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 yourself from infection.
What is HPV?
The human papillomavirus (HPV) is known to cause flat and pointed warts on the skin and mucous membranes.In medicine, such neoplasms are called papillomas or condylomas.However, 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 microtears in the skin.There is a common misconception that the disease is only transmitted through sexual contact, but one can also become infected through close contact with an infected person.HPV is characterized by high resistance to the effects of antiseptics, not to mention soap, and therefore can be picked up even by shaking hands!
Important! There are different ways to transmit HPV.You can become infected with this virus not only through unprotected sex, but also at home.
HPV transmission routes:
- Sexually.This includes all types of sexual contact – vaginal, oral, anal.
- Contact.The virus can be infected through abrasions, scratches, cuts and microtears in the skin - from shaking hands, kissing and other close contact with a sick person.
- During birth from mother to child.
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 of this increases the risk of infection and the chronicity of the infection.
Important! Using a condom does not guarantee protection against HPV.The virus can be transmitted through even minor contact with skin or mucous membranes.
HPV is very common and approximately 14 million people become infected with it each year.Almost every sexually active unvaccinated person will develop it in the course of their life, but very few people learn anything about the disease.Even if you took HPV tests and they all came back negative, there's still a chance you were infected and cleared the virus between tests.
Is reinfection with HPV possible?
Unfortunately yes.After exposure to the virus, lasting immunity does not develop and infection from new sexual partners is very likely.Additionally, if you are infected with one type of virus, you will not develop immunity to other types of viruses.
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 the virus are divided into three groups:
- Conditional oncogenic HPV (the safest),
- HPV with average oncogenic risk,
- HPV with high oncogenic risk (the most dangerous).
HPV with high oncogenic risk includes only 15 virus types (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: about 70% of all cases of cervical cancer - they work.The rest are much less commonly associated with cancer.
Important! If you are infected with one of the “dangerous” viruses, it does not mean that there will necessarily be cancer.In most cases, our immune system defeats HPV within an average of 1-2 years.Even if HPV remains in the body, it may never develop into precancerous lesions or cancer.
It should be clear that different types of HPV affect different parts of the body.Not all of them have anything to do with gynecology.For example, “skin” 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 lining) can cause cancer.HPV types 6 and 11 are responsible for the appearance of genital warts in 90% of cases, but do not cause cervical cancer.
Stages of disease development
In most cases, HPV does not cause any symptoms or problems and the immune system clears it after a few months.However, in 10-20% of women, the HPV infection is chronic - the virus lives on in the body and does not disappear for a long time.In this case, HPV can sooner or later cause cell changes: dysplasia (precancerous lesions) and then cervical cancer.
Important! If HPV is discovered, don't panic!It may disappear until the next examination.Having a virus does not mean you are sick.If HPV remains in the body, you should be checked regularly, at least once a year.A virus can only pose a threat if it is not controlled.Dysplasia must be treated in a timely manner, otherwise cancer will not develop.
This development of the disease is rare (infection leads to cell transformation in less than 1% of infected people), but poses a real danger.
The duration of the development of the disease in this case is individual.In some patients, the early stages can last for years without developing cancer.With increasing age, the likelihood of developing cancer increases.It takes an average of 10-20 years from infection to the appearance of dysplasia (precancerous lesions) and cervical cancer.
Symptoms
In the early stages, a person is usually unaware of their illness, but is contagious to others.HPV very often does not manifest itself at all, but certain types 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 type of tumors caused by HPV vary.In some patients everything is limited to the appearance of 1-2 small warts, in others the affected area and the number of individual elements are quite large.Condylomas can be either single or multiple and have different shapes, from dome-shaped or filiform to mushroom-shaped and plate-shaped with a smooth or bumpy surface.Some genital warts grow so much that they resemble cauliflower.The color of condylomas is usually white or flesh-colored, 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 affect the quality of sexual life.
In women, condylomas can form on the lining of the cervix.The growth of condylomas in the anus and urethra (or urethra) can make it difficult to go to the toilet.Sometimes condylomas can hurt or itch, and if injured, they can bleed.
diagnosis
The effectiveness of treatment and prevention of cancer development largely depends on the timely detection of HPV with a high oncogenic risk.It is believed that all women over 25 years of age should be regularly diagnosed with HPV.
Which doctor should I contact?
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 your general health exam.
You should also see a doctor if you have any suspicious growths on your body.The choice of specialist depends on the location of the warts or new moles.If you are worried about the genital area and anus, it is recommended to make an appointment with a venereologist, urologist or gynecologist.Otherwise, a dermatologist can help you.
Which tests should I take?
As part of female health screening, a Pap test is usually carried out and at the same time an analysis for the presence/absence of HPV with a high oncogenic risk is carried out (cotesting).
Most women are familiar with the PAP test (Papanicolaou smear).The sample is taken from the cervical canal as well as its outer surface and from the vaginal vaults.This cytological examination allows you to detect the smallest changes in cells.To make it even more conclusive, they resort to HPV testing.
Important! When choosing between “conventional” and “liquid-based” cytology, “liquid-based” should be chosen.This method allows you to purify the sample and preserve a larger number of cells for study.
The HPV test is a vaginal swab.It is used 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 amount of virus is not taken into account;The analysis can be either positive or negative.
If both tests are negative (no cell changes, no HPV detection), 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 will be prescribed a colposcopy (examination of the inside of the vagina and cervix) and, if necessary, a biopsy (removal of a small fragment of biomaterial for further examination).Scheduled examinations are carried out at least once a year.
Treatment does not begin until cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Do I need to check for HPV if I have genital warts?
If you have condylomas, no examination is necessary.The appearance of warts in itself indicates an infection with a virus.An analysis of the cervix or vagina is not required, but if necessary, you can do an analysis of the condylomas yourself.
HPV and pregnancy
Experts recommend that women planning pregnancy undergo a comprehensive examination to detect HPV infection.During pregnancy, a woman with HPV may experience genital warts or abnormal cell changes in the cervix.They can be detected through routine examinations.
The vaccine is not recommended for pregnant women.Research suggests it does not cause problems in babies born to women vaccinated during pregnancy, but more research is needed.The expectant mother should not receive an HPV vaccination until after pregnancy.
The risk of passing HPV to your baby during birth is very low.Even when infants become infected with the human papillomavirus, their bodies usually eliminate 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, you should have a PAP test (cytological smear) once a year.It will help prevent the development of cervical cancer.
Condylomas: remove or not?
Condylomas caused by HPV are usually simply monitored (in about half of cases they go away on their own) and treatment is resorted to only in the event of unpleasant symptoms such as itching, bleeding, burning or pain.Usually, the doctor selects individual therapy for condyloma for each patient, taking into account their character and the patient's health characteristics.Such therapy may include:
- the use of local antitumor drugs, cauterizing drugs or catechins - creams or solutions applied selectively to condylomas (some of which are contraindicated during pregnancy),
- Injections of interferons into condylomas (cannot be used during pregnancy),
- Surgical treatment – removal, 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 are not responding to other types of treatment.Condylomas should be removed if the doctor has reason to believe that they may cause cancer (e.g. if they are combined with a precancerous skin condition).
It is pointless to remove condylomas to protect your sexual partner from the virus, as the virus can remain in the body.Even removing warts does not reduce the risk of developing cancer in the future.After condylomas are removed, there is always the possibility that they will recur.
Local preparations
Among the local medications that can be prescribed to treat condyloma:
- Cauterizing agents and keratolytics (salicylic acid, acetic acid, lactic acid),
- Cytotoxic and cytostatic antitumor agents,
- Topical retinoids
- Catechins.
How NOT to treat HPV: Immunomodulators and antiviral drugs
A positive HPV test is often a reason for taking various medications, although there is no cure for this infection.The following will not help you against HPV:
- Immunomodulators and all means “to strengthen immunity”,
- antiviral drugs.
HPV cannot be cured; you can only protect yourself from it through a vaccination.
forecast
Once HPV is detected, the prognosis is generally favorable.The diagnosis of highly oncogenic HPV types is not carried out in women under 25 years of age because the virus is very often detected at a young age and just as often disappears over time.In old age, a positive HPV test is a reason to regularly visit a gynecologist and undergo further examinations.Remember that a virus is not a disease.
Complications
Complications from the human papillomavirus can be dangerous, but they can be avoided if the body is regularly examined for tumors.
Condylomas
A small number of condylomas may not cause any discomfort to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condylomas can:
- bleed
- cause pain, burning and itching,
- hinder going to the toilet,
- disrupt during birth.
cervical cancer
The most common complication of HPV infection is cervical cancer.The risk of contracting it depends on the type of virus.We already know that doctors identify the 15 most “dangerous” types of HPV and that routine examinations for women's health also include analysis of their presence in the body.
In addition, HPV can cause other types of cancer that are far rarer than cervical cancer.HPV types 16 and 18 are the most common cause of anal cancer.However, cancer of the vulva, vagina or penis is not always associated with HPV (as is oropharyngeal cancer).
HPV is often associated with problems that it is not the cause of:
- HPV does not cause infertility,
- HPV is not the cause of 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 birth is allowed if HPV is present.
Disease prevention
Given that there is no cure for HPV, the importance of infection prevention cannot be underestimated.
How not to get infected
First of all, it is necessary to strengthen 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 oral contraceptives as these also make them more susceptible to the disease.
Strengthening the immune system is facilitated by physical activity, a balanced diet and the use of vitamin complexes.Add variety to your diet by adding more vegetables and fruits.In addition to being rich in vitamins, they 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 parents' job is to provide their children with sex education.The risk of developing the disease is reduced by using condoms and refusing to have sex with HPV carriers.
Vaccination
The most effective protection against HPV is vaccination.Today, vaccination against HPV is an integral part of the vaccination schedule in most developed countries of the world.This is especially true for girls under 18 who have not yet started sexual activity.Since HPV infection often occurs during first sexual contact, the ideal vaccination age for girls is 12-14 years.Vaccination is useful for adult women if they plan to change sexual partners.Vaccination helps prevent infection with new types of viruses.
Boys also need vaccinations.Not only does it help reduce the spread of infections, but it 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 virus types 6, 11, 16 and 18,
- ninevalent vaccine - against virus 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, this is two doses of the vaccine with an interval of 6-12 months, for adults three doses (schedule 0, 1-2, 6 months).Additional revaccinations are not required;the effect after vaccination lasts at least 10 years.
Important! HPV vaccines are extremely safe and do not contain live viruses.Adverse effects after vaccination include: redness at the injection site, headache, dizziness, nausea.HPV vaccines do not affect the ability to have children and do not cause infertility.
Conclusion
An infection caused by the human papillomavirus very often does not manifest itself at all and may remain undetected throughout life.Many patients only find out about an infection 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 examination for the presence of the virus in the body and a Pap test are recommended for all women over 25 years old.