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?
Human papillomavirus (HPV) is known to cause flat and pointed warts on the skin and mucous membranes.In medicine, such neoplasms are called papillomas and condylomas.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.It is a common misconception that the disease is spread only through sexual contact, but it can also be caught through close contact with an infected person.HPV is characterized by its high resistance to the effect of disinfectants, not to mention soap, so it can also be picked up by shaking hands!
Important! There are several ways HPV is transmitted.You can get infected with this virus not only during unprotected sex, but also at home.
Ways of transmission of HPV:
- Sexual.This includes all types of sexual intercourse - vaginal, oral, anal.
- Contact.The virus can be transmitted through abrasions, scratches, cuts and micro-cracks on the skin - by shaking hands, kissing and close contact with another sick person.
- From mother to child during childbirth.
It is believed that infection is often preceded by a weakened immune system due to chronic diseases, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking and general fatigue.All this increases the risk of infection and the infection becoming chronic.
Important! Using a condom does not guarantee protection against HPV.The virus can be transmitted even by slight contact with the skin or mucous membranes.
HPV is very common, around 14 million people are infected with it every year.Almost every sexually active, unvaccinated person gets it during their lifetime, but very few people become aware of the disease.Even if you've had HPV tests and they've all come back negative, there's still a chance you've been infected and cleared the virus between tests.
Is it possible to get infected with HPV again?
Unfortunately, yes.After contact with the virus, permanent immunity does not develop, and infection of new sexual partners is very likely.In addition, once you are 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 usually classified according to their ability to cause cancer.All types of viruses can be divided into three groups:
- Conditional oncogenic HPV (the safest),
- average oncogenic risk HPV,
- High oncogenic risk HPV (the most dangerous).
HPV with a high oncogenic risk contains only 15 virus types (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82), while types 16 and 18 cause cervical cancer most often: - the cases are approx.The others are much less commonly associated with cancer.
Important! If you are infected with one of the "dangerous" viruses, this does not mean that you will definitely get cancer.Most often, our immune system defeats HPV in an average of 1-2 years.Even if HPV remains in the body, precancerous lesions or cancer may never develop.
It should be understood that different types of HPV affect different parts of the body.Not all of them are related to gynecology.For example, "skin" viruses (types 1, 2, 3, 4, and 10) cause common or flat warts.Also, not all viruses that affect the skin and mucous membranes of the genitals (penis, scrotum, perineal or anus, vagina, vulva or cervix) 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 such cases, HPV can sooner or later cause cell changes: dysplasia (precancerous condition), then cervical cancer.
Important! If HPV is detected, don't panic!It may disappear during the next scan.A virus does not mean you are sick.If HPV still remains in the body, come for a check-up regularly, at least once a year.A virus can only be dangerous if it is not controlled.Dysplasia must be treated in time, then cancer does not develop.
This development of the disease is rare (the infection leads to cell transformation in less than 1% of those infected), but it represents a real danger.
The duration of the development of the disease in this case is individual.In some patients, the initial stage can last for years without developing cancer.The probability of developing cancer increases with age.On average, it takes 10-20 years from infection to the appearance of dysplasia (precancerous condition) and cervical cancer.
Symptoms
In the initial stage, a person usually does not know about his disease, but it is contagious to others.HPV very often does not appear at all, but certain types of it can cause the growth of flat or pointed warts - papillomas or condylomas - 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 varies.In some patients, it 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 can vary in shape from dome or thread-like to mushroom and plaque-shaped, with a smooth or bumpy surface.Some genital warts are greatly enlarged, giving them some resemblance to cauliflower.The color of condylomas is usually white or flesh-colored, less often pink, red or brown.
Genital warts are benign formations, not dangerous, but they create a complex for many people, cause increased anxiety and worsen the quality of sex life.
In women, condylomas can develop on the cervical mucosa.The growth of condylomas in the anus and urethra (or urethra) can make it difficult to go to the toilet.Condylomas can sometimes hurt or itch, and they can bleed if injured.
Diagnostics
The effectiveness of the treatment and prevention of the development of cancer depends to a large extent on the timely recognition of HPV with a high oncogenic risk.It is believed that all women over the age of 25 should be regularly diagnosed with HPV.
Which doctor should I see?
If you are a woman and have no symptoms or complaints, you still need to see a gynecologist once a year.Your doctor may order an HPV test as part of a general health assessment.
You should also see a doctor if you notice any suspicious growths on your body.The choice of specialist depends on the location of the warts or new birthmarks.If you are concerned about the genital area and the anus, it is advisable to make an appointment with a venereologist, urologist or gynecologist.Otherwise, a dermatologist will help.
What tests do I need to do?
As part of women's health screening, a Pap test is usually performed and at the same time the presence/absence of high oncogenic risk HPV is tested (cotesting).
The PAP test (Papanicolaou smear) is familiar to most women.It is taken from the cervical canal, as well as its outer surface and vaginal vaults.This cytological examination makes it possible to detect the smallest changes in the cells.To make it even more informative, they resort to an HPV test.
Important! If you have a choice between "conventional" and "liquid-based" cytology, the "liquid-based" method should be chosen.This method makes it possible to clean the sample and save a larger number of cells for study.
The HPV test is a thumb smear.They look for the DNA of "dangerous" viruses (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82).The amount of virus is not taken into account;the analysis can be positive or negative.
If both tests are negative (no changes in the cells, no HPV was detected), the next planned test can be performed after 3 years.If the PAP test is negative, but HPV is detected, the patient is at risk.A colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (taking a sample of a small fragment of the biological material for further examination) is prescribed, and scheduled examinations are performed at least annually.
Treatment only begins when cervical dysplasia is diagnosed based on the results of the PAP test and biopsy.
Should I get tested for HPV if I have genital warts?
If you find yourself with condyloma, you do not need an examination.The appearance of warts in itself indicates a viral infection.Analysis from the cervix or vagina will be unnecessary, but if necessary, the condylomas themselves can be analyzed.
HPV and pregnancy
Experts recommend that women planning a pregnancy undergo a comprehensive examination to detect HPV infection.During pregnancy, a woman infected with HPV may develop genital warts or abnormal cell changes in the cervix.They can be detected by routine screening.
The vaccine is not recommended for pregnant women.Research suggests that it does not cause problems in babies of women vaccinated during pregnancy, but more research is needed.The expectant mother should not receive any dose of the HPV vaccine after pregnancy.
The risk of HPV being passed to the baby during delivery is very low.Even when babies 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 diagnosed with human papillomavirus should simply monitor the infection.In this case, a PAP test (cytology smear) must be taken once a year.It helps prevent the development of cervical cancer.
Condylomas: to remove or not?
Condylomas caused by HPV are usually simply monitored (they disappear on their own in about half of the cases), and treatment is sought only in case of unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor chooses an individual therapy for condylomas, which takes into account their nature and the patient's health characteristics.Such therapy may include:
- local antitumor agents, cauterizing agents or catechins - creams or solutions that are applied precisely to condylomas (some are contraindicated during pregnancy),
- interferon injections into condylomas (cannot be used during pregnancy),
- surgical treatment - removal, freezing or cauterization (under local anesthesia).
Surgery is usually recommended if the warts are very large, painful, in the vagina, urethra or around the anus and do not respond to other types of treatment.Condylomas should be removed if the doctor has reason to believe that they may cause cancer (for example, they are combined with a precancerous skin disease).
It is useless to remove condylomas to protect our 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 removal of condylomas, there is always a chance that they will reappear.
Local preparations
Local medications that can be prescribed to treat condylomas include:
- Cauterizing agents and keratolytics (salicylic acid, acetic acid, lactic acid),
- Cytotoxic and cytostatic antitumor agents,
- Topical retinoids
- For catechumens.
How to NOT treat HPV: immunomodulators and antivirals
A positive HPV test is often a reason to take various medications, even though this infection cannot be cured.The following will not help against HPV:
- immunomodulators and any "means to enhance immunity",
- antiviral drugs.
HPV cannot be cured, it can only be protected by vaccination.
Forecast
After detection of HPV, the prognosis is generally favorable.Highly oncogenic types of HPV are not diagnosed in women under 25 years of age, as the virus is very often detected at a young age and just as often disappears over time.At an older age, a positive HPV test justifies a regular visit to the gynecologist and further examinations.Remember that a virus is not a disease.
Complications
Complications caused by human papillomavirus can be dangerous, but can be avoided if the body is regularly examined for cancer.
Condylomas
A small number of condylomas may not cause discomfort to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condylomas:
- he is bleeding
- causes pain, burning and itching,
- interferes with going to the toilet,
- disturbs 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 "most dangerous" type of HPV 15, and routine screening of women's health includes analyzing their presence in the body.
In addition, 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 rectal cancer.Conversely, cancer of the vulva, vagina, or penis is not always associated with HPV (as is oropharyngeal cancer).
The HPV virus often causes problems that are not caused by:
- 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 allowed if HPV is present.
Disease prevention
Given that there is no cure for HPV, the importance of preventing infection should not be underestimated.
How not to get infected
First of all, the level of the body's defenses must be increased.If you have bad habits, it is better to stop them, or at least significantly reduce the consumption of alcohol and tobacco.Girls should also avoid using oral contraceptives, which also predispose to the disease.
The strengthening of the immune system is facilitated by physical activity, a properly balanced diet and the use of vitamin complexes.Vary your diet by adding more vegetables and fruits.Not only are they rich in vitamins, but they also improve bowel movement, which helps cleanse the body of internal toxins that weaken the immune system.
One of the important points of HPV prevention is the selective selection of sexual partners.A healthy monogamous relationship excludes sexual transmission.It is the responsibility of parents to educate their children about sex.The risk of the disease is reduced by the use of condoms and by refusing to have sex with HPV carriers.
Vaccination
The most effective protection against HPV is vaccination.Today, HPV vaccination is an integral part of the vaccination schedule in most developed countries of the world.First of all, it applies to 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 girls to be vaccinated is 12-14 years.It makes sense for adult women to get vaccinated if they plan to change sexual partners.Vaccination helps prevent infection with new types of the virus.
Boys also need vaccinations.It not only helps reduce the spread of infection, but also protects against genital warts.
HPV vaccines protect against several types of virus:
- bivalent vaccine - against the most dangerous viruses types 16 and 18,
- quadrivalent vaccine - against viruses types 6, 11, 16 and 18,
- nine-valent vaccine - against types 6, 11, 16, 18, 31, 33, 45, 52 and 58.
The vaccination schedule depends on age.For children and adolescents under 15 years of age, two doses of this vaccine at intervals of 6-12 months, for adults - three doses (0, 1-2, 6-month schedule).Additional revaccinations are not necessary;the effect after the administration of the vaccine lasts at least 10 years.
Important! HPV vaccines are extremely safe and do not contain live viruses.Adverse effects following vaccination are: redness at the injection site, headache, dizziness, nausea.HPV vaccines do not affect the ability to have children and do not cause infertility.
Conclusion
The infection caused by the human papillomavirus very often does not appear in any way and can remain unnoticed for the rest of your life.Many patients learn about the infection only when 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, together with a Pap test, is recommended for all women over the age of 25.