Human papillomavirus is the most common cause of cervical cancer in women.However, HPV cannot be cured.Vaccination remains the only effective way to prevent 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, 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 widespread 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 high resistance to the action of antiseptics, not to mention soap, so it can be infected even by shaking hands!
important! There are several ways HPV can be transmitted.You can get infected with this virus not only through unprotected sex, but also at home.
Methods of transmission of HPV:
- Sexual.This includes all types of sexual contact - vaginal, oral, anal.
- Contact.The virus can be transmitted through scratches, abrasions, cuts and microcracks on the skin - through handshakes, 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 diseases, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking and general fatigue.All 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 even by light contact with the skin or mucous membranes.
HPV is very common, with about 14 million people contracting it each year.During their lifetime, almost every sexually active unvaccinated person gets it, but very few people learn about 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 re-infection with HPV possible?
Unfortunately, yes.After exposure to the virus, no permanent immunity develops and infection from new sexual partners is quite likely.Also, 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 usually divided according to their ability to cause cancer.All types of viruses are divided into three groups:
- Conditional oncogenic HPV (the safest),
- HPV with an average oncogenic risk,
- HPV with a high oncogenic risk (the most dangerous).
HPV with a 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 cause cancer most often: about 70% of all cases of cervical cancer - theythey work.The rest are associated with cancer much less often.
important! If you are infected with one of the "dangerous" viruses, this does not mean that there will certainly be cancer.Most often, our immune system defeats HPV in an average of 1-2 years.Even if HPV persists 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, "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 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 gets rid of it after a few months.But 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 (a precancerous condition), and then cervical cancer.
important! If HPV is detected, don't panic!It may disappear on the next review.Having a virus does not mean you are sick.If HPV persists in the body, come for examinations regularly, at least once a year.A virus can only be a threat if it is not controlled.Dysplasia must be treated in time, then cancer will 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 disease development in this case is individual.In some patients, the initial stage can last for years without developing into cancer.The likelihood of developing cancer increases with age.It takes an average of 10-20 years from infection to the appearance of dysplasia (a precancerous condition) and cervical cancer.
Symptoms
In the initial stage, a person, as a rule, does not know about his disease, but it is contagious to others.HPV is very often not manifested at all, but some types can cause the growth of flat or pointed warts - papillomas or condylomas - on the skin and mucous membranes.Their appearance can appear several weeks or even months after infection.
The number and nature of tumors caused by HPV varies.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 dome-shaped or filiform to mushroom-shaped and plaque-shaped with a smooth or uneven surface.Some genital warts grow extensively, 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, they are not dangerous, but in many people they create 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 go to the toilet.Sometimes warts can hurt or itch, and they can bleed when injured.
Diagnosis
The effectiveness of treatment and prevention of the development of cancer largely depends on the timely detection of HPV with a high oncogenic risk.It is believed that all women over the age of 25 should be regularly screened for HPV.
Which doctor should I contact?
If you are a woman and do not have any symptoms or complaints, you should still visit a gynecologist once a year.Your doctor may order an HPV test as part of your general health checkup.
You should also consult a doctor if you find 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 a woman's health screening, a Pap test is usually performed and at the same time an analysis is made for the presence/absence of HPV with a high oncogenic risk (co-testing).
The PAP test (Pap smear) is familiar to most women.It is taken from the cervical canal, as well as from its outer surface and from the vaginal vaults.This cytological examination allows you to see the smallest changes in the cells.To be even more informative, they resort to HPV testing.
important! When given a choice between "conventional" and "liquid-based" cytology, "liquid-based" should be chosen.This method allows you to purify the sample and keep a larger number of cells for study.
The HPV test is a vaginal pap smear.It was taken to detect 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 cell changes, no HPV detected), the next scheduled examination can be done in 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 (taking a small fragment of biomaterial for further examination) and planned examinations are carried out at least once a year.
Treatment is only started if cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Should I get tested for HPV if I have genital warts?
If you end up with warts, you don't need an examination.The appearance of warts in itself indicates a virus infection.Analysis from the cervix or vagina will be unnecessary, but if necessary, you can take an analysis from the condylomas themselves.
HPV and pregnancy
Experts recommend that women who are planning a pregnancy undergo a comprehensive examination to detect HPV infection.During pregnancy, a woman with HPV may develop genital warts or abnormal cell changes in the cervix.They can be detected through routine screening.
