Papillomavirus: What It Is, How It Is Transmitted, and Why It Is Dangerous

The line "human papillomavirus detected" in a test result frightens almost everyone who sees it. In reality, HPV is a large group of viruses that virtually every sexually active person encounters in their lifetime, and most often the immune system handles it on its own. I explain this without myths and without selling "antiviral courses": what it is, how it is transmitted, and when it truly requires a doctor's attention.

What human papillomavirus is

HPV is a group of more than 200 related viruses; in taxonomy this is 27 species from 5 genera and over 170 types. The virus affects the skin, the genital area, the anus, and the throat, and in terms of prevalence it is the most common sexually transmitted infection. About 85% of sexually active women and 90% of men become infected during their lifetime; worldwide there are approximately 660 million carriers — 12% of the world's population.

The key point: infection does not equal disease. In most people the immune system controls the virus, and it goes away without consequences. HPV lives in skin and mucosal cells and almost never enters the bloodstream — which is why the immune response is weak and antibodies form slowly.

How HPV is transmitted and where it comes from

The main route is sexual contact, including oral. Condoms reduce the risk but do not eliminate it: the virus passes through microcracks in the skin that a condom does not cover. Estimates of contagiousness vary: for a single contact without a condom, 60–70% is cited, while other researchers speak of 10% of those infected — those who have papillomas.

The standard life cycle of the virus is designed for penetration through microcracks in the skin; mucous membranes are merely a more convenient route. HPV is resistant to antiseptics and survives for some time on objects: toilets, bathhouses, swimming pools, gyms. Hence the household route through touching and handshakes, self-infection during shaving and epilation, infection of a child during birth — the cause of laryngeal papillomatosis in children, and transmission through microcracks in the skin of the hands when touching a partner's genitals. "Where HPV comes from" is not always about sex.

HPV types: 16, 18, and those that cause warts

Two groups are of practical importance. Low-oncogenic types can cause warts on the genitals, around the anus, and in the mouth and throat. High-oncogenic types alter cells so that they can become malignant; the best known are 16 and 18, which account for about 76% of cervical cancer cases. The division is conditional: a tumor can also arise at the site of a low-oncogenic type, and a high-oncogenic type may have no consequences at all.

Manifestations in men and women: warts and genital lesions

In both women and men, there are most often no symptoms at all. Warts are the visible work of low-oncogenic types; a doctor recognizes them on examination. High-oncogenic types usually cause no symptoms. Symptoms appear only if the infection persists for years, causes cell changes, and progresses to cancer — and they depend on the affected organ. The virus also affects the skin, so warts can appear not only on the genitals.

Possible complications

The risk lies not in warts but in long-term persistence of high-oncogenic types. Almost all cases of cervical cancer are caused by persistent infection with oncogenic HPV types; about 95% develop from precancerous lesions. HPV is also associated with cancer of the anal canal, oropharynx, vulva, vagina, and penis. Worldwide, about 750 thousand HPV-associated cancers and 32 million anogenital warts are recorded annually; cervical cancer is the fifth most common in women: about 604,000 new cases and 280,000 deaths in 2024.

The transition of altered cells to cancer takes 15–20 years, and with weakened immunity, 5–10 years. The process is accelerated by the high oncogenicity of the type, reduced immunity (in women with HIV the risk is 6 times higher), other sexually transmitted infections, the number of births, early first pregnancy, hormonal contraception, and smoking.

How HPV is detected and when to see a doctor

A doctor sees warts on examination. For the cervix there is screening: the Pap test, an HPV test on a cell sample, and, if abnormalities are found, colposcopy. Screening is recommended from age 30 once every 5–10 years with a highly effective test; for women with HIV — from age 25 once every 3–5 years. Self-collection of a sample for an HPV test is as informative as collection by a healthcare worker. HPV vaccination given to girls aged 9–14 before the onset of sexual activity protects against types 16 and 18; vaccination does not replace screening.

People see a doctor if:

• warts have appeared on the skin, in the genital area, anus, or mouth;
• a positive HPV test has come back, especially for types 16 and 18;
• a Pap test has shown altered cells;
• a doctor has prescribed colposcopy or repeat screening.

Detecting HPV in itself is not a reason to call an ambulance; 103/112 — if signs of a life-threatening condition appear, for example signs of stroke or heart attack.

This material is for reference: it explains what is happening but does not replace consultation with a doctor who sees your situation as a whole.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer