Human papillomavirus is the most common cause of cervical cancer in women.However, HPV cannot be cured.Vaccination remains the only effective way to protect against infection.
What is HPV?
The human papillomavirus (HPV) is known to cause flat, sharp warts on the skin and mucous membranes.In medicine, these neoplasms are called papillomas and condylomas, respectively.But the most dangerous thing about HPV is that it is a common cause of cervical cancer.
Causes of HPV infection
HPV infection occurs through damaged mucous membranes and microcracks in the skin.There is a common misconception that the disease is transmitted only through sexual contact, but it can also be contracted through close contact with an infected person.HPV is distinguished by its great resistance to the action of antiseptics, not forgetting soap, so it can be picked up even by shaking hands!
Important! There are several ways HPV can be transmitted.You can become infected with this virus not only during unprotected sex, but also at home.
How HPV is transmitted:
- Sexual.This includes all types of sexual contact – vaginal, oral, anal.
- Contact.The virus can be infected through abrasions, scrapes, cuts and microcracks of the skin - through a handshake, kisses and other close contact with a sick person.
- During childbirth from mother to child.
It is believed that infection is often preceded by a weakened immune system due to chronic illnesses, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking and general fatigue.All this increases the risk of infection and the infection becomes chronic.
Important! Using a condom does not guarantee protection against HPV.The virus can be transmitted even by minor contact with skin or mucous membranes.
HPV is very common, with around 14 million people infected each year.During their lifetime, almost all sexually active and unvaccinated people get it, but very few people experience this disease.Even if you've had HPV tests and they all came back negative, it's still possible that you are infected and have shed the virus between tests.
Is it possible to become infected with HPV again?
Unfortunately, yes.After exposure to the virus, lasting immunity does not develop and infection from new sexual partners is very likely.Additionally, if you have been infected with one type of virus, you do not develop immunity to other types.
Types of HPV
There are many types of HPV, more than 200. They are generally divided based on their ability to cause cancer.All types of viruses are divided into three groups:
- Conditional oncogenic HPV (safest),
- HPV of medium oncogenic risk,
- HPV with high oncogenic risk (the most dangerous).
HPV with high oncogenic risk includes only 15 types of viruses (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82), while viruses of types 16 and 18 most often cause cancer: approximately 70% of all cases of cervical cancerthe uterus - they work.The others are much less frequently associated with cancer.
Important! If you are infected with one of the "dangerous" viruses, this does not mean that there will definitely be cancer.Most often, our immune system defeats HPV within 1 to 2 years on average.Even if HPV persists in the body, precancerous lesions or cancer may never develop.
It is important to understand that different types of HPV affect different parts of the body.Not all of them are related to gynecology.For example, “cutaneous” viruses (types 1, 2, 3, 4 and 10) cause common or flat warts.In addition, not all viruses that affect the skin and mucous membranes of the genitals (penis, scrotum, perineal or anal area, vagina, vulva or cervical mucosa) can cause cancer.Thus, HPV types 6 and 11 are responsible for the occurrence of genital warts in 90% of cases, but they do not cause cervical cancer.
Stages of disease development
In most cases, HPV does not cause any symptoms or problems and the immune system gets rid of it after a few months.However, in 10-20% of women, HPV infection becomes chronic - the virus continues to live in the body and does not disappear for a long time.In this case, HPV can sooner or later cause cellular changes: dysplasia (precancerous condition), then cervical cancer.
Important! If HPV is detected, don't panic!It may disappear at the next exam.Having a virus does not mean you are sick.If HPV persists in the body, come and have yourself examined regularly, at least once a year.A virus can only pose a threat if it is not controlled.Dysplasia must be treated in time, so that cancer does not develop.
This progression of the disease is rare (the infection causes cellular transformation in less than 1% of infected people), but it represents a real danger.
The duration of development of the disease in this case is individual.In some patients, the initial stage can last for years without leading to cancer.The likelihood of developing cancer increases with age.On average, 10 to 20 years pass between infection and the appearance of dysplasia (precancerous condition) and cervical cancer.
Symptoms
At the initial stage, a person usually does not know about their illness, but is contagious to others.Very often, HPV does not manifest itself at all, but some types can cause the growth of flat or sharp warts - papillomas or condyloma - on the skin and mucous membranes.Their appearance can occur several weeks or even months after infection.
