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Human Papillomavirus: HPV Information for Clinicians
• Transmission • Prevention • Detection • Clinical Management

Centers for Disease Control and Prevention

April 2007

Contents
Section I: Genital HPV Infection .........................................1 About HPV .............................................................................1 Table 1: Types of HPV......................................................2 Table 2: Factors Associated with HPV Infection ..............3 HPV Transmission .................................................................3 HPV Natural History ..............................................................4 HPV-associated Outcomes ...................................................7 HPV Prevention.....................................................................9 HPV Detection .....................................................................13 Section II: Cervical Cancer Prevention ............................15 Table 3: Cervical Cancer Screening Guidelines .............16 Screening with Cervical Cytology .......................................18 HPV Testing for High-Risk Types.........................................19Cervical Cancer Screening Management Algorithms ....20 Section III: Genital Warts ..................................................23 Diagnosis .............................................................................23 Treatment.............................................................................24 Table 4: Recommended Treatment ...............................24 Special Considerationsfor Women .....................................25 Section IV: References .....................................................26

HPV Infection

Section I: Genital HPV Infection that infects humans is called Why is it human papillomavirus, or HPV. HPV commonly causes epithelial Important proliferations at cutaneous and mucosal surfaces. to Know Types of HPV About HPV?
Genital infection withhuman papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States (U.S.) today.1 Over half of sexually active women and men are infected with HPV at some point in their lives.2 In most cases, infections with HPV are not serious. Most HPV infections are asymptomatic, transient, and resolve without treatment. However, in some individuals, HPV infections result ingenital warts, Pap test abnormalities, or, rarely, cervical cancer.3 The Pap test is useful in early detection of cervical cancer, one of the possible outcomes of an HPV infection. Early detection and treatment of pre-cancerous lesions can prevent development of cervical cancer.4 There are more than 100 different types of HPV. They differ in terms of the types of epithelium they infect. Someinfect cutaneous sites, whereas others infect mucosal surfaces. Over 40 types infect mucosal surfaces, including the anogenital epithelium (e.g., cervix, vagina, vulva, rectum, urethra, penis, and anus). For most of these HPV types, there are sufficient data to divide them into “high-risk” (e.g., oncogenic or cancer-associated) types and “low-risk” (e.g., non-oncogenic) types (see Table 1 on page 2).How Common is HPV?

Approximately 20 million Americans 15 to 49 years of age (approximately 15% of the population) are currently infected with HPV.5 Others may have been infected in the past and may no longer have the virus. About half of those who are infected What is HPV? with HPV are sexually active Papillomaviruses are DNA tumor adolescents and young adults 15 viruses that are widelydistributed to 24 years of age.5 Between 5% throughout animal species; and 30% of individuals infected these viruses are specieswith HPV are infected with specific. The papillomavirus multiple types of HPV.6 

• Each year, about 6.2 million people in the U.S. become newly infected.1 • Estimates for the incidence and prevalence of genital warts

caused by low-risk types of HPV are imprecise....
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