Q. Is it possible to have more than one HPV strain in my body?

Ans: Yes, your body may have more than one HPV strain simultaneously. This is because all the HPV strains differ in properties, making coinfection possible.

Q. Which HPV strain poses the most significant risk of cervical cancer?

Ans: There are twelve high-risk HPV strains, but HPV 16 and HPV 18 tend to be the most dangerous strains. These strains contribute to nearly 70% of total cervical cases globally.

Q. Can I have the HPV vaccination during pregnancy?

Ans: No, HPV vaccination is not recommended during pregnancy. HPV vaccination can have adverse outcomes for the fetus and the mother's health if taken during pregnancy.

Q. Can pregnancy show a positive HPV result?

Ans: Yes, during pregnancy, an HPV result can be positive. This is because pregnancy can cause changes in the cervix, which can be mistaken for HPV infection.

Q. Can I get the HPV vaccine if I am older than 26?

Ans: Yes, in some cases. Adults aged 27 to 45 years can discuss with their doctor whether the vaccine may still benefit them, taking into account their health and sexual history.

Q. Is it possible to get cervical cancer if I have had the HPV vaccine?

Ans: Yes, but the risk is much lower. The vaccine does not cover all types of HPV, so regular screenings are still important even after vaccination.

Q. What cancers are associated with HPV infection?

Ans: HPV infection can cause anal, throat, mouth, penile, vaginal, and vulval cancer. Cervical cancer is not the only cancer that can happen due to HPV infection.

Q. Do all low-risk HPV cause warts?

Ans: No, not all low-risk HPV infections cause warts. While types 6 and 11 often lead to genital and common warts, other low-risk HPV types may not show any symptoms.

Q. How long does it take for the HPV vaccine to provide complete protection?

Ans: The final dose of the HPV vaccine, given at least six months after the first dose, is crucial because it strengthens the immune system's memory. Complete protection usually develops about one to two weeks after receiving this last dose.

Q. Can I test negative for HPV but still have warts?

Ans: Yes, it is possible to test negative for HPV even with visible warts, as most tests detect high-risk types, while warts are usually caused by low-risk types like HPV 6 and 11. Warts are typically diagnosed through a visual exam.

HPV Types: Which Cause Cervical Cancer?

What Are The Different HPV Types and How Are They Classified?

HPV might sound like one virus, but it is a group of over 200 different types. This can be confusing, especially since most people do not know what kind they have until they get tested. These types are classified based on the area of the body they infect and their risk level. Some are low-risk and cause only mild health issues, while others are high-risk and can potentially lead to cervical cancer. Let us look at these different groups and what they signify.

HPV based on where they infect:

Cutaneous HPV Types: Cutaneous types usually infect the outer layer of the skin and can cause warts in the hands and feet. Usually, they are low-risk types; however, in some cases, they can lead to skin cancer.

Mucosal HPV Types: Mucosal types usually infect the mucous membranes in the body, such as the inner lining of the cervix, vagina, and throat. These types are responsible for genital warts, and have two types: High-risk HPV and low-risk HPV.

Types of mucosal HPV types:

Low-risk mucosal types: These low-risk types typically infect soft tissue regions of the body, such as the mouth, throat, and genitals, and are responsible for minimal structural changes in the cells. Unlike high-risk types, they do not cause cancer or any cancerous growth; instead, they cause genital warts. It spreads through skin-to-skin contact during intercourse, which can be easily cleared from your body in 1-2 years.

It includes low-risk HPV types - HPV 6, HPV 11, HPV 40, HPV 42, HPV 44, HPV 54, HPV 61, HPV 62, HPV 71, HPV 74, HPV 81, HPV 84, HPV 89 (CP6108), and HPV 90.

High-risk mucosal types: These high-risk HPV are responsible for abnormal growth in the cells, which can later turn into cancerous growth. It usually spreads through sexual contact, and these variants are the leading cause of cervical, anogenital, and head cancers.