The number and nature of tumors caused by HPV vary.In some patients, everything is limited to the appearance of 1-2 small warts, while in others the affected area and the number of individual elements turn out to be quite large.Condylomas can be single or multiple and have different shapes, from the shape of a dome or thread to the shape of a mushroom and a plaque with a smooth or bumpy surface.Some genital warts grow large, giving them a certain resemblance to cauliflower.The color of condyloma is usually white or flesh, less often pink, red or brown.
Genital warts are benign formations, they are not dangerous, but in many people they form complexes, cause increased anxiety and reduce the quality of sexual life.
In women, warts can form on the cervical mucosa.The growth of warts in the anus and urethra (or urethra) can make it difficult to access the toilet.Sometimes warts can hurt or itch, and when injured, they can bleed.
Diagnosis
The effectiveness of treatment and prevention of cancer development largely depends on the timely detection of HPV with high oncogenic risk.It is believed that all women over the age of 25 should be diagnosed with HPV regularly.
Which doctor should I contact?
If you are a woman and do not have any symptoms or complaints, you should still consult a gynecologist once a year.Your doctor may order an HPV test as part of your general health checkup.
You should also see a doctor if you notice any suspicious growths on your body.The choice of specialist will depend on the location of the warts or new moles.If you are concerned about the genital area and anus, it is advisable to make an appointment with a venereologist, urologist or gynecologist.Otherwise, a dermatologist will help you.
What tests should I take?
As part of women's health screening, a Pap test is usually carried out and, at the same time, an analysis is carried out for the presence / absence of HPV with a high oncogenic risk (cotesting).
The PAP (Papanicolaou smear) test is familiar to most women.It is taken from the cervical canal, as well as from its external surface and from the vaginal vaults.This cytological study makes it possible to note the slightest changes in the cells.To make it even more informative, they resort to HPV testing.
Important! When given the choice between “conventional” and “liquid-based” cytology, “liquid-based” cytology should be selected.This method allows you to purify the sample and retain a larger number of cells for study.
The HPV test is a vaginal smear.It makes it possible to find the DNA of “dangerous” viruses (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82).The quantity of virus is not taken into account;the analysis can be positive or negative.
If both tests are negative (no change in the cells, no HPV detected), the next scheduled examination can be carried out after 3 years.If the PAP test is negative but HPV is detected, the patient is at risk.She is prescribed a colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (removal of a small fragment of biomaterial for further examination), and scheduled examinations are carried out at least once a year.
Treatment begins only if cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Should I test for HPV if I have genital warts?
If you have condyloma, you do not need an examination.The appearance of warts itself indicates infection with a virus.An analysis of the cervix or vagina will be useless, but if necessary, you can do an analysis of the condylomas themselves.
HPV and pregnancy
Experts recommend that women planning pregnancy undergo a comprehensive examination for HPV infection.During pregnancy, a woman with HPV may develop genital warts or abnormal cellular changes on the cervix.They can be detected through routine screening.
The vaccine is not recommended for pregnant women.Research suggests this is not a problem in babies born to women vaccinated during pregnancy, but more research is still needed.The expectant mother should not receive any doses of the HPV vaccine until after the end of her pregnancy.
The risk of passing HPV to your baby during delivery is very low.Even if infants are infected with human papillomavirus, their bodies usually clear the virus on their own.
Treatment
There is no effective treatment for HPV;only the manifestations of the disease can be treated.Women who are diagnosed with human papillomavirus simply need to monitor for infection.In this case, you should do a PAP test (smear cytology) once a year.This will help prevent the development of cervical cancer.
Condyloma: to remove or not?
Condylomas caused by HPV are usually simply monitored (in about half of cases they disappear on their own), resorting to treatment only in case of unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor selects individual treatment for condyloma, taking into account their character and health characteristics of the patient.Such therapy may include:
- the use of local antitumor drugs, cauterizing drugs or catechins - creams or solutions applied punctually to condyloma (some of them are contraindicated during pregnancy),
- interferon injections in condyloma (cannot be used during pregnancy),
- surgical treatment - ablation, freezing or cauterization (under local anesthesia).
Surgery is usually recommended if the warts have grown significantly, are causing discomfort, are in the vagina, urethra, or around the anus, and do not respond to other types of treatment.Warts should be removed if the doctor has reason to believe that they may cause cancer (for example, if they are associated with a precancerous skin condition).
There is no need to remove warts to protect your sexual partner from the virus, since the virus can remain in the body.Getting rid of warts also does not reduce the risk of developing cancer in the future.After the warts are removed, there is always the possibility that they will reappear.
Local preparations
Among the local medications that can be prescribed for the treatment of condyloma:
- Cauterizing and keratolytic agents (salicylic, acetic, lactic acids),
- Cytotoxic and cytostatic antitumor drugs,
- Topical retinoids
- Catechins.
