Clinical Uses of HPV Testing

Clinical Uses of HPV Testing

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650 cases of sexually-transmitted diseases reported in Dubai in 16 months

650 cases of sexually-transmitted diseases reported in Dubai in 16 months

By Nina Muslim, Staff Reporter
Published: January 27, 2008, 17:24

Dubai: Almost 650 cases of sexually-transmitted diseases were reported in the emirate in the span of 16 months, mostly among young women who caught it from their husbands.

From May 2006 to September 2007, 647 cases were seen at Al Badaa Health Centre, which is where the government-run sexually-transmitted disease (STD) clinic is located.

STD cases have also almost doubled in the four-year period between 2000 and 2003, comprising 3.64 per cent of overall medical cases in 2000 to 5.15 per cent in 2003, the latest analysis available.

The Department of Health and Medical Services (Dohms) released the statistics in the lead up to next week's conference of the International Union against Sexually Transmitted Infections and the Annual International Infectious Disease Congress.

Dr Kamal Faour, head of obstetrics and gynaecology at Maktoum Hospital, and co-chair of the conference, told the press the cases mostly comprised Emirati women in their early 30s.

"I can say the women are victims because they caught the disease from their husbands," he said.

He also said Emirati women comprised the bulk of cases because the statistics only reflected visits to public health facilities, which tend to see more locals than expatriates. The actual figure for STDs in Dubai is unknown.

"The (real) number is more because cases at private clinics and hospitals are not being reported. They are underreported because of the stigma," he said.
Dr. Faour blamed the increase of STDs, most of which are genital warts, genital herpes and gonorrhea, on ignorance and globalisation.

"People do not have awareness of the diseases because STDs are a taboo subject," he said.

"That is why we are holding the conference, to show how serious and dangerous these diseases are so that we can decrease the complications and costs of the disease."
Health complications and consequences of STDs include cancer and infertility, and could cause disability to newborns during delivery. Having an STD also increases one's chances of contracting HIV, the virus which causes AIDS.

The congress will discuss STD rapid diagnostic tests and the ethics of STD reporting. Speakers include officials from World Health Organisation and U.S.-based Centres for Disease Control.

HPV and Men - CDC Fact Sheet

Genital human papillomavirus (HPV) is a common virus. Most sexually active people in the United States (U.S.) will have HPV at some time in their lives. There are more than 40 types of HPV that are passed on during sex. These types can infect the genital areas of men, including the skin on and around the penis or anus.

What are the Health Problem caused by HPV in Men?
Most men who get HPV (of any type) never develop any symptoms or health problems. But some types of HPV can cause genital warts. Other types can cause penile cancer or anal cancer. The types of HPV that can cause genital warts are not the same as the types that can cause penile or anal cancer.Anal cancer is not the same as colorectal cancer. Colorectal cancer is more common than anal cancer, but it is not caused by HPV.

How common are HPV related health related problems in Men?

About 1% of sexually active men in the U.S. have genital warts at any one time.
Penile cancer is rare, especially in circumcised men. In the U.S., it affects about 1 in every 100,000 men. The American Cancer Society (ACS) estimated that about 1,530 men would be diagnosed with penile cancer in the U.S. in 2006.
Anal cancer is also uncommon—especially in men with healthy immune systems. According to the ACS, about 1,900 men will be diagnosed with anal cancer in the U.S. in 2007.


Some men are more likely to develop HPV-related diseases than others:

Gay and bisexual men are 17 times more likely to develop anal cancer than heterosexual men.
Men with weak immune systems, including those who have human immunodeficiency virus (HIV), are more likely than other men to develop anal cancer. Men with HIV are also more likely to get severe cases of genital warts that are hard to treat.

What are the Sign & Symptoms?

