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Adrienne Hill-Strathy
Contracting a strain of HPV is very common.
You may have had it as a child in the form of a pesky plantar wart on the bottom of your foot or a small nodule that developed on your finger.
In early adulthood, HPV is commonly contracted through sexual contact, with 80% of women contracting a strain within her lifetime.
The common occurrence of HPV and its often-invisible symptoms may make you wonder, what happens after you’ve been infected, and can a virus reactivate?
Here we breakdown a little more about HPV, HPV testing, how the virus enters latency, and whether infection can come back. We also provide some tips to help you maintain optimal immune health.
What is HPV?
The human papillomavirus includes a diverse group of over 150 viruses that infiltrate the body through our skin tissue and use the machinery of our cells to replicate their viral code.
Depending on the strain and the immune system, an HPV infection may present a range of symptoms from visible papilloma, or warts, on the skin surface or genitals to no symptoms at all.
Few high-risk strains may develop into complications like cervical cancer years after infection.
HPV is typically considered a lifelong infection, once you have contracted a viral strain the DNA lives within your cells. However, the HPV virus can get deactivated and stop producing its viral load, referred to as viral latency.
For more information on HPV, check out our article on What Is HPV? for an in-depth guide to HPV.
HPV Testing
HPV testing is done to evaluate the active presence and strain of HPV in a host. The screening tools for cervical cancer typically classify infection on the following levels:
First HPV-positive results: this is a common result and most new infections will likely revert to a negative within 6 to 12 months but require follow-up.
HPV-positive, cytology negative- patients with positive HPV status but negative cytology are at an increased risk of developing cervical cancer. A patient with the result will be recommended to be followed and repeat HPV and cytology in 12 months.
Recurrent HPV-positive- often a positive HPV screen will be followed by an HPV negative. This suggests the immune system has made the HPV infection latent. The HPV infection can still recur upon reactivation due to a weakened immune system.
Persistent HPV positive- a persistent HPV infection, that has been positive for over 12 months, is likely to develop into a CIN 2 infection within five to seven years. The infection should be closely monitored for potential progression.
Persistent HPV-positive, low-risk cytology and negative colposcopy- In the situation, patients may still be at risk of disease progression, and active surveillance is still needed.
Viral Latency
The majority (80-90%) of HPV infections will enter a state of latency. Latency refers to a virus remaining in a resting state without producing its viral code so symptoms or complications don’t develop.
In a healthy immune system, active infections will initiate an immune response through CD4+ T cells. Once these cells are activated more immune molecules accumulate at the site of infiltration and overtake the viral gene expression.
A compromised or weak immune system seems to be the hallmark of HPV infections, where the failure to develop effective cell-mediated immunity to clear or control the infection results in persistent infection and increases the probability that the cells progress to cancer.
Recurrence of Latent Infections
Because the HPV particles continue to exist within the bottom layer of the epithelial cells, the virus can get reactivated following a change in immune status.
Maintaining viral latency requires one to maintain a healthy immune system. When this fails or is compromised the virus can begin replicating again and may lead to symptoms or progress to complications like cervical cancer.
Can I Get Re-infected?
If you have contracted a strain of HPV in the past, you are not immune from catching further infections.
The 150 different strains of HPV all have slightly different DNA and mechanisms of infiltrating an individual.
It is estimated that 75-85% of females and males carry a strain of HPV. Therefore, engaging in sexual activity can expose an individual to further HPV infections and complications. Even women in long-term monogamous relationships can get re-infected.
Research is looking to evaluate whether exposure to HPV viruses, particularly HPV 16 and 18, which cause the most cases of cervical cancer, can lead to natural protection against additional HPV strains. Thus far, there has been a lack of sufficient data on naturally acquired immunity and whether the previous infection can reduce rates of recurrence.
Maintaining a healthy immune system
Regardless of the strain of HPV, you have contracted, the key to silencing the virus and keeping it in its latency state depends on the health of the immune system.
The immune system is multi-faceted, which means supporting it is complex as well.
First, reducing risk factors like smoking, prolonged oral contraceptive use, assessing coinfections, and immune-related diseases is key to ensuring adequate immune functioning.
Second, implementing a healthy diet, rich in diverse plant-based foods and good-quality proteins, reducing stress, getting good quality sleep, and engaging in regular exercise is also important to support our body and immune health.
Lastly, supplementation can help replenish nutritional deficiencies that are essential for proper immune function. Papillex includes a range of nutrients known to be low in patients with persistent HPV infections and a number of herbs that help optimize our immune system.
Dec 01, 2020
4 min read
Adrienne Hill-Strathy
High-Risk HPV, 16 18 45: What You Need to Know
The family of human papillomaviruses contains a variety of over 150 different strains of HPV. These strains have evolved over time to have different ways to infiltrate and evade the immune system of individuals, causing different disease progressions.
Nearly all sexually active individuals will come into contact with a strain of HPV. It is estimated that 80% of women will contract an HPV infection at some point in their lifetime.
While most cases of HPV infections are asymptomatic, some can manifest in lesions from genital warts to cervical cancer. A few HPV strains, in particular, HPV 16, 18, and 45 have been classified as the most high-risk HPV types, accountable for approximately 70% of cervical cancers around the world.
The prevalence of high-risk HPV infections is estimated at around 22.7%. The most common of these high-risk infections to cause changes to the cervix were HPV types 16, 18, and 45.
High-Risk HPV
High-risk strains often do not cause symptoms so many are unaware that they have contracted a strain of HPV. The high-risk strains develop slowly over time, causing minor changes to the cells of the cervix, anus, or oral cavity.
High-risk strains that persist for a number of years can eventually alter the genome of an individual and increase the risk that cancer will evolve.
12 HPVs (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) are defined by the World Health Organization (WHO) as being high-risk cancer-causing types. Together these HPV’s cause half a million cases of cervical cancer per year worldwide. These strains can also cause cancers at other sites, including the penis, vagina, and vulva and in the oral cavity.
What Makes High-risk Strains More Cancerous?
The reason high-risk strains are more likely to cause cancer is due to where the virus has evolved to infiltrate the body and specific proteins within the viral machinery.
Particular areas within the cervix lining are more susceptible to fostering cell replication than others. HPV that gains access to the transformational zone in the cervix have been linked to higher rates of cancer progression. This site has a lower density of immune cells called Langerhans cells, that provide our first line of defense in fighting off pathogens.
High-risk HPV strains are the leading cause of cervical cancer
Two viral proteins, E6 and E7, have also been found to be more active on high-risk strains of HPV. These proteins are thought to be responsible for allowing the virus to enter the upper layers of the epithelial tract. The proteins have also been found to downregulate toll-like receptors of the innate immune system, leading to greater threats to the individual's DNA.
These E6 and E7 proteins appear to be inactive or weakly active in low risk HPV types.
High-Risk HPV Strains and Cancer Rates
Despite high-risk strains increasing one’s risk of cancer, contracting a strain does not mean you are going to get cancer. The majority (90%) of individuals will clear the infection within three years and have no complications. Of the 10% of cases that become chronic only 1% will result in cervical cancer.
Women with a high-risk HPV strain have a 210-fold higher risk of developing a CIN 3 complication in 6 years as compared with negative women. This means that instead of every 9 in 10,000 women contracting cervical cancer, 210 in 10,000 with a high-risk strain will develop into cancer.
HPV Testing and mRNA E6 E7
HPV testing can detect which strain of HPV you have contracted and indicate whether you have been infected with a high-risk strain.
To provide a better understanding of the strains risk of developing into cancer, mRNA E6 and E7 testing can also be done. Testing can be done to detect the presence of these proteins within an individual.
E6 and E7 are usually expressed at low levels during a transient HPV infection. When the virus has integrated into the individual gnes, the oncogene transcripts are over-expressed, leading to the development of cervical cancer.
HPV E6 and E7 mRNA expression level are highly correlated with the severity of cervical lesions and can be tested and used as a biomarker for HPV infections that are more likely to progress to cancer.
Having more reliable and better testing for HPV has played a significant role in reducing mortality from cervical cancer in the past several years. Staying on top of your pap testing and monitoring your situation with your doctor is key to fighting off high-risk strains.
