Genital Condyloma (HPV Infection)
Genital warts (condyloma acuminata) are very common. They are sexually transmitted. Ninety percent are caused by types 6 and 11 of the human papilloma virus (HPV). The epidemiology, clinical presentation, differential diagnosis, treatment, and prevention
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Eduardo Schejter
16.1 Epidemiology
It has been estimated that about 1% of the sexually active adult population in the Western world Genital warts (condyloma acuminata) are one of suffers from clinical warts during their lifetime. the most common benign vulvar diseases. It is The peak prevalence is between 20 and 24 years mostly caused by the human papilloma virus of age (6.2/1000 person years) in women and 25 (HPV) types 6 and 11 (90% of cases), although and 29 years of age (5.0/1000 person years) in many more types of HPV may be associated with men [1, 4], and this incidence has increased sigit. It is transmitted through sexual contact (geni- nificantly during the last three decades [5, 6]. It is tal, orogenital, manual-genital, and non-estimated that around 30 million persons suffer penetrative genital contact), with a transmission from genital warts worldwide [7]. Many healthrate of 60% between partners [1]. care providers have stressed the importance of At least 40 identified HPV types infect the raising awareness of the risks of contracting sexugenital tract. If a college female student has at ally transmitted diseases in young populations; least one different partner per year for 4 years, however, there has been a further dramatic the probability is greater than 85% that she will increase in sexually transmitted diseases in the leave college with an HPV infection. Condoms 30- to 45-year age range as well. It is estimated do not completely protect from acquiring the that this increase in infection stems from what is virus because the areas around the genitals, known as the “second chapter” in life, following including the inner thigh, are obviously not pro- divorce, and that the increase in casual sex tected, thus exposing them to the infected part- increases the risks of contracting sexually transner’s skin. Sharing of contaminated objects may mitted diseases in mature individuals [8, 9]. transmit HPV, but nonsexual transmission is less The prevalence of condyloma acuminata common. Finger-genital contact is also a possible seems to be similar for men and women. A study way of transmission, but it is unlikely to be a sig- from one sexually transmitted disease (STD) nificant source [2–4]. clinic found that 13% of men and 9% of women had condylomata acuminata [10]. One of the long-held beliefs is that intercourse using a condom is safe, but the virus may be transmitted by contact of uncovered skin in the genital area, making the protection for HPV infection partial at E. Schejter (*) best. The facts that the virus is highly prevalent, Women’s Health Center, Maccabi Healthcare and that it is latent without any external manifesServices, Tel Aviv, Israel tations, significantly increase the risk of infection. e-mail: [email protected] © Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_16
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E. Schejter
In addition, unlike the level of awareness of risks of HIV infection, knowledge about diseases t
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