Among men who do develop health problems, these are some of the signs to look for:

Signs of genital warts:
One or more growths on the penis, testicles, groin, thighs, or anus.
Warts may be raised, flat, or cauliflower-shaped. They usually do not hurt.
Warts may appear within weeks or months after sexual contact with an infected person.
Signs and symptoms of anal cancer:
Sometimes there are no signs or symptoms.
Anal bleeding, pain, itching, or discharge.
Swollen lymph nodes in the anal or groin area.
Changes in bowel habits or the shape of your stool.
Signs of penile cancer:
First signs: changes in color, skin thickening, or a build-up of tissue on the penis.
Later signs: a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed.
There may be no symptoms until the cancer is quite advanced.

How do men get HPV?

HPV is passed on through genital contact –most often during vaginal and anal sex. Since HPV usually causes no symptoms, most men and women can get HPV – and pass it on - without realizing it. People can have HPV even if years have passed since they had sex.

Is there a test for HPV in Men?
Currently, there is no test designed or approved to find HPV in men. The only approved HPV test on the market is for women, for use as part of cervical cancer screening. There is no general test for men or women to check one’s overall “HPV status.” But HPV usually goes away on its own, without causing health problems. So an HPV infection that is found today will most likely not be there a year or two from now.

REMEMBER: HPV is very common in men and women. Most men with HPV will never develop health problems from it. Finding out if you have HPV is not as important as finding out if you have the diseases that it can cause. Scientists are still studying how best to screen for penile and anal cancers in men who may be at highest risk for those diseases (see below).

Is there a test to find genital warts?
Most of the time, you can see genital warts. Some doctors may use a vinegar solution to help find flat warts—but this test can sometimes wrongly identify normal skin as a wart.

Is there a test to screen for HPV-related cancers in men?
Screening tests can find early signs of disease in people who are not yet sick. Screening tests for penile or anal cancer are not widely recommended.

Some experts recommend yearly anal Pap tests for gay, bisexual, and HIV-positive men, since anal cancer is more common in these groups. This test can find abnormal cells in the anus that could turn into cancer over time. If abnormal cells are found, they can be removed. CDC does not recommend anal Pap tests because there is not enough research to show that removing abnormal anal cells actually prevents anal cancer from developing in the future. More studies are needed to understand if anal Pap tests and treatment of abnormal cells prevent anal cancer in men.

You can check for any abnormalities on your penis, scrotum, or around the anus. See your doctor if you find warts, blisters, sores, ulcers, white patches, or other abnormal areas on your penis—even if they do not hurt.

Is there any cure or treatment?
There is no treatment or cure for HPV. But there are ways to treat the health problems caused by HPV in men.

Genital warts can be treated with medicine, removed (surgery), or frozen off. Some of these treatments involve a visit to the doctor. Others can be done at home by the patient himself. No one treatment is better than another. But warts often come back within a few months after treatment—so several treatments may be needed. Treating genital warts may not necessarily lower a man’s chances of passing HPV on to his sex partner. Because of this, some men choose not to treat genital warts. If they are not treated, genital warts may go away on their own, stay the same, or grow (in size or number). They will not turn into cancer or threaten your health.

Penile and anal cancers can be treated with new forms of surgery, radiation therapy, and chemotherapy. Often, two or more of these treatments are used together. Patients should decide with their doctors which treatments are best for them.

Are there ways to lower chances of getting HPV?
Because HPV is so common and usually invisible, the only sure way to prevent it is not to have sex. Even people with only one lifetime sex partner can get HPV, if their partner was infected with HPV. Condoms (used all the time and the right way) may lower your chances of passing HPV to a partner or developing HPV-related diseases. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

I heared new HPV vaccine, Can it help me?
The new HPV vaccine was developed to protect against most cervical cancers and genital warts. At this point, it is only licensed to be used in girls/women, ages 9-26 years. Studies are now being done to find out if the vaccine is also safe in men, and if it can protect them against genital warts and certain penile and anal cancers. The FDA will consider licensing the vaccine for boys and men if there is proof that it is safe and effective for them.