What Can You Do If You Have Contracted HPV?
In addition to regular testing, fighting off high-risk strains of HPV requires a healthy immune system. We believe implementing a healthy lifestyle is built around four foundational lifestyle therapies:
1. Nutrition and Supplementation
The gut is home to around 80% of the immune system. Consuming a fruit and vegetable-rich diet, limiting sugar and refined carbohydrate intake has been found to have a positive effect on the overall function of the immune system.
Papillex is a supplement which is designed specifically to help your body respond to HPV and is packed full of ingredients which have been researched with HPV in mind.
Building a strong immune system with good nutrition is an important factor in your body's ability to fight off viral infections
2. Psychological Stress
Prolonged stress has been found to create an imbalance in the ability of the body to fight incoming infection, by over activating areas of the immune system that exacerbate chronic illness. Engaging in daily stress management practices like meditation, exercise, and socializing can have a positive effect in improving the bodies overall resiliency.
3. Sleep
Getting adequate rest, seven to eight hours of quality sleep per night, allows the immune system time to revitalize, balance hormones and it initiates cellular repair. Setting a regular bedtime, limiting caffeine intake in the afternoon, and eating a nutrient-dense diet are all ways we can improve our sleep quality.
4. Exercise and Movement
From improved circulation to naturally increasing the bodies white blood cell and antibody count, staying active has a range of benefits in helping support the immune system and defense against disease. We recommend talking daily walks and engaging in bi-weekly strength training and aerobic activity.
Oct 01, 2020
5 min read
HPV Diet: Can I Help Healing from HPV with Food and Diet?
Christine Chung
Food is the foundation for all health. You can make or break the future of your health through simple decisions made in your diet.
How does this apply in HPV?
Human Papilloma Viruses can be complex, yet so simple at the same time.
Learn how to help support the treatment of HPV symptoms and prevent recurrences through 3 simple steps in your diet!
Healing HPV Through FOOD
If you have been diagnosed with HPV, warts, or abnormal cervical cells, like cervical dysplasia, we can understand that the future may not seem as bright as it used to.
It doesn’t have to be that way.
There are many treatment options for HPV complications from intensive surgeries to at-home treatments.
Step 1: Diet
Rather than patiently waiting for your doctor to make the call for treatment, in the meantime, you can take your health into your own hands through education, nutrition, and lifestyle.
Is there a cure for HPV?
While there is no cure for HPV, as outlined in some of our other blogs, you can make healthier lifestyle choices starting with the foundations – DIET.
Through diet, you can get the nutrients necessary to help boost your immune system, keeping it robust enough to reduce HPV symptoms and prevent recurrent infections of the human papilloma virus.
How do you start changing your diet?
Studies have shown that those who eat nutrient-poor diets, especially those low in fruit and vegetables, are missing key nutrients. This makes those with poor diets more likely to develop persistent HPV. Fruits and vegetables have high levels of antioxidants, which help to neutralize toxic molecules in your body. They also contain key nutrients such as folate, beta-carotene, vitamin C, among other nutrient goldmines!
We know that dietary changes can be difficult; especially the part of knowing exactly what you can and cannot include. Severe restrictions may not be warranted for you depending on your medical conditions, and are also easy to maintain long-term. What we can help with is making general suggestions that everyone will benefit from. We want to help make things easy, so here it is:
3 Suggestions to Help your Body Heal from HPV with Food
Cut out any simple, refined carbohydrates from your diet
Wondering what simple refined carbohydrates are?
They include white sugar, white bread, white flour, white pasta. You get the trend!
Opt for whole grains instead; the more complex the carbohydrate, the healthier it is for you. This includes, wheat, oats, quinoa, beans and starchy vegetables, like white potato.
Natural sugar forms are far better for your health
Choosing natural forms of sugar are less toxic and are more supportive for your body by including super-nutrients like antioxidants, such as acerola cherry, raspberries, or goji berries. Citrus fruits are also great for high levels of vitamin C, which helps to support your immune system.
