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Human Papilloma Virus (HPV)
Human papilloma virus otherwise known as HPV is a group of viruses that causes infection in both men and women. There are over 100 varieties of HPV, more than 40 of which are passed through sexual contact. It is so common - It is estimated that 85% of us will get HPV at some point in our life. It can result in skin wart formations, or it can just be an asymptomatic infection of the private areas. Most people infected by genital HPV have no clear history of contact. It can be transmitted through genital skin-to-skin contact during sexual activity and very rarely, during delivery from the infected mother to the baby.
Your risk of infection is higher if you have
- Multiple sexual partners. While using condoms can help reduce the risk of HPV infection, it does not cover all genital skin nor guarantee a 100% protection
- If you started having sexual intercourse at an early age
- If you have a weakened immune system. People with weakened immune systems due to HIV/AIDS or if they are on immune suppressing drugs are at higher risk of HPV infection.
Effects of HPV
Thankfully, Most HPV infection clears up on their own. 80-90% recovers on its own within 2 years.
However there certain HPV types that can cause persistent infection leading to cancer and other diseases over time. Almost all cervical cancers are linked to genital infection with HPV. HPV sub-types 16 & 18 account for about 70% of cervical cancer cases while sub-types 6 & 11 are responsible for about 90% of genital warts cases. It can also cause several other types of cancers, such as anal cancer, mouth cancer, throat cancer, vaginal cancer, vulvar cancers and penile cancer.
HPV infection has no treatment or cure. The best way is to get vaccinated before you are even exposed to the virus HPV vaccines prevent infection from certain types of Human papilloma viruses, depending on the type of vaccines you have been injected with.
Types of HPV vaccines
In the Singapore market, there are two brands of HPV vaccinations available, namely cervarix and Gardasil 9. Cervarix covers for HPV subtype 16 and 18, while Gardasil 9 covers for 9 subtypes, namely 6,11, 16, 18, 31, 33, 45, 52 and 58.
Who should get the HPV vaccines?
Cervarix is licensed in Singapore for females only. It is highly recommended for all females between 9 to 26 years old to get cervarix. You will require 2 or 3 doses of cervarix depending on your age.
Gardasil 9 is approved in Singapore for vaccination of both males and females. It can be given up to the age of 45. The advantage it has over cervarix is that it covers an additional 7 HPV subtype which accounts for an additional 20% of cancer causing types and that it is clinically effective for males as well. Again, 2 to 3 doses are required, depending on your age.
Both the vaccines are most effective if given before first sexual exposure. It can be easily done at your nearest family physician clinic, so please speak to your doctor about your suitability. It is potentially life-saving.
Current evidence shows a sustained protection in long term follow up and no additional boosters are recommended yet.
Side effects of HPV vaccines
- Injection side pain, swelling, itching and redness
Things to note
It is not recommended for ladies who are pregnant and breast feeding. However, please remember that having the vaccinations does not replace your regular cervical cancer screening. Getting HPV vaccines is protective against cervical cancer but it does not mean you will NOT get cervical cancer. Regular screening is still mandatory. For women aged 25 to 29, get your Pap smear done once every three years. For women aged 30 years and above, you can get your HPV DNA testing done once every 5 years.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)