of the genital area, anus (back passage), mouth and throat.[2]
There are over 100 types of HPV, they vary according to the site of infection. Around 40 types infect the anogenital area, they are known as genital HPV.
[3] Depending on their ability to cause cancer, the HPV types are classified as low risk or high risk.
HPV is known to cause a variety of cancers.
Within three years of introducing HPV vaccination in Australia, we have seen a decline in the spread of viruses.
In Australia, the HPV vaccine is routinely available for young people in high school.
The Australian Cervical Cancer Foundation has an awareness program called HPV & Me which empowers high school students with preventive strategies to reduce the health risks associated with the Human Papillomavirus (HPV). See the program here, including Teacher information and Student FAQs
HPV Symptoms
Most HPV infections cause no symptoms and are cleared naturally from the body in one to two years.
Low risk genital HPV types (including types 6 and 11) can cause genital warts. Genital warts do not cause cancer. Infections caused by these HPV types are usually cleared from the body within a short time.
High risk types (including types 16 and 18) have a higher risk of significant cell changes which can progress to cancer if not discovered and treated. Infections with these HPV types remain in the body for a long time. HPV related cancers can take up to ten years to develop.
How HPV Spreads
HPV is spread by skin to skin contact via tiny breaks in the skin. Genital HPV is spread through intimate genital contact.[4] You can be exposed to HPV as soon as you become sexually active even with just one partner. People with HPV infection may not realise they have it and can continue spreading it to others.
People with multiple sexual partners are at increased risk of developing HPV.
It is not very common but sometimes a pregnant people can pass HPV to their baby during delivery. The child could develop a dangerous condition where warts develop inside the throat.
[5]
HPV Complications
Oral and upper respiratory lesions
Some HPV infections cause lesions (wounds) of the tongue, tonsils, soft palate (back part of the roof of the mouth), or within the larynx (voice box) and nose.
Cancer
Certain strains of HPV can cause cervical cancer. These strains may also contribute to cancers of the genitals, anus and upper respiratory tract (nose, mouth, throat and voice box).
[6]
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6. Mayo Clinic Diseases and Conditions HPV infection Diagnosis and Treatment 15 May 2021 (Accessed 29 August 2021)
HPV Prevention
Vaccination
Two HPV vaccines are registered for use in Australia:
Gardasil 9 and Cervarix
Vaccinating against HPV with Gardasil (4vHPV) provides effective protection against HPV types 6, 11, 16 and 18. HPV types 16 and 18 cause up to 80% of all cervical cancers and 90% of HPV-related cancers in males. HPV types (6 and 11) cause 95% of genital warts in people of all genders.
[7]
Gardasil 9 replaces Gardasil in the 2018 National Immunisation Program (NIP). Gardasil 9 includes the HPV types covered by Gardasil (6, 11, 16 and 18) plus an additional five cancer producing HPV types (31, 33, 45, 52 and 58). These five HPV types cause an additional 15% of all cervical cancers above those caused by HPV 16 and 18.
[8]
Gardasil 9, HPV vaccine is free at school for young people aged 12-13 years through the National Immunisation Program. This is the best time to vaccinate before individuals become sexually active. If individuals have become sexually active and they have been infected with any of the nine types of HPV then vaccination will be less effective in reducing cancers and other diseases. This age group also has an improved immune response to the vaccine compared to older teenagers.
[9] There is also a catch up program for people aged 9-18, funded by the NIP (for first 2 doses only).
Cervarix, which protects against HPV 16 and 18 is available on private prescription.
Pap Tests/ HPV tests
The best way to prevent cervical cancer is to have the HPV vaccine at 12-13 years of age and then regular pap tests from 18 years of age or two years after first sexual activity whichever comes later. Pap tests can detect abnormal cells before they become cancerous so that they can be treated.
However, from 1st December 2017, under the renewed National Cervical Screening Program, the two-yearly Pap test for those aged 18 to 69 years will change to a five yearly human papillomavirus (HPV) test for people aged 25 to 74 years.
[10]
Condoms
Condoms offer some but not complete protection against HPV as they do not cover all parts of the genital area.
Vaccine safety
Immunisation against HPV is safe and effective. Side effects after immunisation are usually mild and transient (occurring in the first few days after vaccination). Side effects may include: pain, swelling and redness around the injection site, mild fever, headache or nausea.
[11]
Over nine million doses of the HPV vaccine have been given in Australia and over 200 million doses have been given worldwide. Studies continue worldwide and no serious side effects have been found.
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7. Australian Government of Australia Immunize Australia Program About Immunization Human Papilloma Virus (page last update 29 September 2019)
8. Australian Government Department of Health Australian Technical Advisory Group on Immunisation (ATAGI) Clinical Practice Introduction of Gardasil 9 in a 2-Dose Schedule Under the School-Based National Immunisation Program (NIP) 18 December 2017
9. Reisinger KS, Block SL, Lazcano-Ponce E, et al. Safety and persistent immunogenicity of a quadrivalent human papillomavirus types 6, 11, 16, 18 L1 virus-like particle vaccine in preadolescents and adolescents: a randomized controlled trial. Pediatric Infectious Disease Journal 2007;26:201-9.
10. Australian Government Department of Health National Cervical Screening Program (page last updated 19 January 2021)
11. Lu B, Kumar A, Castellsagué X, Giuliano AR. Efficacy and safety of prophylactic vaccines against cervical HPV infection and diseases among women: a systematic review and meta-analysis. BMC Infectious Diseases 2011;11:13.