BONUS: Vitamin C is also seen to be lower in those with HPV-related cervical cancer. Check out our blog post on Vitamin C and HPV for more details!
Increasing your daily intake of fruit and vegetables
This is the simplest way to improve your overall health.
Try to aim for two handfuls of fruit or vegetables with every meal, equaling out to 7 to 10 servings a day. This may seem like a lot, but 4 to 5 cups (1/2 cup = 1 serving) of fruit and vegetables a day isn’t too hard to implement if you do it strategically!
There are easy ways to sneak more vegetables into your diet, like making a spaghetti sauce that’s jam-packed with veggies, or a smoothie full of blended veggies, balanced out by some sweet fruit!
It's common knowledge, legumes and vegetables are good for you!
Choose your favorite vegetables and eat those in large quantities! Green leafy vegetables, such as kale and spinach, are great sources of folate, carotenoids, vitamin C, vitamin K, fiber, and calcium.
Cruciferous vegetables, such as broccoli, Brussel sprouts, cabbage, and again, kale, have a number of very important components, one being diindolylmethane, or DIM, another being indole-3-carbinol (I3C) that play a key role in killing HPV infected cells and cancer cells.
Some small human trials are showing new evidence that I3C supplementation may help to treat conditions related to HPV, including CIN. Significant regressions of CIN were seen in I3C treatment groups, even though they originally had higher numbers of HPV-positive subjects!
Sulfurophane, found in high quantities in broccoli has shown in preliminary cell studies to increase cell death of cervical cancer cells!
Try to incorporate half of your vegetable servings from these 2 groups of veggies!
Support Your Immune System with Herbs and Nutrients
In addition to an optimal HPV diet, there are several key herbs and nutrients that have been studied in relation to HPV.
These nutrients enhance the immune system, and are found concentrated in herbs such as Green Tea, Astragalus membranaceous, and Reishi Mushroom, all of which are key ingredients in Papillex.
Other immune system enhancing herbs that are traditionally considered to be anti-viral HPV herbs or HPV natural remedies include Goldenseal, Curcumin, AHCC, and many more. Through enhancement of the immune system with these natural, herbal approaches, you suffer no side effects and help your body support and regulate itself.
Jan 01, 2020
4 min read
Staying Positive While HPV Positive
Christine Chung
I’m HPV positive…what do I do now?
This is a thought on the mind of many people who get diagnosed with HPV.
With the risks for cervical cancer and other complications, the future may seem grey.
Most people feel a fear of judgment from anyone who may find out, causing them to keep their diagnosis hidden. This can create a cascade of events surrounding a negative outlook.
What you may not know is that HPV is more common than you think, and technology has come a long way to bring a bright future.
Is HPV as Scary as It Seems?
Reading material on the topic of HPV can be overwhelming, intimidating, and scary, especially with all the misinformation and stigma out there.
The truth is, most sexually active people are likely to have been exposed to HPV at some point in their lives. It can occur through any sexual contact: skin to skin contact, oral sex, anal sex included.
What about my cancer risk?
Not all HPV infections will cause cancer.
In fact, only a few out of the 100+ strains of HPV known cause cancer. Most of the time with a robust immune system, your body is able to clear these infections without any symptoms!
With routine screening, your doctor has caught your HPV progression and will take measures to prevent cancer from occurring.
Positively Affecting Your Immune System
Your immune system is key when fighting HPV. One aspect that can truly impact your outcome, is your mindset.
Happiness and positivity has been shown to reduce stress and promote healthier lifestyle habits, all of which will help boost your immune system. Did you know that positive individuals were shown to be more likely to consume fruits and vegetables?
This is all connected by your HPA axis that regulates your happy hormones and your immune system, among other bodily functions. Positive people sleep better, get sick less, exercise more, stress less, eat better…and much more!
Where Do I Begin?
Sharing your experience with those close to you may help build your support team to help you stay positive.
Disclosing your HPV status to your sexual partner, family, or friends can be a supportive and affirmative experience. There are also support groups available where you can share your experiences and others may understand on a deeper level.
