[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Human papillomavirus (HPV) infection

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# Human papillomavirus (HPV) infection

Human papillomavirus (HPV) infection is very common and sexually spread; most infections clear on their own, but some types cause warts or cervical cancer.

Updated 2026-10-30

## Structures involved

Tap one to see what it is and open it in 3D.

- [Cervix](https://durgical.com/en/anatomy/cervix-of-uterus/)
- [External os](https://durgical.com/en/anatomy/external-os-of-uterus/)
- [Vagina](https://durgical.com/en/anatomy/vagina/)
- [Labia minora](https://durgical.com/en/anatomy/labium-minus-of-vulva/)
- [Labia majora](https://durgical.com/en/anatomy/labium-majus-of-vulva/)
- [Vaginal fornix](https://durgical.com/en/anatomy/vaginal-fornix/)
- [Perineal body](https://durgical.com/en/anatomy/perineal-body/)

## In biochemistry

- [Ubiquitin–proteasome system](https://durgical.com/en/biochemistry/topics/ubiquitin-proteasome-system/)

## Microorganisms that cause it

- [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/)

## In histology

- [Cell cycle, mitosis and meiosis](https://durgical.com/en/histology/cell-cycle-mitosis-and-meiosis/)
- [Cell adaptations: hypertrophy, hyperplasia, atrophy, metaplasia](https://durgical.com/en/histology/cell-adaptations-hypertrophy-hyperplasia-atrophy-metaplasia/)
- [Cervix and vagina: the transformation zone](https://durgical.com/en/histology/cervix-and-vagina-the-transformation-zone/)

## Why it happens

- [Oncogenic viruses and H. pylori: the table to know](https://durgical.com/en/general-pathology/oncogenic-viruses-and-h-pylori-the-table-to-know/)
- [Dysplasia and carcinoma in situ](https://durgical.com/en/general-pathology/dysplasia-and-carcinoma-in-situ/)
- [Cytology: the Pap test, fine-needle aspiration and body fluids](https://durgical.com/en/general-pathology/cytology-the-pap-test-fine-needle-aspiration-and-body-fluids/)
- [Oncogenes and tumour suppressor genes](https://durgical.com/en/biochemistry/topics/oncogenes-and-tumour-suppressor-genes/)

## What it is

Infection with human papillomavirus, a DNA virus passed mainly by sexual [skin](https://durgical.com/en/anatomy/skin/) -to-skin contact. Most infections clear on their own; low-risk types cause genital warts and persistent high-risk types can cause cervical and other anogenital and oropharyngeal cancers.

## Who gets it

The most common sexually transmitted infection worldwide; most sexually active women and men acquire it at some point. In HPV-positive Latin American women from the ESTAMPA screening study, HPV16 was found in 65.1% of cervical cancers. In Colombia, HPV vaccination for girls is part of the national programme, and organised cervical screening exists.

## Causes

- Human papillomavirus, with many types
- Low-risk types (mainly 6 and 11) cause anogenital warts
- High-risk types (mainly 16 and 18, plus others) cause precancer and cancer
- Spread by genital, anal or oral skin and mucosal contact; also from mother to newborn (rare)

## Risk factors

- Early sexual debut
- Multiple sexual partners or a partner with multiple partners
- Immunosuppression, including HIV infection
- Smoking (increases persistence and progression to cervical cancer)
- No vaccination

## Pathophysiology

The virus reaches basal epithelial cells through microabrasions, especially in the cervical transformation zone. Most infections are cleared by the immune system. In persistent high-risk infection, viral proteins E6 and E7 inactivate p53 and Rb, allowing uncontrolled proliferation, precancerous lesions and, over years, invasive cancer.