How HPV is NOT treated: immunomodulators and antiviral drugs
A positive HPV test often becomes a reason to take various medications, even if this infection is incurable.The following will not help you against HPV:
- immunomodulators and any means “to strengthen immunity”,
- antiviral medications.
HPV cannot be cured; you can only protect yourself from it by vaccination.
Forecast
Once HPV is detected, the prognosis is generally favorable.Diagnosis of highly oncogenic types of HPV is not carried out in women under 25 years of age, since the virus is detected very often at a young age and just as often disappears over time.At an older age, a positive HPV test is a reason to regularly visit a gynecologist and undergo additional examinations.Remember that having a virus is not an illness.
Complications
Complications from the human papilloma virus can be dangerous, but they can be avoided if the body is regularly examined for tumors.
Condyloma
A small number of condyloma may not cause a person any discomfort, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condyloma can:
- bleed
- hurt, cause burning and itching,
- hinder going to the toilet,
- interfere during childbirth.
Cervical cancer
The most common complication of HPV infection is cervical cancer.The risk of developing it depends on the type of virus.We already know that doctors identify the 15 most “dangerous” types of HPV and that routine screening of women’s health includes analysis of their presence in the body.
Additionally, HPV can cause other types of cancer that are much less common than cervical cancer.HPV types 16 and 18 are the leading cause of anal cancer.Cancers of the vulva, vagina or penis, on the contrary, are not always associated with HPV (as is the case with oropharyngeal cancer).
HPV is often associated with problems that it is not the cause of:
- HPV does not cause infertility,
- HPV does not cause inflammatory diseases of the cervix and vagina,
- HPV does not disrupt the menstrual cycle,
- HPV cannot cause miscarriage or missed pregnancy,
- HPV, which often causes cancer, is not transmitted during pregnancy and childbirth;natural childbirth is permitted if HPV is present.
Disease prevention
Since there is no cure for HPV, the importance of preventing infection cannot be underestimated.
How not to get infected
First of all, it is necessary to increase the level of the body's defenses.If you have bad habits, it is better to give them up or at least significantly reduce the consumption of alcohol and tobacco.Girls should also avoid using oral contraceptives, which also predispose them to the disease.
Strengthening the immune system is facilitated by physical activity, a well-balanced diet and the use of vitamin complexes.Add variety to your diet by adding more vegetables and fruits.They are not only rich in vitamins, but also improve intestinal motility, which helps cleanse the body of internal toxins that weaken the immune system.
An important point in HPV prevention is the selective choice of sexual partners.A healthy monogamous relationship excludes sexual transmission.The task of parents is to provide their children with sex education.The risk of contracting the disease is reduced by using condoms and refusing sex with HPV carriers.
Vaccination
The most effective protection against HPV is vaccination.Today, in most developed countries around the world, HPV vaccination is an integral part of the vaccination schedule.First of all, this concerns girls under the age of 18 who have not yet started sexual activity.Since HPV infection often occurs during first sexual contact, the ideal age for vaccination of girls is 12 to 14 years old.It makes sense for adult women to get vaccinated if they are considering changing sexual partners.Vaccination will help prevent infection with new types of viruses.
Boys also need vaccines.This not only helps reduce the spread of infections but also protects against genital warts.
HPV vaccines protect against several types of viruses:
- bivalent vaccine - against the most dangerous viruses of types 16 and 18,
- quadrivalent vaccine - against viruses types 6, 11, 16 and 18,
- Neuvalent vaccine - against viruses types 6, 11, 16, 18, 31, 33, 45, 52 and 58.
The vaccination schedule depends on age.For children and adolescents under 15 years old, it is two doses of vaccine with an interval of 6-12 months, for adults - three doses (schedule 0, 1-2, 6 months).Additional revaccinations are not necessary;the effect after the vaccine lasts at least 10 years.
Important! HPV vaccines are very safe and do not contain live virus.Adverse reactions after vaccination include: redness at the injection site, headache, dizziness, nausea.HPV vaccines do not affect the ability to have children or cause infertility.
Conclusion
Very often, an infection caused by the human papillomavirus does not manifest itself in any way and can remain undetectable for the rest of life.Many patients only discover the infection if characteristic warts appear on the skin or mucous membranes.The main danger of HPV is the risk of developing cancer, to which women are more susceptible than men.Regular screening for the presence of the virus in the body is recommended for all women over the age of 25, accompanied by a Pap test.