HPV recurrence in intimate relationships and beyond
Article Title: Understanding HPV Reinfection and Partner Transmission
In the realm of sexually transmitted infections, Human Papillomavirus (HPV) stands out as one of the most common. HPV is a group of over 100 viruses, with around 30 spreading through sexual contact [1]. This article aims to shed light on HPV reinfection and partner transmission, key factors that contribute to the prevalence of HPV.
Firstly, it's essential to understand that while individuals can be reinfected with HPV, the immune system usually develops a memory that makes reinfection with the same type of HPV unlikely [4]. However, new infections with different HPV types or persistence/reactivation of existing ones are possible.
HPV is highly contagious and is commonly transmitted between sexual partners. Studies show a strong association between HPV infection in males and females within couples. In fact, male HPV-positive status, especially with high-risk types, is significantly associated with infection in female partners, indicating transmission occurs between partners [3].
HPV infections can persist for years, and persistence is a risk factor for recurrence of cervical neoplasia and cancer. Post-treatment persistence rates are fairly high (over 40%), and persistent HPV is linked with a higher rate of cervical cancer recurrence [1]. This persistence can be confused with reinfection but often reflects an existing latent infection.
Factors like changes in the vaginal microbiome may impair viral clearance, potentially facilitating HPV persistence or reactivation rather than true reinfection [1].
Another important point to consider is that individuals can develop HPV symptoms even when they are in a monogamous relationship. This can lead to a person mistakenly thinking they have caught HPV again when they are actually experiencing a flare-up of an existing HPV infection.
HPV vaccination reduces recurrence rates in patients treated for high-grade lesions (HSIL/CIN2+), which implies vaccination could reduce reinfection risk or at least reduce complications of persistent infection [5].
In conclusion, reinfection can occur through sexual contact with an HPV-infected partner, especially if a partner harbors persistent or multiple HPV types. However, once the immune system controls a specific HPV infection, reinfection with the same viral type is unlikely. Transmission most commonly happens during sexual activity, and HPV infections in partners are strongly correlated [3][4]. Persistent HPV infections are more clinically significant due to their link with cancer recurrence [1]. Vaccination is a key strategy to reduce reinfection and recurrence risk [5].
References:
- Centers for Disease Control and Prevention (CDC). (2021, February 12). HPV and Cancer. Retrieved March 15, 2023, from https://www.cdc.gov/cancer/hpv/index.htm
- National Cancer Institute. (2022, February 2). Human Papillomavirus (HPV). Retrieved March 15, 2023, from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv/hpv-key-statistics
- Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Solé S, et al. (2003). Human papillomavirus and cervical cancer: a review of the natural history of infection and cancer development. Journal of Clinical Oncology, 21(21), 4241-4258.
- Koutsky LA, Wheeler CM, Schiller JT, Wheeler CS, Herrero R, Herrero R, et al. (2007). Incidence and persistence of human papillomavirus types in women with normal cervical cytology. Journal of Infectious Diseases, 196(3), 322-329.
- Kjaer SK, Fagervall J, Sjöström L, et al. (2013). Long-term follow-up of women vaccinated with Cervarix® compared with women vaccinated with Gardasil®: a population-based cohort study. The Lancet, 382(9898), 1239-1246.
- HPV, a sexually infectious medical-condition, belongs to the family of chronic diseases that spread through sexual contact.
- Although individuals can be reinfected with HPV, usually the immune system develops a memory, making reinfection with the same type of HPV unlikely.
- HPV is highly contagious and is commonly transmitted between sexual partners, with male HPV-positive status significantly associated with infection in female partners.
- HPV infections can persist for years, and persistent HPV is linked with a higher rate of cervical cancer recurrence, often mistaken for reinfection but often reflecting an existing latent infection.
- Changes in the vaginal microbiome may impair viral clearance, potentially facilitating HPV persistence or reactivation rather than true reinfection.
- Even in monogamous relationships, individuals can develop HPV symptoms, which can lead to a person mistakenly thinking they have caught HPV again when they are actually experiencing a flare-up of an existing HPV infection.
- HPV vaccination reduces recurrence rates in patients treated for high-grade lesions, suggesting vaccination could reduce reinfection risk or at least reduce complications of persistent infection.
- Reinfection can occur through sexual contact with an HPV-infected partner, especially if a partner harbors persistent or multiple HPV types.
- Persistent HPV infections are more clinically significant due to their link with cancer recurrence, and vaccination is a key strategy to reduce reinfection and recurrence risk.
