Human papillomavirus, usually called HPV, is a very common group of viruses affecting the skin and mucous membranes. Most sexually active people are exposed to HPV at some point in their lives, often without knowing it because the infection usually causes no symptoms.
In most cases, the immune system clears the infection naturally within one or two years. However, some HPV types can cause genital warts, while persistent infection with certain high-risk types may lead to precancerous cell changes and several types of cancer.
HPV vaccination and regular cervical cancer screening are the most important ways to reduce the risk of HPV-related disease.
What is HPV?
More than 200 HPV types have been identified. They are generally divided into low-risk and high-risk types.
Low-risk HPV types, particularly HPV 6 and 11, can cause genital warts. They are not considered cancer-causing types.
High-risk HPV types can cause persistent infection and abnormal cell changes. HPV 16 and 18 are especially important because they are responsible for a large proportion of HPV-related cancers. Other high-risk types are also clinically significant and are included in modern HPV tests and vaccines.
Persistent high-risk HPV infection is associated with:
- cervical cancer;
- vulvar and vaginal cancer;
- anal cancer;
- penile cancer;
- some cancers of the mouth and throat.
Having HPV does not mean that a person has cancer or will inevitably develop cancer. The risk is mainly associated with a high-risk infection that persists over time and causes progressive cellular changes.
How is HPV transmitted?
HPV is transmitted mainly through intimate skin-to-skin contact, including vaginal, anal and oral sexual contact. Penetrative intercourse is not required for transmission.
A person can transmit HPV even when there are no visible warts or other symptoms. Because the virus can affect areas not covered by a condom, condoms reduce the risk but cannot provide complete protection. They remain important because they also reduce the risk of many other sexually transmitted infections.
HPV may be detected years after the initial exposure. A positive result therefore does not show when the infection was acquired or from whom, and it does not by itself indicate recent infidelity.
HPV symptoms in women and men
Most genital HPV infections cause no symptoms. A person may carry and transmit the virus without being aware of it.
When symptoms occur, they may include genital warts. These can appear as small, flesh-coloured or grey growths in the genital or anal area. They may be flat, raised or clustered and sometimes resemble a cauliflower. Warts may occasionally cause itching, irritation or bleeding, although they are often painless.
High-risk HPV infection and early precancerous changes usually do not cause symptoms. This is why cervical screening is important even when a woman feels completely well.
Symptoms such as bleeding after sex, bleeding between periods, bleeding after menopause, persistent pelvic pain or unusual discharge are not specific to HPV, but they should be assessed by a gynecologist.
What does a positive HPV test mean?
A positive high-risk HPV test does not mean that you have cervical cancer. It means that a type of HPV associated with an increased risk of cervical cell changes has been detected.
Most HPV infections clear naturally. The appropriate next step depends on several factors, including:
- your age;
- the HPV type detected;
- the cytology result;
- previous HPV or cervical screening results;
- any history of precancerous changes or treatment;
- immune system conditions and other individual risk factors.
Depending on the result, your doctor may recommend additional cytology, a repeat HPV test after a specified interval or colposcopy to examine the cervix more closely. Treatment is required only if clinically significant cell changes or another HPV-related condition are detected.
Do not try to interpret an HPV result in isolation. The laboratory result should be assessed together with cytology, previous tests and your medical history.
HPV testing and cervical screening in Latvia
Latvia has an organised state-funded cervical cancer screening programme for women from 25 to 70 years of age.
Women aged 25–29 are invited for cervical cytology screening every three years. HPV infections are common and frequently temporary in this age group, which is why cytology remains the primary screening method.
From the age of 30, high-risk HPV testing is used as the primary screening method, generally every five years. If high-risk HPV is detected, additional cytology is performed to determine whether abnormal cervical cells are present. Further assessment depends on the combined results.
Screening is intended for people without symptoms. If you have abnormal bleeding, pain or another concerning symptom, do not wait for a screening invitation—book a medical assessment.
Women who have received an HPV vaccine should still participate in cervical screening because vaccination does not protect against every HPV type that can cause cancer.
Can HPV be treated?
There is currently no medicine that directly eliminates HPV from the body. In most people, the immune system suppresses or clears the infection naturally.
Medical treatment focuses on conditions caused by HPV rather than on the virus itself. Depending on the diagnosis, treatment may include:
- topical treatment for certain genital warts;
- cryotherapy;
- removal by electrosurgery, laser or minor surgery;
- monitoring of mild cervical cell changes;
- treatment of clinically significant precancerous lesions.
Genital warts can return after treatment because removing a visible lesion does not necessarily mean that the virus is no longer present in the surrounding tissue.
