
Transmission modes
HPV is transmitted by :
- sexual contact (vaginal, anal and oral)
- by skin contact (rubbing, sexual fondling)
Transmission of HPV is possible even without an apparent wart or any symptoms.
HPVs are spread through direct contact with the infected area. Thirty types of HPV can be transmitted during sexual intercourse (of which there are 200). These can be caught from any intimate contact with an infected area.

Symptoms
For condyloma
- One or more warts (condyloma) on the anus, perineum, vulva, penis.
- Irritation, itching
Condylomata have an incubation period that varies from person to person, Symptoms appear between 3 weeks and several years after infection. These condylomas are usually visible to the naked eye.
For cancers
Some types of HPV can cause precancerous lesions, which in turn can develop into cancer of the cervix, anus, vulva, penis or throat. Cervical cancer is the most common of these cancers.
These precancerous lesions are not not visible to the naked eyeTherefore, a cervical smear should be taken. Depending on the practice, for the throat, anus and penis, a specialist may perform a visual examination.

Consequences if undetected and untreated
- Condyloma proliferation
- If precancerous lesions develop, they can lead to cancer of the cervix, vulva, anus, penis or throat. There is a risk of infertility and even death.
Cervical cancer is one of the most common cancers caused by HPV. Early detection and treatment of precancerous cells helps prevent cervical cancer. In 2018, more than 200 people died of cervical cancer in Belgium.
Other HPVs cause common warts, for example on the hands and feet.

Screening
At present, HPV screening is generally only carried out on the cervix via a smear test (reimbursed every 3 years from the age of 25).
For those who practice anal sex, a preventive proctological examination with a smear test may be recommended.
Screening of the penis, vulva, mouth and throat is not recommended on a routine basis. Keep an eye on your body and in case of suspicious lesions, it is advisable to consult a doctor.
For condyloma
The diagnosis of condyloma is made by a medical examination by a general practitioner, gynaecologist, dermatologist or proctologist. The doctor inspects the patient's anogenital area and may apply a liquid to make the infected area react.
For cancers
Screening for precancerous lesions is carried out by a cervical smear by a gynaecologist.
Screening for precancerous lesions in areas other than the cervix is not yet sufficiently advanced to be performed.

Treatment
For condyloma
Condylomata can be treated with ointments applied locally ointments to be applied locally or by removing the warts using liquid nitrogen, acid, laser or electric scalpel treatments. Very often, warts reappear even after local treatment.
For cervical cancer
A positive HPV test after a cervical smear does not mean that you will necessarily develop cancer! The virus disappears in most cases through natural immunity This is why the gynaecologist will not treat you directly.
If the virus progresses over the months and is not eliminated naturally, the gynaecologist will propose a local laser treatment on the areas of the cervix affected by the virus.
If the virus has spread widely, the gynaecologist will then perform surgery: conization. This involves removing a cone-shaped portion of the cervix. This surgery can lead to complications during pregnancy, miscarriages, etc.
It is important to detect these lesions early so that they do not develop into cervical cancer. If cancer is present, the surgeon removes part or all of the uterus (called a hysterectomy). This surgery causes the person to become infertile.

Protection
The only safe way to avoid HPV would be to never have sex... Even if a person has only one partner, that person could be infected without knowing it because there are often no symptoms. The best strategy is vaccination, if possible before becoming sexually active, in combination with periodic testing.
In 2020, there are three different vaccines vaccines that protect against against certain types of HPV that cause cancer and condyloma: some protect against more types of HPV than others.
However, these vaccines do not protect against all types of HPV, so it is important to examine yourself with the naked eye and visit a gynaecologist or doctor to have a cervical smear.
The best thing to do is to get the vaccine that protects against 9 strains of HPV, it will be much more effective.
The vaccine contains particles that are identical to most types of virus. But these particles are not active and therefore cannot cause an infection. Once the vaccine is injected, the person's immune system reacts by building up antibodies against these particles. The body then builds a defence system that will fight the real virus in the event of transmission.
Vaccines :
Gardasil (2006)
Ø Protects against 4 types of HPV (6,11,16,18)
Ø Protects against genital warts
Cervarix (2007)
Ø Protects against 2 types of HPV (16,18)
Gardasil 9 (2014)
Ø Protects against 9 types of HPV (6, 11, 16, 18, 31, 33, 45, 52, 58)
Ø Protects against genital warts
- Types 16, 18: 71% of cancer cases
- Types 6, 11: 90% of genital warts
Even if they offer only partial protection, condoms (external or internal) condoms (external or internal), the latex square or the nitrile glove can protect against HPV. As a reminder, the internal condom (formerly called the "female" condom) covers a larger area of the vulva or anal region, which limits the transmission of HPV.

Recommendation
It is recommended to have a cervical smear (reimbursed) every 3 years or in case of lesions.
In case of regular practice of anal sex, an examination by a proctologist may be recommended every 2 years in certain cases.