High-risk types include variants - HPV - 16, HPV 18, HPV 31, HPV 33, HPV 35, HPV 39, HPV 45, HPV 51, HPV 52, HPV 56, HPV 58, HPV 59, HPV 66, and HPV 68.

Knowing how HPV types are classified guides prevention and treatment efforts to reduce HPV-related diseases.

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Which High-Risk HPV Types Are Most Commonly Linked To Cervical Cancer?

Among the many HPV types, specific high-risk variants are known to be aggressive, significantly increasing the risk of cervical cancer. While not all high-risk types lead to cancer, HPV 16 and HPV 18 stand out as the most serious ones, together responsible for approximately 70% of cervical cancer cases. Recognising the role of these high-risk types is essential for early prevention of cervical cancer, detection, and effective management of HPV-related diseases.

The reason why HPV 16 and HPV 18 are dangerous:

High oncoprotein ratesHPV 16 and 18 are the most dangerous because they produce harmful oncoproteins E6 and E7, which can interfere with your body's natural defence against cancer by targeting the tumour suppressor. They shut down all the body's helper cells, promoting abnormal cells to grow uncontrollably. These oncoproteins can integrate with the cell's DNA, allowing cancer to stay active for a long time.

Higher penetration ratesHPV 18's genome is more dangerous as it can easily penetrate inside your body's chromosomes. This integration can cause abnormal changes in the cells. These cells become carcinogenic due to interference with the oncoproteins E6 and E7. Studies suggest that HPV 16 can also integrate with human chromosomes, but HPV 18 does so more often.

Difference in the variantsEven HPV 16 have different variants like A1, B1, C1, and D1, where some variants are more carcinogenic than others, causing more damage. This difference is due to the variation in the genetic makeup of these variants of HPV 16, which can affect how the virus causes cervical cancer.

Results in specific cancersHPV 16 usually results in cancer that stays outside the cervix, also known as squamous cell carcinoma, whereas HPV 18 causes agenocarcinomas. HPV 18 causes cancer, which is rare but aggressive and a massive contributor to cervical cancer.

Recognising the main HPV types linked to cervical cancer aids in better health management

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Is It Possible to Have More Than One HPV Type at the Same Time?

Yes, it is possible to be infected with more than one type of HPV at the same time, a condition known as coinfection. Since HPV (human papillomavirus) is one of the most common sexually transmitted infections, most sexually active individuals are likely to encounter at least one type in their lifetime.

Here is what you should know about HPV coinfection:

Coinfection simply means that multiple types of HPV are present in the body at the same time. This is more common than many people realise, mainly because HPV includes over 100 different strains, each with its own characteristics and risks.

HPV spreads mainly through sexual contact, and repeated exposure increases the chance of being infected with more than one strain. This can occur gradually over time, primarily through sexual contact with different partners.

Each HPV strain is unique, and the body only builds immunity to the specific type it has already encountered. That means having one HPV type does not protect you from getting infected with another, making coinfections possible with previous HPV infections.

In the early stages of infection, it is common for more than one HPV type to be detected. As the disease progresses, however, one type, often a high-risk strain, may become dominant and more likely to cause complications if not monitored. If you want to learn more about whether these infections cause symptoms before they develop into cervical cancer, read our guide on Early Warning Signs of Cervical Cancer.

Can HPV coinfection include other diseases like HIV or hepatitis?

Coinfection of HPV with viruses like HIV or hepatitis is quite common, especially in individuals with weakened immune systems. A healthy immune system can easily ward off the HPV infection; however, a compromised immune system will fail, creating a loop of persistent infection. Cases of HPV- hepatitis C virus coinfection usually occur when someone has had a liver transplantation. This is because HCV can impact immune response, making your body more susceptible to HPV infection.

Multiple HPV infections can occur together, making regular screenings essential for early detection.

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How Do Different High-Risk HPV Types Affect Your Chances Of Cervical Cancer?

There are more than 200 types of HPV, but about 12 are high-risk because they tend to persist longer and can cause changes to cervical cells that may lead to cancer. While most infections clear naturally, some high-risk types are more complex to eliminate, making regular screening and early detection essential.

