Anogenital Warts

Comments from Expert Advisory Committee

1. Anogenital warts are caused by human papilloma virus (HPV), usually types 6 and 11 which are not associated with dysplasia or malignancy
2. Infection with HPV is common in non-HPV vaccinated sexually active people, most infections do not lead to visible anogenital warts and clear spontaneously
3. Most HPV infection is acquired through sexual contact. Perinatal infection can occur and is rarely harmful to children
4. The current HPV vaccination programme for adolescent girls and boys is with a nonavalent vaccine which protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58. 
5. The HPV vaccine is recommended for MSM ≤ 45 years, people living with HIV ≤ 26 years, HIV infected MSM aged ≤45 years, haematopoietic stem cell or solid organ transplant recipients aged ≤45 years. Patients with Fanconi Anaemia aged over 12 months should be offered HPV vaccine as soon as the diagnosis is made.
6. Individuals diagnosed with anogenital warts should be offered testing for other STIs including HIV, Hepatitis B, syphilis, chlamydia and gonorrhoea.
7. Hepatitis C testing should be considered part of routine sexual health screening in the following circumstances: MSM, People living with HIV; Commercial sex workers; People who inject drugs (PWID). Partners of the above should also be considered for HCV testing.
8. Anogenital warts are a notifiable disease.

Treatment options

Small volume warts may resolve without treatment. All treatments are associated with non-response, relapse and local skin irritation.

Patient information

• Patient information on STIs and genital conditions is available at the HSE Sexual Health and Crisis Pregnancy website
• Genital Warts PIL

Safe Prescribing (visit the safe prescribing page)

• Doses are oral and for adults unless otherwise stated
• Safety in Pregnancy and Lactation
• Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed June 2021