Human Papillomavirus Infection and Treatment

Different types of HPV, signs, and symptoms, and complications

Human Papillomavirus (HPV) is a sexually transmitted infection that could lead to various complications. Although it is possible to prevent HPV using various vaccines, it remains the most common sexually transmitted infection in the United States (Wolicki, 2017). There are over 150 different types of HPV viruses, which differ in terms of risks and complications. For example, high-risk types of HPV include HPV 16 and 18. These types of HPV lead to cervical abnormalities and anogenital cancers (Wolicki, 2017). Low-risk types of HPV include types 6 and 11 and can lead to genital warts, respiratory papillomas, and low-grade cervical abnormalities (Wolicki, 2017). There are also cutaneous types of HPV, which cause warts on hands and feet, and mucosal types, which do not lead to any serious complications. As noted by Wolicki (2017), most types of HPV do not manifest in any symptoms; warts are a common sign of high- and low-risk types of HPV, as well as of cutaneous HPV. The signs and symptoms of high-risk types of HPV are typically associated with their complications (cancer and cervical abnormalities) and may include bleeding, itching, discharge, or pain.

Treatment of choice for HPV including mechanisms of actions, adverse reactions, drug/food interaction, and precautions

The treatment of HPV depends on the type of virus and its symptoms. According to clinical guidelines, subclinical genital types of HPV tend to clear without any treatment, which is why antiviral therapy is not recommended (Workowski & Bolan, 2015). However, in symptomatic types of HPV, the treatment can be used to target the clinical manifestations of the condition, such as genital warts or pathologic precancerous lesions. Given that external anogenital warts are the most common symptom of HPV, it would be useful to focus on their treatment.

Imiquimod cream is recommended by clinical guidelines for the treatment of external anogenital warts (Workowski & Bolan, 2015; Park, Introcaso, & Dunne, 2015). There are two available formulations: a 5% cream and a 3.75% cream. The 5% cream is to be applied topically at bedtime 3 times per week for up to 16 weeks, whereas the 3.75% formulation can be used every night at bedtime for the same duration (Park et al., 2015). Imiquimod works by improving the immune response, thus enabling the body to fight the infection. According to Canada Drug Bank (2018), “Imiquimod is an immune response modifier that acts as a toll-like receptor 7 agonists” (para. 5). Although imiquimod does not treat HPV infection, it minimizes the appearance of warts and prevents further growth. Adverse effects associated with the use of the medication include inflammatory skin reactions, such as swelling, redness, irritation, and ulcers (Workowski & Bolan, 2015). The drug does not have any reported food interactions, but it is advised that multiple drugs containing imiquimod should not be used in the same area to avoid drug interactions. Additional precautions are to be taken when prescribing imiquimod to pregnant women, as well as people with inflammatory or autoimmune skin diseases (Workowski & Bolan, 2015). Overall, imiquimod appears to be an effective treatment for anogenital warts resulting from HPV and has few considerations.

The best effective education to preventing HPV

Due to the difficulty of treating HPV and the severity of possible complications, patient education is critical to preventing the infection. Firstly, the education of young adults should include recommendations about immunization, like most types of HPV can be effectively prevented with vaccination (Workowski & Bolan, 2015). Also, it is essential to provide information about HPV and other sexually transmitted infections, their risks, and prevention methods. Finally, clinical guidelines suggest that sex education should be part of prevention efforts targeting young adult populations (Workowski & Bolan, 2015). Thus, offering education about safe condom use and abstinence is also required.

References

Canada Drug Bank. (2018). Imiquimod. Web.

Park, I. U., Introcaso, C., & Dunne, E. F. (2015). Human papillomavirus and genital warts: A review of the evidence for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clinical Infectious Diseases, 61(8), S849-S855.

Wolicki, J. (2017). Human papillomavirus – 2017. Web.

Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR: Recommendations and Reports, 64(3), 1-137.