I just found out that my partenar has HPV!!!!
What does it mean for my health? Partners usually share HPV. If you have been with your partner for a long time, you probably have HPV already. Most sexually active adults will have HPV at some time in their lives. Men with healthy immune systems rarely develop health problems from HPV. But you should check regularly for any abnormalities on your penis. If you have a weak immune system or HIV, ask your doctor about checking for anal and penile cancers.

If your partner is new, condoms may lower your chances of getting HPV or developing HPV-related diseases. But not having sex is the only sure way to avoid HPV.

What does it mean for our relationship?
A person can have HPV for many years before it is found or causes health problems. So there is no way to know if your partner gave you HPV, or if you gave HPV to your partner. HPV should not be seen as a sign that you or your partner is having sex outside of your relationship.

80 percent of sexually active female teens infected with HPV

Exceeding rates observed in previous research, a new study found four out of five sexually active adolescent women infected with human papillomavirus, a virus linked to cervical cancer and genital warts. Darron R. Brown and colleagues of Indiana University School of Medicine studied 60 adolescent women, ages 14 to 17, at three primary care clinics in Indianapolis. They reported their results in the Jan. 15 issue of The Journal of Infectious Diseases, now available online.

From IDSA:

Very High Prevalence of Virus Linked to Cervical Cancer Found in Adolescent Women

Exceeding rates observed in previous research, a new study found four out of five sexually active adolescent women infected with human papillomavirus, a virus linked to cervical cancer and genital warts. Darron R. Brown and colleagues of Indiana University School of Medicine studied 60 adolescent women, ages 14 to 17, at three primary care clinics in Indianapolis. They reported their results in the Jan. 15 issue of The Journal of Infectious Diseases, now available online.

Human papillomavirus (HPV) infection is a common sexually transmitted infection whose effects may range from asymptomatic carriage of the virus to genital warts to cervical cancer. In this study, 95 percent of the subjects were sexually active, and the median number of sexual partners was two. Eighty-five percent were African American, 11 percent were Caucasian, and 3 percent were Hispanic.

Participation in the study involved quarterly visits to a primary care clinic for a cervical swab test and up to five 3-month diary collection periods during which subjects recorded their sexual behavior daily and performed self-vaginal swabbing weekly. Each woman participated in the study for an average of two years. Brown and colleagues collected a total of about 2,100 swab specimens adequate for analysis of HPV infection.

During the course of the study, 49 of 60 subjects tested positive for HPV infection. In addition to an 82 percent prevalence rate, the investigators identified several characteristics of the HPV infections detected. Many of the HPV-positive study participants were infected with not just one, but multiple, HPV types. The mean number of types per participant was about five. Among these different types, a substantial number were those associated with an increased risk for cervical cancer: 39 percent of the swab specimens were classified as high-risk types and 20 percent as low-risk. Clinically, 37 percent of the study participants had at least one abnormal result for cervical examination during the study period.

Brown and colleagues hypothesized that relative to earlier research, the high cumulative prevalence of HPV infection in their study was primarily a result of the high number of swab specimens obtained from each study participant. Many infections were detectable for only a few weeks, and might have been missed had specimens been obtained at longer intervals of time. They also attributed the high prevalence to their use of an assay that detects more HPV types than some other assays do, and to the at-risk nature of this particular study population.

Distinguished by its long follow-up and frequent testing procedures, this study confirms previous findings that HPV infection is common in sexually active adolescent women. ''We hope the results of our research increase our understanding of HPV infection in this population,'' said Dr. Brown, ''and help others design effective interventions to prevent infection in adolescent women.''

STD Testing

Sexually transmitted diseases are common in the U.S., with the Center for Disease Control and Prevention (CDC) estimating 19 million new infections among young people every year. If you are a sexually active person, it is vitally important to practice safer sex each and every time you are intimate. Going for STD testing when you decide to become intimate with someone new is also imperative to staying sexually healthy. To understand a bit more about what happens when you get a STD test, here is a helpful overview of the different tests done for the more common STDs.