Below are the most common HPV types that cause cervical cancer:

HPV 16

It is one of the most common and aggressive HPV types, which accounts for 50 - 60 % of cervical cancer cases globally.

Highly virulent - HPV 16 is said to be the most virulent infection, with a very high viral load. This means that the count of active HPV in the body is high, indicating the severity of the disease. It can cause aggressive cellular changes that have the potential to turn into high-grade lesions.

Tumour type - It leads to squamous cell carcinoma(SCC), the most common type of cervical cancer. The cervix has a protective layer of squamous cells. HPV 16 promotes abnormal growth in this protective layer, which can become a tumour.

HPV 18

It is the second most common HPV type responsible for cervical cancer, and constitutes 10 - 12% of cervical cancer cases globally.

Increases cancer risks - HPV 18 can be more dangerous than HPV 16, as it is highly oncogenic - cancer-causing. This means that infection with HPV 18 can lead to faster progression of lesions to fully grown tumours.

Tumour type - HPV 18 causes cervical adenocarcinoma, which means that it leads to abnormal growth in mucus-generating organs like the mouth, throat, and vagina. Cervical cancer caused by HPV 18 is easy to miss due to the lack of symptoms and is difficult to screen for using Pap smears and HPV screening.

Other HPV infections

The other remaining high-risk HPV types account for a small proportion of cases. Amongst all the high-risk types, the noticeable ones that cause more damage ae HPV - 31, 33, 45, 52, and 58.

Pose less threat - While these types can cause cancer, a persistent infection carries a lower risk for high-grade disease progression compared to a persistent HPV 16 or 18 infection.

Variable risk - The risk levels differ even among these types. For instance, HPV 31, 33, and 58 are associated with a greater risk of high-grade disease than types 39, 51, 56, and 68.

Different HPV types influence cancer risk differently, so understanding this guides better care decisions.

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Can Health Problems Increase the Risk of Cervical Cancer Linked To High-Risk HPV?

Specific health issues can increase your risk of contracting high-risk HPV types and developing cervical cancer. Many underlying conditions affect the immune system or cause inflammation, making it harder for your body to clear HPV infections. Existing health conditions that can increase HPV risks-

Weak immune response

Persistent swelling in the body can hinder immune defences, making HPV infections harder to clear. For instance:

For example:

Diabetes: Uncontrolled Diabetes, especially type II diabetes, can impact the immune response. High blood sugar makes it harder for the immune system to fight HPV infection. As a result, persistent HPV infection can lead to cervical cancer.

Liver cirrhosis: Cirrhosis is severe liver damage that weakens the immune system. A damaged liver can not support the immune response well, making it harder to fight HPV infections. This increases the risk of HPV - related cancers like cervical cancer.

Chronic inflammation

It is the second most common HPV type responsible for cervical cancer, and constitutes 10 - 12% of cervical cancer cases globally.

Hypertension and HPV infection are not directly linked. Studies suggest that hypertension can cause inflammation of the blood vessels, which can hamper the immune responses. A weak immune response can not.

Health problems like diabetes or cirrhosis may make it harder for your body to clear HPV, increasing long-term risks.

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How Does Pregnancy or Childbirth Influence the Transmission of HPV Types?

Pregnancy, including hormonal balance and the immune system, changes your body unimaginably. These changes give HPV a chance to stick around for a longer duration during pregnancy, causing long-term damage. Usually, HPV does not directly harm the body, but if it persists for a long time, there is a chance it could pass to the baby during birth, resulting in cervical cancer. If you are pregnant and have been diagnosed with cervical cancer, our guide Cervical Cancer and Pregnancy - What to Expect can help you understand your options and what lies ahead.

Hormonal shifts during pregnancyRising estrogen and progesterone during pregnancy can make cervical cells more sensitive, giving HPV more of a chance to take hold.

A naturally suppressed immune systemDuring pregnancy, the immune system is naturally suppressed to support the developing baby, which can make it harder to clear HPV infections.