Educating people is one way of actively breaking the stigma associated with
sexually-transmitted infections, which is crucial to helping people establish
safe sex practices, including those around oral sex. No matter what happens,
take comfort in making brave, compassionate and honest choices.
If you plan on having that conversation with your partner, you don’t need to be scared. There is so much support available around this subject. Check out our blog on How to Talk to Your Partner about your HPV Status for some tips.
How else can you support your body naturally?
Most HPV
infections are easily cleared by a strong, healthy immune system. Your immune
system can be supported in a number of natural ways:
Eat plenty of fruits and vegetables
Quit smoking
Reduce alcohol consumption
Drink green tea
Exercise to sweat
Papillex™, is a clinically-researched, nutrient-rich supplement designed to increase your body’s ability to respond to HPV naturally.
By optimizing your natural immunity and replacing missing and low nutrients, Papillex™ helps you to create an environment inhospitable to HPV and its common symptoms, cervical dysplasia and genital warts.
Nov 20, 2019
3 min read
Photodynamic Therapy for HPV: What Is It and Does It Work?
Christine Chung
Photodynamic therapy is a treatment typically used in the treatment of acne, warts, and a range of cancers, including mouth (oral), head and neck, lung, and skin cancer, and has been for a number of years now.
However, PDT is now being considered a
novel approach to eradicating the human papillomavirus.
This follows a study conducted by scientists at the Mexico National Polytechnic Institute who found it to be effective in clearing the virus.
Furthermore, it was reported that a researcher who worked on the project, Eva Ramón Gallegos, has used the method to remove HPV from 100% of a 29-women sample.
So is PDT the cure for HPV that we’ve all been looking for?
That remains to be seen.
The latest reports are yet to be
published in a peer-reviewed journal, and they were made a considerable amount
of time ago now, back in February 2019.
Nevertheless, PDT is worth exploring in the eradication of a virus which is the leading cause of cervical cancer in the world, and one of the most commonly transmitted sexual infections in the world.
How Does
PDT Work?
PDT involves using a particular type of light in combination with a photosensitizing agent called aminolevulinic acid (ALA), which is applied as either a topical cream or injected into your blood to make your cells sensitive to light.
Aminolevulinic acid, particularly
5-aminolevulinic acid, is an amino acid that is involved in a pathway called porphyrin synthesis in your body.
When combined with the correct light wavelength, the procedure damages those surface layer cells affected by HPV, while surrounding tissue is left undamaged.
Photodynamic Therapy in action for Acne
In other words, ALA, makes your cells
more sensitive to light, and when exposed to a certain wavelength of light, can
kill cancer cells.
PDT also works well for treating genital warts. The combined therapy attacks the skin cells of genital warts that continue to expand when they shouldn’t. In addition, the therapy was specific enough that it targeted these cells but left the normal, healthy skin cells alone.
What Are
The Benefits of PDT?
Many women who suffer from HPV are of child-bearing age, so the risk of treatment to future pregnancies is a concern for this population. Luckily, photodynamic therapy poses a lower risk to current and future pregnancies.
PDT is safer than other treatments during pregnancy
Among other benefits, photodynamic therapy is also non-surgical, which also means there is no blood loss, no sustained damage to cervical tissue, and no reports of infertility related to treatment.
Are There
Any Downsides?
PDT can be associated with some side effects, such as red, itchy skin, swelling, burning, or stinging at the site of treatment, however, these are relatively minor problems, especially in comparison to some of the treatments mentioned above.
However, PDT can be expensive.
This is dependent on the length of treatment and resistance of HPV, however, studies show that it is more cost-effective in comparison to some other treatments.
How Effective
Is PDT?
We did the digging so you wouldn’t have to. So sit back, sip your green tea, and relax. Most clinical trials show that PDT is highly effective when compared to a placebo treatment, or a treatment where the study participants THINK they are getting PDT treatment, but in reality, they are not.
When targeting CIN or HPV infections specifically to each patient, the complete remission rate is improved significantly. Keep in mind, the studies in this review were of lower quality. Studies show that with ALA-PDT, HPV can be effectively eliminated in those with latent or subclinical infections within 3 months.
This is the population of people who have been diagnosed with HPV but have not or are not currently showing symptoms.