Human Papilloma Virus
Every year, about 6.2 million Americans are infected with the Human Papilloma Virus also known as genital warts. There are two types of HPV virus, the "low-risk" type and the "high-risk" type. People infected with low-risk HPV are more likely to develop genital warts, which can be treated but not cured. Those with a high-risk HPV infection are less likely to develop HPV symptoms but have a significant risk of developing cervical cancer or some other form of genital cancer.

People infected with HPV strains that lead to genital herpes may be able to have their infection diagnosed through a visual inspection. During your exam, your doctor will examine your genitals for any signs of genital warts. However, genital warts are not always visible to the naked eye. Therefore, your health care provider may also swab the area with acetic acid, which will help make small warts visible.

Because the HPV strains linked to cervical cancer typically do not produce symptoms, it is also important to have regular pap tests done, which will test your cervical cells for signs of HPV infection.

Crabs or Pubic Lice
Pubic lice, or crabs, are a common sexually transmitted disease. Some symptoms of pubic lice include itchiness of the infected area or visible lice. Crabs are diagnosed with a physical examination of the infected area. However, because of the intense itching that these parasites cause, you will likely be aware of the problem before you get yourself to a doctor.

Once at the doctors, she will do a visual examination of the area, looking for the actual lice as well as nits, which are clusters of lice eggs. Your doctor may also examine other areas of your body in order to assess whether the lice have migrated. Treatment of crabs is usually washing with over-the-counter or prescription shampoos.

Genital Herpes
There are two types of genital herpes, herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). According to the CDC, most herpes infections are caused by HSV-2. Many people do not know when they are infected because there may be little to no symptoms of herpes present.

If you are experiencing a herpes outbreak, a visual examination of the area is sometimes enough to make a diagnosis. However, herpes sores can be mistaken for other types of infections or may not be present. Therefore, viral and blood tests are generally thought to be the most effective means of testing for herpes. While there is no cure for herpes, a variety of herpes treatment are available.


Blood, Urine or Cell Samples

Most STDs can be conclusively diagnosed through the use of blood, urine or cell testing.

Chlamydia
It has been estimated that as much as 2.8 million Americans are infected with chlamydia while in 2004 alone, more than 900,000 chlamydia infections were reported to the Centers for Disease Control and Prevention. In women, symptoms of chlamydia are typically absent or mild, making it difficult to notice the signs right away.

To diagnose chlamydia in women, your health care provider will do a pelvic exam, during which time she will examine your genitals for signs of infection. Additionally, she will take a cervical swab, which is much like a pap smear. This swab will then be sent to a lab, where specialists will look for signs of the bacteria that cause chlamydia. If you are found to be infected, your doctor will prescribe an effective chlamydia treatment.

Gonorrhoea
The CDC reports that every year more than 700,000 people are infected or re-infected with gonorrhea. Symptoms of gonorrhea include green or yellow discharge from the genitals as well as abdominal pain.

Gonorrhea is diagnosed through both a physical examination and a culture test. For the culture test, your health care provider will take a sample of any discharge that is present. This sample will then be sent to a lab and left to culture for two days. After this time, the sample will be examined under a microscope for the presence of bacteria.

It is also possible to perform a urine test for gonorrhea. However, this test is not as accurate as a culture test and is best used to rule out the infection. Once diagnosed, your doctor can prescribe the appropriate treatment.

Syphilis
In 2002, over 32,000 cases of syphilis were reported in the U.S. Although they may be not be immediately apparent, some of the signs of syphilis include sores, skin rashes and internal organ damage. Because syphilis occurs in stages, testing for the infection varies from stage to stage.

During the initial stages of the infection, a diagnosis will be made through both a physical exam, during which time your doctor will look for chancres, as well through a fluid sample from the chancres. However, it is necessary to have chancre sores visibly present on your body in order to perform this diagnosis.