Injury to the cervix during childbirthDuring childbirth, the cervix can get small tears or injuries. These tiny wounds can give HPV a chance to reactivate or spread more easily in the body.

Rare HPV transmission from mother to childIn rare cases, babies can catch HPV when they pass through the birth canal and cervix during vaginal delivery, as they come into contact with the virus there.

Postpartum-reactivation of HPV infectionPost-delivery, as your hormones balance out and your immunity gets stronger, an old HPV infection that was inactive might flare up.

Pregnancy and birth can change how HPV behaves and affect the risk of passing it on, so monitoring and care are essential.

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Are There Geographic or Demographic Differences in HPV Type Distribution in Cervical Cancer?

While HPV is a common virus, it is essential to know that not all types are the same; they behave differently and can affect different parts of the body in various ways. Geographic and demographic differences in the types of HPV linked to cervical cancer are primarily influenced by factors like access to vaccines, availability of screening programs, socioeconomic conditions such as poverty and education, and rates of HIV infection. In lower-income areas where healthcare services are limited, cervical cancer and HPV infections tend to be more common, often involving specific HPV strains that are more common in those regions. These differences in healthcare access and risk factors lead to varied patterns of HPV infection and cervical cancer rates around the world.

Region-based division of specific high-risk HPV variants:

HPV 16HPV 16 is one of the most commonly found variants in regions like Europe and the United States of America. It is found less in sub-Saharan Africa and China.

HPV 18HPV 18 is the second most common variant in some parts of Uganda.

HPV 52It is not as dangerous as HPV 18 and HPV 16, but it's prevalent in areas like sub-Saharan Africa and China.

Since different places and groups have different HPV type mixes, knowing what's common where you live helps protect you better.

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How Effective Are HPV Vaccines Against the High-Risk Types That Cause Cervical Cancer?

HPV vaccination is the best defence against HPV-related cancer, such as cervical, throat, vaginal, anal, and throat. Research suggests that modern HPV vaccinations are close to 100 % effective in shielding you from high-risk strains.

Current HPV vaccinations available in India are:

Cervavac (Quadrivalent)It is the first indigenous HPV vaccination made in India. It is quadrivalent, which protects against four HPV variants - HPV 6, 11, 16, and 18.

Gardasil (Quadrivalent)This quadrivalent vaccination protects against four HPV types - HPV 6, 11, 16, and 18.

Gardasil 9 (Nonavalent)This nonavalent vaccine provides broader protection, covering nine HPV types: 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Cervarix (Bivalent)It is a bivalent vaccine, protecting two high-risk HPV types, 16 and 18, which are responsible for most cervical cancer cases.

HPV vaccines are highly effective in protecting against the high-risk virus types that lead to cervical cancer.

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How Can You Prevent Cervical Cancer?

Cervical cancer can be easily prevented, and the earlier you start taking care of your health, the better. Especially for young women, building healthy habits now can make a big difference later. With just a few simple lifestyle changes, you can strengthen your immune system and protect your cervix from infections like HPV, which is the leading cause of cervical cancer.

Get vaccinatedHPV vaccines are one of the best ways to prevent cervical cancer. If you are 21 or older and have not gotten vaccinated, now is the time. It is a simple step that offers robust, long-term protection.

Go for regular screeningsTests like Pap smears and HPV screenings help catch any changes early, before they turn serious. You can even use HPV self-sampling kits from the comfort of your home, easy, private, and effective.

Practice safe sexUsing protection during sex can help lower your chances of getting HPV. Safe sex is not just smart, it's a way to protect your health.

Eat a balanced dietFruits, vegetables, whole grains, and other healthy foods give your body the nutrients to stay strong and fight infections. A good diet helps support your immune system and lowers your risk.

Manage your stressOngoing stress can weaken your immune system. By using effective coping strategies for cervical cancer, you can transform your health. Try simple activities like walking, stretching, deep breathing, or journaling to stay balanced and calm.

Small lifestyle changes give lasting protection.