jodawi | HPV

Getting to Know a Virus, and When It Can Kill

Christine Baze of Marblehead, Mass., was 31, married and hoping to start a family when she learned she had invasive cervical cancer and would need a total hysterectomy.

Now 36 and childless but free of cancer, she is waging a campaign to keep what happened to her from afflicting other women. She created a Web site, popsmear.org, and the Yellow Umbrella Tour, a national concert tour, to spread the word.

"A Pap test is not enough," she now knows. "I was tested every year, and my cancer was missed. There is now new technology - a liquid-based Pap and HPV testing - that wasn't available to me."

HPV, the human papillomavirus, is a cause of genital warts and cervical cancer. ... Over 100 types of HPV have been identified, and about 15 of them cause nearly all cases of cervical cancer. These are called high-risk types, or oncogenic. ... But becoming infected with an oncogenic virus only rarely results in cancer. Even when it does, a very long time elapses between the initial viral infection and the development of malignancy, making it possible for doctors to intercept and prevent cancer. Low-risk HPV's more often cause genital warts; they rarely, if ever, result in cancer.

An overwhelming majority of sexually active women can expect to be infected with one or another HPV. ...

Most HPV infections are subclinical, showing no outward sign. Similarly, the infections often suggested by cellular changes can go undetected in a Pap test. Three studies of college-age women indicated that hidden HPV infections may be 10 to 30 times as common as those that cause cellular abnormalities.

... the virus is spread through contact with infected genital skin, mucous membranes or fluids from an infected partner. Any form of sexual encounter - including oral-genital and manual-genital contact - can spread the virus. Condoms and diaphragms only partly protect against an HPV... Factors that increase a woman's chances of acquiring HPV include having multiple sexual partners (especially those who have had multiple partners), having another sexually transmitted disease, cigarette smoking (including previous smoking), pregnancy and any condition or treatment that impairs immunity.

In most cases, however, the body's immune system knocks out the virus over a period of months or years. ...

The best way to check for both cell abnormalities and HPV is to have a liquid-based Pap and, using the same fluid, a test for high-risk HPV. ... Two HPV vaccines are in the final stages of testing. ... When either vaccine is approved, the ideal group to be immunized will be girls and boys 9 to 15 who aren't yet sexually active. ...