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What is HPV?

"HPV" is an acronym for "human papillomavirus".

HPVs are viruses that can infect many parts of the body. Some types of HPV are transmitted sexually and can cause warts or have other consequences, such as cancer.

It is important to note that this acronym does not refer to a single virus but to a large family of nearly 200 different viruses. Of these, about 40 are sexually transmitted. These viruses are divided into two main types: 

  • HPV with low cancer risk, some of which cause condyloma 

  • High-risk HPV, some of which cause cervical lesions 

Why get tested?

Most sexually active men and women will have an HPV infection at some point in their lives. A person can be infected with more than one type of HPV in their lifetime. They can also be infected with the same type of HPV more than once.

If you have had risky, unprotected sex, you should see your health care professional for testing.

If you have abnormal vaginal bleeding or if you think you have condylomata, see a health professional. He or she can do the necessary tests to make a diagnosis.

In Canada, screening for human papillomavirus (HPV) is done only as part of cervical cancer screening (PAP test). To obtain this test, we invite you to make an appointment with a healthcare professional.

Signs and symptoms

In most cases, HPV carriers have no symptoms. Others develop symptoms only when their immune system is weakened, either by age, disease or certain treatments. When symptoms do appear, they also depend on the type of HPV involved:

  • Low cancer risk HPV:

    The appearance of condylomata, which are small bumps or wart-like lumps of flesh on the genitals, around the anus and, more rarely, inside the mouth or throat. These can appear between 1 and 8 months after contact, sometimes even longer.

    They do not pose any health risks. They look like small pimples, cockscomb or cauliflower. They can be pink, reddish, greyish or have the same colour as the skin. They are usually painless, although they sometimes cause itching, irritation or slight bleeding. Without treatment, they usually disappear after a few years but may reappear randomly. 

  • High cancer risk HPV:

    In some women, HPV can cause lesions or abnormal cells to form on the cervix. These can cause abnormal vaginal bleeding, especially during sex. Some of these lesions can even become cancerous.

Window or incubation period (time interval before the disease is detectable) 

Approximately 1 to 8 months, although longer delays are sometimes seen in symptomless carriers (up to several years or decades). It can therefore be difficult to know when the disease was transmitted.

Transmission

HPV is transmitted through direct contact during unprotected sex, most often by someone who does not believe they are a carrier and contagious: 

  • Oral sex (contact of the mouth with the penis, vulva, vagina or anus) 

  • Vaginal intercourse (penetration of the penis into the vagina) 

  • Anal intercourse (penetration of the penis into the anus) 

  • Contact between genitals 

  • Sharing sex toys 

  • Mother-to-child transmission at birth (rarer) 

Prevention

The most effective way to prevent HPV transmission is through vaccination. In Quebec, two HPV vaccines are available free of charge through the Quebec Immunization Program. People who do not qualify for free vaccination can also receive the vaccine, although they must pay for it. 

Vaccination is recommended even for individuals who have HPV, as it provides protection against other types of HPV. 

In addition to vaccination, it is important to remember the importance of wearing a condom to prevent the disease. Condoms must be used during all contact between the genitals and during all oral, vaginal and anal sex. 

For women between the ages of 21 and 65, it is also recommended to have a gynecological cytology (PAP test) every 2 years to validate the appearance of the cervix and its cells. 

Complications

Varies by HPV type: 

  • Low cancer risk HPV:

    • Appearance of condylomata inside the larynx, airways or on the vocal cords (rare)

  • HPV at high risk of cancer

    • In women, the appearance of lesions on the vulva or the cervix, which may develop into cancer in these areas.

    • In men, the appearance of lesions on the penis can develop into cancer of this region. 

    • In both sexes, lesions in the anus, mouth or throat may develop into cancer in these areas.

    • Increased risk of HIV infection.

Treatment

Although the immune system clears the HPV infection within a few months, nothing treats the viruses that cause HPV infections themselves. However, some symptoms of HPV infections can be treated:

  • Condylomes 

    • Application of creams 

    • Liquid nitrogen treatment (cryotherapy) 

    • Laser treatment

  • Cervical lesions

    • Laser vaporization of lesions

    • Various surgeries