Testing in the second stage of syphilis will involve your health care provider checking your lymph glands and for signs of a bodily rash. A blood test will also be ordered, which will look for antibodies to the syphilis bacteria. A positive diagnosis will be confirmed through a second test.

People in the late stages of syphilis infection will have the Cerebrospinal Fluid Test performed. For this test, a sample of your spinal fluid will be collected and assessed to determine the extent of your infection. Syphilis can be treated through the use of penicillin.

Trichomoniasis
Caused by the Trichomonas Vaginalis parasite, trichomoniasis, or trich, is a common sexually transmitted disease. Many people infected have no trichomoniasis symptoms or they mistake their infection for a yeast infection. However some symptoms include lower abdominal pain or unusual discharge from the genitals.

To test for trich, your doctor will perform a pelvic exam, during which time he will feel for any sores on your cervix. Additionally, a cervical swab will be taken and this sample will be combined with a salt solution before being examined under a microscope to check for the presence of the parasite.

Human Immunodeficiency Virus (HIV)
A person infected with HIV may initially have no symptoms. Signs of HIV in the more advanced stages include rapid weight loss, recurring fevers, and unusual blemishes in the mouth or in the throat.

HIV can be tested by a blood sample test called the HIV antibody test. For this test, a sample of blood will be drawn and then sent to a lab, where specialists will look for the presence of HIV antibodies in your system. If antibodies are identified, you are considered to be HIV positive.

Because it can take up to three months for the HIV infection to become apparent in your system, it is often recommended to wait to test if you think you have been exposed. However, if you choose, you can be tested as soon as three weeks after exposure although you will need to be re-tested again three months later if you receive a negative test the first time around.

HIV can be treated through the use of antiretroviral drugs. There is no cure for HIV, though, and this infection almost always leads to the development of AIDS and is fatal. The best way to deal with HIV is to avoid it all together through abstinence or safe sexual practices.

Recent facts and statistics for HPV | How to test for HPV | side effects of HPV vaccine

HPV Facts


HPV is the short form for Human Papillomavirus. HPV is a family of very common viruses that cause almost all cervical cancers, plus a variety of other problems like common warts, genital warts and plantar warts. HPV also causes cancers of the vulva, vagina, anus, and cancers of the head and neck. Both women and men become infected with HPV types that cause cervical cancer through sexual intercourse and sexual contact.
Are there different kinds of HPV?

There are over 100 strains of the HPV virus, with over 35 known different HPV types that infect the genital tract. At least 15 of these can lead to cervical cancer. The most common cancer-causing types of the virus are 16 and 18. This is important to know because these two types alone cause about 70% of all cervical cancer. The cervical cancer vaccine protects against these two types 100% of the time.
How does HPV work?

An HPV infection rarely leads to cervical cancer. In most women infected with HPV, the cells in the cervix return to normal after the body’s immune system destroys the HPV infection without the woman ever having any signs or symptoms of the HPV. However, some HPV infections do not go away and may remain present in the cervical cells for years. Long-standing infection can lead to changes in the cells that can progress to cancer. It is these cell changes that a Pap test can detect. When the HPV virus is not treated, the cells will continue to change until they become cervical cancer. Because it can last so long in your body before any cell changes occur, it is difficult to know who transmitted the HPV to you. Don’t make assumptions and blame your current partner.
How Common Is HPV?

HPV is the most common sexually transmitted infection. It is common in all sexually active people. At least 70% of sexually active people will get HPV at some time in their lives. HPV is most common in young women and men who are in their late teens and early 20s. The CDC estimates that there are 6.2 million new infections each year in the United States. Since it is so common, there is nothing to be ashamed about. If you are diagnosed with HPV, talk to your health care provider about it. Get answers to your questions.
HPV Facts
What are the signs and symptoms of HPV?

