How does hpv start

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Last updated: April 8, 2026

Quick Answer: HPV (human papillomavirus) starts when the virus enters the body through tiny cuts or abrasions in the skin or mucous membranes, typically during sexual contact. The virus infects basal epithelial cells in the genital area, mouth, or throat, where it can remain dormant for years before potentially causing cellular changes. HPV is extremely common, with about 80% of sexually active people contracting at least one type by age 45. Most infections clear within 1-2 years, but persistent infection with high-risk types can lead to cancer decades later.

Key Facts

HPV is the most common sexually transmitted infection worldwide, with over 40 types affecting genital areas
Approximately 79 million Americans are currently infected with HPV, with about 14 million new infections occurring annually
HPV causes nearly all cervical cancers, with about 570,000 new cases and 311,000 deaths globally in 2018
The HPV vaccine was first approved by the FDA in 2006 and can prevent over 90% of HPV-related cancers
HPV infections typically start in adolescence or young adulthood, with peak acquisition occurring within 5-10 years of first sexual activity

Overview

Human papillomavirus (HPV) is a group of more than 200 related viruses, with about 40 types that primarily infect the genital areas, mouth, and throat. First identified in the 1950s, HPV gained significant medical attention in the 1970s when German researcher Harald zur Hausen discovered the link between HPV and cervical cancer, work that earned him the 2008 Nobel Prize in Physiology or Medicine. The virus has a long history, with evidence suggesting it has infected humans for thousands of years. HPV is classified into low-risk types (causing warts) and high-risk types (causing cancer), with types 16 and 18 responsible for approximately 70% of cervical cancers globally. The development of the HPV vaccine, beginning with Gardasil's FDA approval in 2006, marked a major breakthrough in prevention. Today, HPV remains a global health concern despite vaccination efforts, particularly in developing countries where screening and vaccination programs are less accessible.

How It Works

HPV transmission occurs primarily through skin-to-skin contact, most commonly during vaginal, anal, or oral sex. The virus enters the body through microscopic tears in the epithelial tissue of the genital tract, mouth, or throat. Once inside, HPV targets basal epithelial cells in the deepest layer of the epithelium. The virus's circular DNA genome integrates into the host cell's DNA, hijacking cellular machinery to replicate. High-risk HPV types produce oncoproteins E6 and E7 that interfere with tumor suppressor proteins p53 and pRb, disrupting normal cell cycle regulation and DNA repair mechanisms. This leads to uncontrolled cell division and accumulation of genetic mutations. The infection typically progresses through stages: initial infection, viral persistence, development of precancerous lesions (like cervical intraepithelial neoplasia), and potentially invasive cancer over 10-30 years. Most infections are cleared by the immune system within 1-2 years, but persistent infections with high-risk types can lead to cellular transformation.

Why It Matters

HPV matters profoundly because it causes approximately 5% of all cancers worldwide, including nearly all cervical cancers, 90% of anal cancers, 70% of oropharyngeal cancers, and significant percentages of vaginal, vulvar, and penile cancers. In the United States alone, HPV causes about 36,000 cancer cases annually. The economic burden is substantial, with cervical cancer screening and treatment costing billions globally. Beyond cancer, HPV causes genital warts affecting about 1% of sexually active adults. The development of HPV vaccines has been a major public health achievement, with vaccination preventing an estimated 90% of HPV-related cancers when given before exposure. However, vaccination rates remain suboptimal in many regions, and disparities in access to screening and treatment contribute to higher mortality in low-income countries, where cervical cancer remains a leading cause of cancer death among women.