The vaccine is not recommended for pregnant women.Research shows that it does not cause problems in babies born to women who were vaccinated during pregnancy, but more research is still needed.The mother-to-be should not receive any doses of the HPV vaccine until after pregnancy.
The risk of passing HPV to your baby during birth is very low.Even if infants become 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 should simply monitor the infection.In this case, you should do a PAP test (cytology smear) once a year.It will help prevent the development of cervical cancer.
Condylomas: remove or not?
Condylomas caused by HPV are usually simply observed (in about half of the cases they disappear on their own), resorting to treatment only if there are unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor chooses an individual therapy for condylomas, taking into account their nature and the patient's health characteristics.Such therapy may include:
- the use of local antitumor, cauterizing drugs or catechins - creams or solutions that are applied pointwise to condylomas (some of them are contraindicated during pregnancy),
- injections of interferons in warts (cannot be used during pregnancy),
- surgical treatment - removal, freezing or cauterization (under local anesthesia).
Surgery is usually recommended if the warts have grown significantly, cause discomfort, are located in the vagina, urethra, or around the anus and do not respond to other treatments.Condylomas should be removed if the doctor has reason to believe that they may cause cancer (for example, they are combined with a precancerous condition of the skin).
It is useless to remove warts to protect your sexual partner from the virus, as 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 warts, there is always a chance that they will reappear.
Local preparations
Among the local drugs that can be prescribed for the treatment of condylomas:
- Cauterizing agents and keratolytics (salicylic, acetic, lactic acid),
- Cytotoxic and cytostatic antitumor drugs,
- Topical retinoids
- Catechins.
How NOT to treat HPV: immunomodulators and antiviral drugs
A positive test for HPV often becomes the reason for taking various drugs, despite the fact that this infection has no treatment.The following will not help you against HPV:
- immunomodulators and any means "to increase immunity",
- antiviral drugs.
HPV cannot be cured, you can only protect yourself from it by vaccination.
Forecast
Once HPV is detected, the prognosis is generally favorable.The diagnosis of highly oncogenic types of HPV is not carried out in women under the age of 25, because 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 a disease.
Complications
Complications due to the human papillomavirus can be dangerous, but can be avoided if the body is regularly examined for tumors.
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, warts can:
- they bleed
- hurts, causes a burning and itching sensation,
- interferes with going to the toilet,
- interferes with childbirth.
Cervical cancer
The most common complication of HPV infection is cervical cancer.The risk of development depends on the type of virus.We already know that doctors identify the 15 most dangerous types of HPV, and routine screening for women's health includes an analysis of their presence in the body.
In addition, HPV can cause other types of cancer that are much rarer than cervical cancer.HPV types 16 and 18 are the leading cause of anal cancer.Cancer of the vulva, vagina, or penis, on the other hand, is not always associated with HPV (as is oropharyngeal cancer).
HPV is often associated with problems it does not cause:
- 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 in the presence of HPV.
Disease prevention
Given that HPV has no cure, the importance of preventing infection cannot be understated.
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, proper balanced nutrition and the use of vitamin complexes.Vary your diet by adding more vegetables and fruits.They are not only rich in vitamins, but also improve intestinal motility, which helps to cleanse the body of internal toxins that weaken the immune system.
An important point in the prevention of HPV is the selectivity in the choice of sexual partners.A healthy monogamous relationship excludes sexual transmission.The task of parents is to provide their children with sexual education.The risk of 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, in most developed countries around the world, HPV vaccination is an integral part of the vaccination schedule.First of all, it is relevant for girls under 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 older women to get the vaccine if they plan to change sexual partners.Vaccination will help prevent infection with new types of virus.
Boys also need vaccinations.It not only helps to 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 type 16 and 18,
- quadrivalent vaccine - against viruses type 6, 11, 16 and 18,
- nine-valent 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 of age, these are two doses of the vaccine with an interval of 6-12 months, for adults - three doses (scheme 0, 1-2, 6 months).Additional revaccinations are not required;the effect after the vaccine lasts at least 10 years.
important! HPV vaccines are very safe and do not contain live viruses.Adverse reactions after vaccination include: redness at the injection site, headache, dizziness, nausea.HPV vaccines do not affect the ability to bear children and do not cause infertility.
Conclusion
The infection caused by the human papillomavirus very often does not manifest itself in any way and can remain undetected until the end of life.Many patients learn about an infection only 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, along with a Pap test, is recommended for all women over the age of 25.