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, 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 micro-cracks in the skin.There is a common misconception that the disease is only transmitted through sexual contact, but it can also be contracted through close contact with an infected person.HPV is distinguished by its high resistance to the action of antiseptics, not to mention soap, so it can be picked up even by shaking hands!
Important! There are several ways to transmit HPV.You can contract this virus not only through unprotected sex, but also at home.
Methods of transmission of HPV:
- Sexually.This includes all types of sexual intercourse - vaginal, oral, anal.
- Contacts.The virus can be contracted through abrasions, scratches, cuts and micro-cracks on the skin - through handshakes, kisses and other close contact with sick people.
- During childbirth from mother to child.
It is believed that infection is often preceded by a weakened immune system due to chronic diseases, normal 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 condoms does not guarantee protection against HPV.The virus can be spread even through small contact with the skin or mucous membranes.
HPV is very common, with about 14 million people infected by it each year.During their lifetime, almost every unvaccinated person is sexually infected, but very few people know about this disease.Even if you take HPV tests and they all come back negative, there's still a chance you'll get infected and clear the virus between tests.
Is it possible to get infected with HPV again?
Unfortunately, yes.After exposure to the virus, lasting immunity does not develop, and infection from a new sexual partner is highly likely.In addition, if you have been infected with one type of virus, you do not develop immunity to other types.
HPV types
There are many types of HPV, more than 200. They are usually divided depending on their ability to cause cancer.All types of viruses are divided into three groups:
- Conditionally oncogenic HPV (safest),
- HPV of average oncogenic risk,
- HPV has a 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 cervical cancer - about 18 cases of cervical cancer - about all cases: The rest are associated with cancer approx.frequently
Important! If you are infected with one of the "dangerous" viruses, this does not mean that cancer will definitely occur.Usually, our immune system defeats HPV in an average of 1-2 years.Although HPV persists in the body, precancerous or cancerous lesions 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.In addition, not all viruses that affect the skin and mucous membranes of the genitals (penis, scrotum, perineal area or anus, vagina, vulva or cervical mucosa) can cause cancer.Therefore, HPV types 6 and 11 are responsible for the occurrence of genital warts in 90% of cases, but they do not cause cervical cancer.
Disease progression stage
In most cases, HPV does not cause any symptoms or problems, and the immune system will get 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 cell changes: dysplasia (a precancerous condition), and then cervical cancer.
Important! If HPV is detected, do not panic!It may disappear on the next exam.Having a virus does not mean you are sick.If HPV persists in the body, come for regular checkups, at least once a year.Viruses can only pose a threat if they are not controlled.Dysplasia must be treated in time, then cancer will not develop.
The development of this disease is rare (infection leads to cell transformation in less than 1% of infected people), but it poses a real danger.
The period of development of the disease in this case is individual.In some patients, the early stage can last for years without leading to cancer.The likelihood of getting cancer increases with age.On average, 10-20 years pass from infection to the appearance of dysplasia (precancerous conditions) and cervical cancer.
symptoms
In the early stages, a person, as a rule, does not know about his disease, but is contagious to others.HPV is often not noticeable 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 may occur 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 either single or multiple, and have different shapes from dome-shaped or thread-like to mushroom-shaped and plaque-shaped with a smooth or wavy surface.Some genital warts grow widely, giving them a slight resemblance to cauliflower.The color of condyloma is usually white or flesh-colored, less often pink, red or brown.
Genital warts are benign formations, they are harmless, but in most people they form complexes, causing increased anxiety and reducing the quality of sexual life.
In women, condylomas can form on the cervical mucosa.Condyloma growths in the anus and urethra (or urethra) can make it difficult to go to the toilet.Sometimes condylomas can be painful or itchy, and when injured, they can bleed.
Diagnostics
The effectiveness of treatment and prevention of cancer development largely depends on the timely detection of high oncogenic risk HPV.It is believed that all women over the age of 25 should be regularly diagnosed with HPV.
Which doctor should I contact?
If you are a woman and you do not have any symptoms or complaints, you should still see 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 find any suspicious growths on your body.The specialist's choice will depend on the location of the new wart or mole.If you are concerned about the genital and anal area, it is advisable to make an appointment with a venereologist, urologist or gynecologist.If not, a dermatologist will help you.
What tests should I take?
As part of a woman's health examination, a Pap test is usually performed and, at the same time, an analysis is performed for the presence/absence of oncogenic high-risk HPV (cotesting).
A PAP test (Papanicolaou smear) is common for most women.It is taken from the cervical canal, as well as its outer surface and from the vaginal vault.This cytological study allows you to see slight changes in the cells.To make it more informative, they use the HPV test.
Important! When given the choice between "conventional" and "liquid-based" cytology, "liquid-based" should be chosen.This method allows you to clean the sample and save more cells for study.
The HPV test is a vaginal swab.It is taken to look for "dangerous" viral DNA (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;analysis can be either positive or negative.
If both tests are negative (no changes 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 (sampling of a small fragment of biomaterial for further examination), and scheduled examinations are carried out at least annually.
Treatment begins only if cervical dysplasia is diagnosed based on the results of the PAP test and biopsy.
Do I need to look for HPV if I have genital warts?
If you find yourself with condyloma, you do not need an examination.The appearance of the wart itself indicates a viral infection.An analysis from the cervix or vagina is not required, but if necessary, you can take an analysis from the condyloma itself.