## Classification

- Low-risk types: anogenital warts (condylomata acuminata), recurrent respiratory papillomatosis
- High-risk types: low- and high-grade squamous intraepithelial lesions (CIN 1–3) and cancer
- Sites: cervix, [vagina](https://durgical.com/en/anatomy/vagina/), vulva, anus, penis and oropharynx

## Symptoms and signs

- Usually no symptoms
- Anogenital warts: soft, flesh-coloured, cauliflower-like papules on the vulva, perineum, vagina, cervix or perianal skin
- Itching or discomfort from warts
- Precancerous lesions cause no symptoms and are found by screening

## Red flags

- Postcoital or intermenstrual bleeding (possible cervical cancer)
- Bleeding, ulcerated or pigmented genital lesions, or lesions not responding to treatment
- Extensive warts in a person with immunosuppression

## Diagnosis

**Clinical**
Genital warts are diagnosed by their appearance. Precancerous lesions are detected through cervical screening and confirmed by colposcopy and biopsy.

**Tests**
Cervical cytology (Papanicolaou) and high-risk HPV testing for screening; visual inspection with acetic acid is used in some settings; biopsy of atypical lesions; tests for HIV, syphilis and other sexually transmitted infections.

**Imaging**
Not needed for infection; colposcopy (a magnified examination) guides biopsy of the [cervix](https://durgical.com/en/anatomy/cervix-of-uterus/).

## Differential diagnosis

- Molluscum contagiosum
- Condylomata lata of secondary syphilis
- Vestibular papillomatosis (normal variant)
- Seborrhoeic keratosis or skin tags
- Vulvar intraepithelial neoplasia or carcinoma

## Goal of treatment

There is no antiviral cure: treatment removes warts and precancerous lesions, prevents progression to cancer and reduces transmission.

## Treatment

**Medical**
Topical patient-applied or clinician-applied treatments for warts: immune response modifiers or cytotoxic agents.

**Procedure**
Cryotherapy, excision, electrocautery or laser for warts.

**Procedure**
Treatment of cervical precancer by ablation (cryotherapy or thermal ablation) or excision (loop electrosurgical excision or conisation).

**Follow-up**
Follow-up with cytology and HPV testing after treatment, according to national guidelines.

## Drugs for this condition

- [Interferon alfa](https://durgical.com/en/pharmacology/interferon-alfa/)
- [Human papillomavirus (HPV) vaccine](https://durgical.com/en/pharmacology/human-papillomavirus-vaccine/)

## Complications

- Cervical, vaginal, vulvar, anal, penile and oropharyngeal cancer
- Recurrent warts
- Recurrent respiratory papillomatosis in children after perinatal transmission
- Psychological distress

## Prognosis

Most infections clear within one to two years. Warts often recur but are benign. Precancerous lesions found through screening are highly curable.

## Prevention

- HPV vaccination, most effective before sexual debut
- Regular cervical screening according to national guidelines
- Condoms reduce but do not eliminate transmission
- Not smoking

## Test yourself

Think of the answer, then tap the question to see it.

## Which HPV types cause most genital warts?

Low-risk types 6 and 11.

## Which HPV types cause most cervical cancers?

High-risk types 16 and 18.

## How do HPV proteins E6 and E7 promote cancer?

E6 leads to degradation of p53 and E7 inactivates the retinoblastoma protein (Rb), removing cell-cycle control.

## In which part of the cervix do HPV-related lesions usually arise?

In the transformation zone, where columnar epithelium changes to squamous epithelium.

## When is the HPV vaccine most effective?

When given before sexual debut, before exposure to the virus.

[Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/human-papillomavirus-infection/)

## Related conditions

- [Cervical cancer](https://durgical.com/en/conditions/cervical-cancer/)
- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- [Syphilis](https://durgical.com/en/conditions/syphilis/)
- [Chlamydia infection](https://durgical.com/en/conditions/chlamydia-infection/)
- [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Human Papillomavirus](https://www.ncbi.nlm.nih.gov/books/NBK448132/) (StatPearls (NCBI Bookshelf), 2023); [Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America](https://europepmc.org/article/PMC/PMC9337688) (PloS one, 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/human-papillomavirus-infection/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/human-papillomavirus-infection/