HPV in Malaysia: Symptoms, Testing, Treatment & Vaccination
HPV is the most common STI (also called STD) worldwide. Most infections clear silently, but persistent high-risk strains cause cervical, anal, penile and throat cancer, and low-risk strains cause genital warts. There is no test for asymptomatic HPV in men. HPV vaccination (Gardasil 9 in Malaysia) prevents around 90% of HPV-related disease.
Disemak secara perubatan oleh Dr. Azzim Emir · MBChB, berdaftar MMC · Patogen: Human papillomavirus (HPV)
What is hpv (human papillomavirus)?
HPV is a family of viruses that infect skin and mucous membranes. Around 40 strains affect the genital area. "Low-risk" strains (mainly HPV 6 and 11) cause genital warts; "high-risk" strains (mainly HPV 16 and 18) cause cervical, anal, penile, vulvar and oropharyngeal cancer.
Most HPV infections clear spontaneously within 1-2 years. The minority that persist for years are the ones that drive cancer.
HPV has also been detected in people with no reported history of sexual contact, and in long-term mutually monogamous couples where neither partner reports an outside exposure. This is consistent with non-sexual modes of transmission described in the literature.[5][6]
Patogen: Human papillomavirus (HPV) (Non-enveloped DNA virus, over 200 strains).
Bagaimana ia tersebar
- Skin-to-skin genital contact (penetrative sex is not required)
- Vaginal, anal and oral sex
- Berkongsi alat seks
- Non-sexual skin-to-skin contact, including autoinoculation from a person's own cutaneous (hand) warts to genital skin
- Indirect contact with contaminated objects (fomites). HPV DNA has been recovered from shared towels, undergarments, gym and clinic surfaces, and medical instruments. This route is uncommon for genital HPV but is documented.[5][6]
- Condoms reduce but do not fully prevent HPV (areas not covered by the condom can still transmit)
Siapa yang berisiko? Haruskah saya diuji?
- Anyone sexually active - most people acquire HPV at some point
- Multiple lifetime sexual partners
- Early age of first sexual activity
- Immunocompromised individuals (HIV, transplant recipients)
- Smokers (higher persistence and cancer progression rates)
- Unvaccinated people up to age 45
Haruskah saya diuji? Pemeriksaan diri cepat
Jawab soalan di bawah - perkhidmatan peribadi anda boleh memberi nasihat tentang langkah seterusnya.
- Have you noticed any flesh-coloured bumps or cauliflower-like growths on the genitals or anus?
- Have you ever had a partner with genital warts or an HPV-related cancer?
- Are you under 45 and not yet HPV-vaccinated?
- Have you had multiple sexual partners or new partners in the past 12 months?
- Are you a man who has sex with men (higher anal HPV risk)?
- Do you smoke (increases HPV persistence and cancer risk)?
Gejala
- The vast majority of HPV infections cause no symptoms at all
- Flesh-coloured, soft, cauliflower-like genital warts (low-risk HPV 6/11)
- Warts on the penis, scrotum, vulva, perianal area or inside the anus/vagina
- Itching or mild discomfort around warts (rarely painful)
- Abnormal Pap smear results (cervical cell changes from high-risk HPV)
- Persistent throat or oral lesions (oropharyngeal HPV - usually silent until cancer develops)
Tanpa gejala pada lelaki
Around 80-90% of HPV infections in men are completely silent and self-clear within 2 years; anal Pap is available for asymptomatic HPV detection in men who receive anal intercourse
Tanpa gejala pada wanita
Most infections are also silent in women; Pap smear and HPV cervical testing detect cellular changes from high-risk strains
Sumber: rujuk rujukan [1] di bawah.
Statistik Malaysia
| HPV is the most common STI worldwide; lifetime prevalence in sexually active adults exceeds 80%. | [1] |
| Malaysian cervical cancer cases per year (driven by HPV 16/18) | ~1,700 new cases, ~990 deaths annually[2] |
| Cervical cancer is the 3rd most common cancer in Malaysian women | [2] |
| Malaysian school-based HPV vaccination programme (girls aged 13) | Coverage >90% since 2010 - among the highest in the region[3] |
| Genital warts attributable to HPV 6 and 11 | ~90% of cases[1] |
Ujian & tempoh jendela
Kaedah
Clinical examination for visible warts. HPV DNA testing on cervical samples (women). Anal Pap for asymptomatic HPV in men who receives anal intercourse.
Spesimen
Visual inspection; cervical/vaginal swab for HPV DNA testing in women; biopsy of suspicious lesions
Tempoh jendela
Warts typically appear weeks to months after exposure (sometimes years). HPV DNA can be detected on cervical samples once cells are infected.
Ujian semula
Cervical HPV screening every 3-5 years per Malaysian Cancer Council guidelines for women aged 25-65.
Rawatan
Barisan pertama: Genital warts are treated in-clinic - typically by cryotherapy (liquid nitrogen freezing) or electrocautery, with topical agents prescribed where appropriate by our medical team. Multiple sessions may be needed.
Alternatif: Surgical excision is offered for large or resistant warts. Treatment removes visible warts but does not eradicate the underlying HPV infection.
Pengurusan pasangan: Partner examination and HPV vaccination if eligible. Routine partner testing is not recommended (no validated test).
Wart recurrence is common in the first 3-6 months. HPV vaccination after diagnosis prevents future infection with covered strains and may reduce recurrence in some studies.
Susulan
- Visual check at 3 and 6 months for recurrence
- Cervical screening for female patients on the national schedule
- Discuss Gardasil 9 vaccination if under 45
- Anal screening considered for MSM and immunocompromised patients
Pencegahan
- Gardasil 9 HPV vaccination - the single most effective prevention
- Consistent condom use (reduces but does not eliminate transmission)
- Avoid smoking (reduces HPV persistence)
- Routine cervical screening for women aged 25-65
Vaksinasi
Gardasil 9 protects against 9 HPV strains - HPV 6 and 11 (90% of genital warts) and HPV 16, 18, 31, 33, 45, 52, 58 (most HPV-related cancers). Licensed in Malaysia for ages 9-45, given as a 2 or 3-dose course. Vaccination is recommended even after HPV exposure because it protects against strains not yet acquired.
Lihat juga: HPV & wart removal service, Pilihan ujian JSB
HPV (Human Papillomavirus) - frequently asked questions
Clear answers, written by our clinical team. Tap any question for its direct permalink, or reach out to your Personal Concierge for anything else.
Uncommonly, yes. HPV is overwhelmingly transmitted sexually. Non-sexual routes described in the literature include autoinoculation from a person's own cutaneous (hand) warts, and indirect contact via contaminated items such as towels, undergarments, and medical instruments. HPV has also been detected in sexually inexperienced individuals and in long-term mutually monogamous couples where neither partner reports an outside exposure. This usually reflects a long-dormant infection acquired earlier in life or one of these non-sexual routes.
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Rujukan
- [1] World Health Organization. Human papillomavirus (HPV) and cervical cancer - key facts (2024).
- [2] GLOBOCAN / IARC. Malaysia cancer statistics.
- [3] Ministry of Health Malaysia. National HPV Vaccination Programme reports.
- [4] Centers for Disease Control and Prevention. HPV Treatment Guidelines (2021).
- [5] Petca A, et al. Non-sexual HPV transmission and role of vaccination for a better future (Review). Experimental and Therapeutic Medicine, 2020.
- [6] Sabeena S, et al. Possible non-sexual modes of transmission of human papilloma virus. Journal of Obstetrics and Gynaecology Research, 2017.
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