Do not use ordinary pharmacy wart treatments on genital tissue. Products intended for warts on the hands or feet may injure sensitive genital skin and mucous membranes.
HPV vaccination
HPV vaccination is the most effective way to prevent infection with the HPV types most commonly associated with cancer and genital warts. The vaccine is preventive: it does not treat an existing infection or remove already developed cell changes.
Vaccination is most effective before exposure to HPV, which is why it is recommended at a young age before sexual activity begins. However, some adults may still benefit because previous exposure to one HPV type does not mean exposure to all types covered by the vaccine.
The HPV vaccine is non-live and cannot cause HPV infection. Vaccination does not replace cervical cancer screening.
Who is eligible for state-funded HPV vaccination in Latvia?
State-funded HPV vaccination is routinely available to girls and boys aged 12–17. It is also available to women and men aged 18–25 and to certain higher-risk groups under the eligibility criteria established in Latvia. For adult groups, availability may also depend on vaccine supplies.
Eligible higher-risk groups include certain patients with precancerous lesions, immunosuppression or HIV. A family doctor or gynecologist can help determine whether state-funded vaccination is currently available in your individual situation.
Adults who do not qualify for state-funded vaccination can discuss self-funded vaccination and the appropriate dosing schedule with a doctor.
Should I get vaccinated if I already have HPV?
An HPV vaccine does not treat the HPV type you already have. Nevertheless, vaccination may still protect against other vaccine-covered types to which you have not previously been exposed.
A positive HPV test is not automatically a reason to avoid vaccination. The potential benefit depends on your age, vaccination history, test results and individual risk factors, and should be discussed with a healthcare professional.
HPV and pregnancy
Having HPV does not usually prevent pregnancy and most HPV infections do not affect the course of pregnancy. Cervical screening results and any history of cervical treatment should nevertheless be discussed with the healthcare professional responsible for your pregnancy care.
The HPV vaccine is not routinely administered during pregnancy. If a vaccine dose was given before the pregnancy was recognised, this is not usually a reason for alarm, but subsequent doses are generally postponed until after pregnancy. Individual advice should be obtained from a doctor.
Does my partner need an HPV test?
Routine HPV screening tests are primarily used for cervical cancer prevention. There is no equivalent routinely recommended HPV screening test for most men or for partners without symptoms.
Partners often share HPV, and it is generally impossible to determine who transmitted the infection or when it occurred. A partner should seek medical advice if genital warts, lesions or other symptoms appear. Vaccination may also be worth discussing if the partner has not been vaccinated.
When should you see a gynecologist?
Arrange a gynecologist consultation if:
- you have received a positive high-risk HPV result and do not understand the recommended follow-up;
- cytology has shown abnormal cervical cells;
- you have visible genital warts or another genital lesion;
- you experience bleeding after sex, between periods or after menopause;
- you have persistent pelvic pain or unusual discharge;
- you have missed cervical screening or are unsure when your next test is due;
- you would like personalised advice about HPV vaccination.
Seek prompt medical attention for very heavy bleeding, severe pain, fainting or bleeding during pregnancy.
Frequently asked questions about HPV
Does a positive HPV test mean cancer?
No. A positive test means that high-risk HPV has been detected. Most infections do not progress to cancer. Further management depends on cytology, the HPV type, previous results and individual risk factors.
Can HPV disappear without treatment?
Yes. Most HPV infections are controlled or cleared by the immune system within one or two years. Persistent high-risk infection requires appropriate follow-up because it can cause cell changes over time.
Can HPV return after a negative test?
HPV may be newly acquired, become detectable again after a period of very low activity or vary around the detection threshold of a test. A later positive result does not necessarily prove a recent infection.
Do condoms protect against HPV?
Condoms reduce the risk but cannot provide complete protection because HPV can be transmitted through contact with skin that is not covered. They remain advisable for reducing the risk of HPV and other sexually transmitted infections.
Can I be vaccinated after becoming sexually active?
Yes. Vaccination may still provide protection against HPV types you have not encountered. The expected benefit should be considered according to age, previous vaccination and individual circumstances.
Does vaccination eliminate the need for cervical screening?
No. Vaccinated women should continue cervical screening according to national recommendations.
Is HPV the same as genital herpes?
No. HPV and herpes are caused by different viruses. They have different symptoms, complications, tests and management.
Have you received a positive HPV test?
A positive result can be worrying, but it does not mean that you have cervical cancer. Our gynecologists can explain your HPV and cytology results, assess whether additional examinations are required and recommend an appropriate follow-up plan.
Book a gynecologist appointment in central Riga
Address: Republikas laukums 3–18, Riga