Catch it early, and ALA-PDT therapy may work for you!
Multiple 4-hour treatments of 5-ALA and PDT in males with genital warts show complete clinical remission after the last session. The number of sessions and strength of treatment was specified for each patient depending on HPV viral load, a number that dictates the severity of infection.
By monitoring the viral load, doctors were able to keep an eye on the effectiveness of treatment, knowing when they needed to increase the intensity, or back off with treatment.
Treatment effectiveness
According to the evidence, the percentage strength of the aminolevulinic acid may impact effectiveness.
Comparing 2 different studies, one clinical trial used a 20% aminolevulinic acid gel and showed a high complete response rate, meaning no more symptoms for the patients with HPVafter 3 treatments. Even after 1 year, follow-up tests showed very low levels of recurrence of symptoms in patients.
Another study of higher quality used a 3% aminolevulinic acid gel with photodynamic therapy. Their results were generally positive for use in the treatment of HPV symptoms, however, they were not significantly different from the placebo group (recall: study participants THINK they are getting PDT treatment, but in reality, they are not). This study was of higher quality, so perhaps the other study was not as accurate.
A third clinical trial from Mexico used a 6% aminolevulinic acid gel with photodynamic therapy. They were looking into eliminating HPV-16and HPV-18 and associated cervical intraepithelial neoplasia (CIN) in Mexican women. They found that at this percentage, HPV infections were successfully eliminated, with or without CIN progression.
Specifically, in groups of people with cervical intraepithelial neoplasia, PDT showed to be very promising. CIN precancerous lesions, including carcinomas and early invasive cancer of the cervix, responded very well to photodynamic therapy.
Improving HPV outcomes
Well, newer studies are showing the effectiveness of using different analyses and numbers to track and guide the effectiveness of treatment. Researchers and doctors are keeping tabs on the HPV viral load to measure the effectiveness of treatment. This helps the treatment team to know if the current treatment is working if the dose should be increased, or if the treatment is working so well that they can start to use lower doses.
PDT has been shown to significantly lower viral load after treatment. The better the treatment, the lower the viral load!
They can also keep track using polymerase chain reaction assays (PCR) to give a grade of HPV, measuring the status of the HPV infection. DNA detection with genotype identification has also been used in this patient setting. The only thing you really need to know about this technique is that it can help find some precancerous or HPV lesions that are unnoticed.
Using these techniques, one clinical trial saw two cases of anal warts cleared with no detectable HPV at the end of treatment or at 1 year after treatment.
Mechanisms of Action
ALA-PDT also works by downregulating the expression of the human papilloma virus E6/E7 oncogene, the gene responsible for producing precancerous and cancer cells associated with HPV.
It also upregulates tumor suppressors, including p53, something that’s usually produced in your body to prevent tumors from growing.
ALA-PDT causes apoptosis of H8 cells, which is very important. H8 cells are HPV-16 immortalized cervical epithelial cells.
These cells are highly studied in HPV, as they activate the E6/E7 oncogenes and otherwise hide in plain sight by acting and functioning as normal human skin cells. One study found that by downregulating the E6/E7 oncogene and upregulating tumor suppressor, they were able to cure HPV infection-associated diseases and prevent progression into cervical cancer. The higher the dose of treatment, the higher the level of cell death of H8 cells. That’s a win in our books!
In summary:
Current research on available clinical trials show that PDT
combined with ALA is very effective in the treatment for HPV and associated
conditions.
Infections of early or late stage, with or without CIN, and even infections progressed into cervical cancer are all potentially treatable by ALA-PDT. Trials are all new and of varying qualities, but the research available is all we have to determine the benefits of this new therapy.
What else can you do?
Lifestyle modifications, a healthy diet, and supplementation
are key in maintaining a robust immune system to help clear the HPV infection.
Even with the PDT, ensuring adequate wellness and a fully supported immune
system will work in conjunction with the treatment to fight the battle against
HPV!
Discover the innate benefits in each Papillex ingredient and what exactly it does to support your immune system so you stay HPV-symptom free!
May 21, 2019
6 min read
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