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The human papilloma virus can infect many parts of the body. Some types of HPV are sexually transmitted and can cause warts or other consequences such as cancer (cervical, penile and anal).

HPV infections are common. Even if the link between HPV and cancer exists, but it is important to remember that if you have an HPV infection, it is unlikely that you will develop cancer.

What are the signs and symptoms of HPV in men?

Most men who have anogenital HPV do not have symptoms and most infections will go away without treatment within a couple of years. However, in some people HPV infections can persist for many years.

Some people with a HPV infection may develop anogenital warts. HPV infection is also associated with the development of cancers in men including penile and anal. The precancerous and cancerous changes that may result from HPV infection usually do not present with any noticeable symptoms, and therefore regular health check-ups are essential.

Does HPV cause anogenital warts?

Some HPV infections can cause anogenital warts. Anogenital warts are usually flesh-coloured, soft to the touch and may appear as tiny flat bumps, or bumps that look like cauliflowers. They are usually painless but may itch. They usually grow in more than one location and may cluster in large groups. Sometimes anogenital warts can be present but may not be visible if they are internal (inside the vagina or rectum) or if they are on the skin but are too small to be seen. If you are sexually active, you should have regular check-ups. If you think you have warts you should speak with a health care professional.

What is the link between HPV infection and cancer?

Persistent HPV infection, with high risk types, is the major cause of over 99 per cent of cervical cancers. Infection with high-risk HPV types has also been found to be an important cause of anal cancer. HPV can also play a role in the development of cancers of the penis and oropharynx (in the throat, at the back of the mouth).

How do men get anogenital HPV?

HPV is estimated to be one of the most common sexually transmitted infections around the world. Any person who is sexually active can get the virus. Studies show that approximately 75% of sexually active men and women will acquire an anogenital HPV infection at some point in their lives. Most HPV infections occur without any symptoms and go away without treatment within two years.

The types of HPV that cause anogenital warts are spread by skin-to-skin contact, usually during vaginal, anal, or possibly oral sex with someone who has the infection. It is possible, however, to become infected with the virus without having penetrative sex if you come into contact with an infected area (skin-to-skin) in the anogenital region. HPV infection is more likely to be transmitted when warts are present, but the virus can be transmitted even when there are no visible warts.

How to test HPV in men?

Anogenital warts are diagnosed by a visual inspection during a physical exam by a health care professional. In the case you cannot see warts, it does not mean that you do not have any. They may be small, or in a place where you cannot see them, such as inside the rectum.

Can HPV be treated?

Although there is no cure for HPV infection, warts, lesions and precancerous and cancerous changes caused by the viruses can be managed and treated. No treatment guarantees that the HPV infection is no longer present in the body.

Some treatments for anogenital warts, such as cryotherapy (freezing the warts), are done in a clinic or doctor’s office while other treatments, such as prescription creams, can be used at home. Repeat treatments are often necessary. Just because you can no longer see the wart does not mean the HPV infection is gone - the virus may still be present which means you could develop warts again without being re-exposed to the virus. For most people, warts will clear on their own over time.

The lesions and precancerous changes caused by high risk types of HPV can be treated if a health care provider feels that it is necessary. A large number of these infections will clear without any treatment. Only a small number of high risk persistent infections will progress to cancer. As with many other cancers, early detection is one of the key factors to successful treatment.

How can you protect yourself from getting HPV?

While condoms do not eliminate the risk of HPV infection, using a condom, consistently and properly during vaginal, anal and oral sex decreases the chances of getting HPV or passing it on to your partner. You need to remember that a condom can only protect the area it covers, so it may be possible to become infected by any uncovered warts (on the scrotum). Using a condom will also help to protect you from other sexually transmitted infections and reduce the chances of unintended pregnancies.

Other ways to reduce your risk of infection include delaying sexual activity (waiting until you are older), limiting your number of sex partners and considering your partners’ sexual history as this can create a risk to yourself (if they have had multiple previous partners).

There are now two HPV vaccines authorised for use in Việt Nam. One of them provide protection against HPV that cause approximately 90 per cent of all anogenital warts in males and females (HPV-6, HPV-11). It is approved for use in Việt Nam in females and males from 9 to 26 years old. — Family Medical Practice

Dr. Mathieu Nalpas - Internist, Family Medical Practice Hanoi