HPV and pregnancy
Experts recommend that women planning pregnancy undergo a thorough examination to detect HPV infection.During pregnancy, women with HPV may develop genital warts or abnormal cellular changes in the cervix.They can be detected through routine checks.
The vaccine is not recommended for pregnant women.Research suggests it does not cause problems in babies born to women who were vaccinated during pregnancy, but more research is needed.Expectant mothers should not receive any doses of the HPV vaccine until after their pregnancy.
The risk of passing HPV to your baby during delivery is very low.Even if 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 only monitor the infection.In this case, you need to take a PAP test (cytological smear) once a year.It will help prevent the development of cervical cancer.
Condyloma: to remove or not?
Condyloma caused by HPV is usually only monitored (in about half of the cases it disappears on its own), using treatment only if there are unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor chooses an individual therapy for condyloma, which takes into account their character and the characteristics of the patient's health.Such therapies may include:
- the use of local antitumor, cauterization drugs or catechins - creams or solutions applied precisely to condyloma (some are contraindicated during pregnancy),
- interferon injection into the condyloma (cannot be used during pregnancy),
- surgical treatment - removal, freezing or cauterization (under local anesthesia).
Surgery is usually recommended if the wart has grown significantly, causes discomfort, is in the vagina, urethra, or around the anus, and has not responded to other types of treatment.Condyloma should be removed if the doctor has reason to believe that it can cause cancer (for example, it is combined with a precancerous skin condition).
It is useless to remove the condyloma to protect your sexual partner from the virus, because the virus can remain in the body.Removing warts also does not reduce the risk of getting cancer in the future.After the removal of condylomas, there is always a chance that they will reappear.
Local setup
Among the local drugs that can be prescribed for the treatment of condyloma:
- Cauterizing and keratolytic agents (salicylic, acetic, lactic acid),
- Cytotoxic and cytostatic antitumor drugs,
- Topical retinoids
- Catechin.
How HPV is NOT treated: immunomodulators and antiviral drugs
A positive test for HPV is often a reason to take various drugs, despite the fact that this infection has no cure.The following will not help you fight HPV:
- immunomodulators and any means "to increase immunity",
- antiviral drugs.
HPV cannot be cured, you can only protect against it through vaccination.
Forecast
Once HPV is detected, the prognosis is generally favorable.Diagnosis of highly oncogenic types of HPV is not carried out for women under the age of 25, because this virus is detected very often at a young age and just as often disappears over time.At an older age, a positive test for HPV is a reason to regularly visit a gynecologist and undergo additional examinations.Don't forget that having a virus is not a disease.
Complications
Complications due to human papillomavirus can be dangerous, but they can be avoided if the body is regularly checked for tumors.
Condyloma
A small number of condylomas may not cause discomfort to a person, but their growth in some cases greatly affects the quality of life: sexual activity, psychological state.In addition, condyloma can:
- bleeding
- pain, causing a burning sensation and itching,
- bothering to go to the toilet,
- disturbing 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 routine examinations for women's health include analysis for their presence in the body.
In addition, HPV can cause other types of cancer that are rarer than cervical cancer.HPV types 16 and 18 are the main causes of anal cancer.Cancer of the vulva, vagina or penis, on the other hand, is not always associated with HPV (like oropharyngeal cancer).
HPV is often associated with problems it does not cause:
- HPV does not cause infertility,
- HPV is not the cause of cervical and vaginal inflammation,
- HPV does not interfere with 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
Since HPV has no cure, the importance of preventing infection cannot be underestimated.
How not to get infected
First of all, it is necessary to increase the level of body defense.If you have bad habits, it is better to stop or at least significantly reduce the use of alcohol and tobacco.Girls should also avoid using oral contraceptives, which are also susceptible to this disease.
Strengthening the immune system is facilitated by physical activity, proper balanced nutrition 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 increase intestinal motility, which helps cleanse the body of internal toxins that weaken the immune system.
The important thing in HPV prevention is to be selective in choosing a sexual partner.A healthy monogamous relationship does not include sexual transmission.The duty of parents is to provide sex education to their children.The risk of 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 in the world, vaccination against HPV is part of the vaccination schedule.First of all, it is relevant for 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 12-14 years.It makes sense for adult women to get vaccinated if they plan to change sexual partners.Vaccination will help prevent infection with new types of viruses.
Boys also need vaccinations.It not only helps reduce the spread of infection, but also protects against genital warts.
The HPV vaccine protects against several types of viruses:
- bivalent vaccine - against the most dangerous viruses types 16 and 18,
- quadrivalent vaccine - against virus types 6, 11, 16 and 18,
- nine-valent vaccine - against virus types 6, 11, 16, 18, 31, 33, 45, 52 and 58.
Vaccination schedule depends on age.For children and adolescents under the age of 15, 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 revaccination is not required;the effect after the vaccine lasts at least 10 years.
Important! The HPV vaccine is very safe and does not contain live viruses.Unwanted effects after vaccination include: redness at the injection site, headache, dizziness, nausea.The HPV vaccine does not affect the ability to have children and does not cause infertility.
Conclusion
Infections caused by human papillomavirus often do not manifest in any way and may remain undetected for life.Many patients learn about the infection only if characteristic warts appear on the skin or mucous membranes.The main danger of HPV is the risk of getting 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, along with a Pap test.