Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious sexually transmitted infection caused by some sub-types of human papillomavirus (HPV). It is spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. Genital warts are the most easily recognized sign of genital HPV infection. They can be caused by strains 6, 11, 30, 42, 43, 44, 45, 51, 52 and 54 of genital HPV; types 6 and 11 are responsible for 90% of genital warts cases. Most people who acquire those strains never develop warts or any other symptoms. HPV also causes many cases of cervical cancer; types 16 and 18 account for 70% of cases.
The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once cells are invaded by HPV, a latency (quiet) period of months to years may occur. HPV can last for several years without a symptom. Having sex with a partner whose HPV infection is latent and demonstrates no outward symptoms still leaves one vulnerable to becoming infected.
Depending on the size and location of the wart, and other factors, a doctor will offer one of several ways to treat them.
Podophyllin and podofilox should not be used during pregnancy, as they are absorbed by the skin and could cause birth defects in the fetus. 5-fluorouracil cream should not be used while trying to become pregnant or if the person taking the medication could be pregnant.
Some doctors inject the antiviral drug interferon-alpha directly into the warts, to treat warts that have returned after removal by traditional means. The drug is expensive, and does not reduce the rate that the warts return.
Although treatments can remove the warts, they do not remove the HPV, so warts can recur after treatment. Traditional theories postulated that the virus remained in the body for a lifetime. However, new studies using sensitive DNA techniques have shown that through immunological response the virus can either be cleared or suppressed to levels below what PCR tests can measure.  According to the Center for Disease Control's report on HPV to Congress in 2004, studies have shown that 70% of new HPV infections clear within one year, and as many as 91% clear within two years. The median duration of new infections is typically eight months. The gradual development of an effective immune response is thought to be the likely mechanism for HPV DNA clearance. The state of the immune system determines the chances of removing the virus entirely and can be affected by factors such as HIV infection, certain medications, stress, or illness. There is even some suggestion that effective treatment of the wart may aid the body's immune response.
Genital warts (condylomata) should not be confused with Molluscum contagiosum (MC), which is often transmitted sexually, but does not occur internally as do condylomata. MC looks like small warts, which are much smaller than condylomata genital warts. It does not increase the risk of cervical cancer for women. Genital warts should not be confused with Fordyce's spots, which are considered benign.
Estimation of the incidence of genital warts and the cost of illness in Germany: A cross-sectional study.(Research article)
Jun 02, 2008; Authors: Peter Hillemanns (corresponding author) ; J Gabrielle Breugelmans [2,7]; Friederike Gieseking ; Stève Bénard ;...