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Paul A. Offit, MD, explains the widespread nature of human papillomavirus (HPV) and how it can be detected.
Paul Offit: Hi, my name's Paul Offit. I'm talking to you today from the Vaccine Education Center at The Children's Hospital of Philadelphia.
Given that human papillomavirus is as common as it is; given that we know that human papillomavirus can cause not only anal and genital warts but cancer, I think any person can reasonably ask the question, “How can I know whether or not either me or my partner are infected with HPV and, therefore, have a chance to do something about it?”
Well, the answer to that is this: Most people never know they're infected with HPV. The reason is that it's commonly transmitted from one person to the next — 80 percent of people will eventually be infected with HPV, and most people will never know it because they'll never develop symptoms. They'll shed virus from the genital tract for months, and then they'll stop shedding the virus, and they'll never know they were infected.
Probably the best single way to know whether you're infected is to do a test specific for human papillomavirus. Those tests, which have the fancy name PCR, which stands for polymerase chain reaction, are able to detect in say cervical fluid or semen for example that there is a presence of HPV genome. So, those … that's a very specific test, and very rarely actually do people get that test because for the most part there's no reason to get it.
The third way, and again this is sort of falls under the category of closing the door after the horse has already escaped the barn, is the so-called Pap test, which stands for Papanicolaou. This was developed by a Greek physician many decades ago who realized that as one is infected for example, now we know with human papillomavirus, that there's a progression, really, of these cervical cells or cells that line the cervix from, really, what are sort of mild changes to moderate and then to severe changes — all on the road to developing cancer.
What Dr. Papanicolaou realized in his test, the Pap test, show is that very early on you can start to see some of these changes before it gets to more moderate or severe changes that, frankly, are cancer. It's kind of so call precancerous lesions. And so if you have those precancerous lesions by … as seen by the Pap test, what that tells you is then you need obviously to discuss with your physician what the best next steps are, but that's what a Pap test is.
So, a Pap test tells you that not only have you been infected with HPV, but the HPV you've been infected with hasn't left your body; it's still continuing to cause harm, which is to say that it's causing cells to be transformed, i.e., on the road to cancer, and so that needs to be taken care of.
But, you know, certainly there are people who have negative Pap tests that still are infected with HPV because the Pap test only tells you that you've been infected with HPV and the HPV is already on the road to cancer. Obviously, not everyone, frankly most people who are infected with HPV don't have cells that are transformed and on their way to cancer. So, a negative Pap test doesn't mean you're not infected with HPV, it just means that if you've been infected with HPV, it hasn't caused the cells of your cervix to change.
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Vaccine Education Center