Human Papillomavirus (HPV)
Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) worldwide. It is estimated that up to 80% of sexually active people come into contact with the virus during their lifetime. In most cases, HPV infection is transient and asymptomatic: the immune system is able to eliminate it spontaneously within one or two years. In some cases, however, the virus can persist and cause genital warts or precancerous lesions, which over time may develop into cancers of the cervix, anus, penis, vulva, vagina, or oral cavity.
HPV transmission occurs mainly through vaginal, anal, or oral sexual intercourse, but it can also occur through direct contact with the skin or mucous membranes in the genital area. Because HPV is extremely common, it is possible to contract the infection even with a single sexual partner.
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On this page
- What Is Human Papillomavirus (HPV)?
- What Are the Symptoms of HPV?
- How Is HPV Diagnosed?
- How Is HPV Treated?
- How Is HPV Prevented?
What Is Human Papillomavirus (HPV)?
Human papillomavirus (HPV) is a group of over 100 sexually transmitted viruses responsible for infections affecting the skin and mucous membranes. Most types of HPV cause benign lesions, such as skin warts (on the hands, feet, or face) or genital and oral warts and papillomas.
In most cases, genital HPV infections are transient and resolve spontaneously, without the need for treatment. However, some strains of the virus can persist over time and lead to precancerous lesions or cancers.
In particular, the following genotypes are considered high-risk for cancer: HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, mainly associated with cervical cancers, but also with other cancers of the genital tract and oral cavity.
In Italy, more than 2,000 new cases of cervical cancer are recorded each year, a neoplasm almost always linked to human papillomavirus (HPV) infection.
About 70% of cervical cancers, and most other HPV-related cancers, are caused by genotypes 16 and 18, which are considered high-risk for cancer.
The main cancers associated with HPV infection include:
- Cervical cancer
- Oropharyngeal cancer (mouth and throat)
- Anal cancer
- Penile cancer
- Vaginal cancer
- Vulvar cancer
What Are the Symptoms of HPV?
The symptoms of HPV vary depending on the type of virus and the site of infection. In most cases, however, human papillomavirus infection does not cause noticeable symptoms and can remain silent for years.
Low-risk HPV strains can cause genital warts (condylomas), located:
- Inside the vagina
- Around or inside the anus and in the perineum
- On the external genitalia
- More rarely, in the mouth or throat
Genital warts appear as:
- Small or large single or multiple growths
- Flat or cauliflower-shaped lesions
- Skin-colored, lighter, or darker than surrounding skin
- Sometimes itchy or painful, but often asymptomatic
High-risk oncogenic HPV strains, on the other hand, do not cause warts but can lead to cellular and tissue changes in the genital mucosa, especially the cervix.
These changes are generally asymptomatic and can only be detected through screening tests such as:
- Pap smear (Pap Test)
- HPV Test
- Colposcopy, vulvoscopy, or oral cavity inspection (depending on the lesion site)
How Is HPV Diagnosed?
The diagnosis of HPV depends on the type of infection and the clinical manifestations.
Genital warts are usually identified through a physical examination performed by a gynecologist or dermatologist. In some cases, a biopsy of the affected tissue may be performed to confirm the diagnosis or rule out other conditions.
For infections caused by high-risk oncogenic HPV strains, the diagnosis relies on specific tests that detect cellular changes or the presence of viral DNA, such as
- Pap Test: examines cervical cells to detect early changes.
- HPV Test: directly identifies human papillomavirus DNA, even in the absence of visible lesions.
Cervical screening plays a crucial role in preventing cervical cancer, as it allows precancerous lesions to be detected and treated promptly, preventing progression to malignant forms.
How Is HPV Treated?
In most cases, HPV infections resolve spontaneously within 1–2 years thanks to the immune system response, without the need for any treatment. However, even after warts or lesions disappear, the virus can remain latent in the body and reactivate over time.
When lesions persist or cause symptoms, the main treatment options for HPV include:
- Topical medications applied directly to the skin or mucous membranes.
- Cryotherapy, which involves freezing the lesions with liquid nitrogen.
- Laser therapy, to precisely vaporize the infected tissue.
- Surgical excision, useful for larger or treatment-resistant cases.
Genital warts can sometimes recur even after treatment, as the virus may persist in surrounding tissues. In mild or asymptomatic cases, clinical monitoring without immediate intervention may be an option.
Precancerous cervical lesions, on the other hand, require targeted treatment: a portion of tissue is removed to completely eliminate the lesion while preserving fertility and the possibility of pregnancy.
Finally, HPV-associated oropharyngeal cancers are treated with oncologic surgery; in more extensive cases, a combined approach with chemotherapy and radiotherapy may be necessary.
Prevention of Human Papillomavirus (HPV) Infection through Vaccination
HPV vaccination is the most effective method to prevent human papillomavirus infection and related cancers. In addition to protecting the vaccinated individual, it helps reduce the spread of the most dangerous strains within the population.
- The HPV vaccine is offered free of charge to girls and boys starting at age 11.
- Currently, three types of vaccines are available:
- Bivalent: protects against strains 16 and 18
- Quadrivalent: effective against strains 6, 11, 16, 18
- Nonavalent: the most widely used today, offering broader coverage against strains 6, 11, 16, 18, 31, 33, 45, 52, and 58
Scientific studies show that HPV vaccination is up to 90% effective in preventing virus-related cancers.
In addition to vaccination, several good prevention practices can further reduce the risk of HPV infection and other sexually transmitted infections (STIs):
- Avoid sexual activity when infection symptoms are present
- Limit the number of sexual partners
- Do not share sex toys, or use protection and clean them properly between uses
- Always use condoms, including during oral and anal sex
- Undergo regular cervical screening, such as Pap tests and HPV tests, according to your doctor’s guidelines
Reviewed October 2025.