Most women and men do not know when they are infected with HPV. There are usually no symptoms. Anyone who has ever had genital contact with another person, not just sexual intercourse, can get HPV. Both men and women can get it—and pass it on to their sex partners without even realizing it. An abnormal Pap test result is usually a woman’s first clue of an infection, but most HPV-infected women do not ever have an abnormal Pap test result. HPV is not HIV or Herpes. They are different viruses with different symptoms.
How can I protect against HPV infection?

The only sure way to prevent HPV infection is to abstain from all sexual activity. Sexually active adults can reduce their risk by being in mutually faithful relationship with someone who has had no other or few sex partners, or by limiting their number of sex partners. But even persons with only one lifetime sex partner can get HPV if their partner has had previous partners.
Do condoms protect against HPV?

Recent studies suggest that condoms provide some protection against the HPV infection. However, since condoms do not cover all areas of the body involved in sexual contact that can be the source of the spread of HPV, they do not offer complete protection. However, in addition to HPV protection, they do reduce the risk of HIV and other sexually transmitted disease when used all the time and in the right way.
What are the factors that increase your risk for HPV?

You are more likely to get HPV if you smoke, if you start having sex at a young age, or if you have many sex partners or your sex partner has many sex partners.
How do I know if I have HPV?

The only way to know if you have an HPV infection is if your health care provider tests you for the virus. This may be done directly from the Pap test container or by using an additional swab at the time of the Pap test. Your health care provider may or may not perform the HPV test, depending on many factors including your age and risk factors. The only way to tell if a cancer-causing type of HPV infection has caused the cells in your cervix to change is to have a Pap test. Signs of an HPV infection may appear weeks, months or years after the first infection, which is why it is important to have regular Pap tests and HPV tests as recommended by your health care provider.
HPV Facts
Why isn’t there an HPV test for men?

The diseases that HPV causes in women do not happen in men. So the test results will not be helpful for a man.
I’ve been told I have HPV. How do I know if or when it has cleared up?

Most HPV infections will clear on their own. Those women that have long-standing HPV infections are more at risk for developing cervical precancerous lesions or cervical cancer. There is no shot or pill that is available to clear your HPV infection. Hopefully, as in most women, your body’s immune system will clear your HPV infection on its own. If your health care provider is performing an HPV test on you, and your test is negative, it is likely that your infection cleared.
Should I get an HPV Test?

The HPV test detects high-risk-or cancer causing types of HPV that can cause changes in your cervical cells. However, this test cannot tell you the exact type of high-risk HPV. Women 30 years of age and older can have both the Pap test and the HPV test for cervical cancer screening. The HPV test can also be used to help understand the meaning of a borderline abnormal Pap test. In that situation, your health care provider may do an HPV test to find out more about the abnormal cells. However, if your Pap test shows a definite pre-cancerous abnormality, an HPV test is not needed. Virtually all of these changes are caused by HPV. You can assume the HPV test will be positive.
Is there a cure for HPV?

Currently, there is no cure for the virus. There are treatments for the cervical changes that HPV can cause. If your Pap and HPV tests show that cells in your cervix have changed, you should discuss treatment options with your health care provider.
Can you prevent HPV?

Good news! There is now a vaccine to prevent HPV infection. Girls and women age 9-26 can protect themselves from HPV and cervical changes related to HPV by getting the cervical cancer vaccine.
How does the vaccine work?

The cervical cancer vaccine takes prevention a giant leap forward by blocking the first step along the pathway to cervical cancer, HPV infection. The vaccine is given in the arm or thigh three times—at the first visit, two months later and four months after that. The best protection is achieved after all three shots are given. It is not known at this time whether booster shots will be needed later. Studies show that the vaccine is extremely safe. There are no live viruses in the vaccine. The most common side effects are redness and soreness where the shot was given. Headaches (like when you have a cold or fever) are also common. Fever can also occur. Over the counter pain and fever medications will help if you have symptoms. As with any new medication, safety issues will continue to be monitored.