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 aspect of 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 misconception that the disease is transmitted only through sexual contact, but it can also be transmitted through close contact with an infected person.HPV is distinguished by its high resistance to the effects of antiseptics, except for soap, so it can be picked up even by shaking hands!
It is important! There are several ways HPV can be transmitted.You can get this virus not only during unprotected sex, but also at home.
HPV transmission methods:
- Sex.This includes all types of sexual intercourse - vaginal, oral, anal.
- Contact.The virus can be transmitted through scratches, scrapes, cuts and microcracks on the skin - during handshakes, kisses and other close contact with a sick person.
- From mother to child at birth.
It is believed that a weakened immune system occurs due to frequent chronic diseases, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking and general fatigue before infection.All this increases the risk of infection and the infection becomes chronic.
It is important! Condom use does not guarantee protection against HPV.The virus can be transmitted even through minor contact with the skin or mucous membranes.
HPV is very common and about 14 million people get it every year.Almost every sexually active unvaccinated person gets it during their lifetime, but very few people learn about the disease.Even if you take HPV tests and they're all negative, there's a chance you'll get infected and clear the virus between tests.
Is it possible to get HPV again?
Unfortunately, yes.After exposure to the virus, permanent immunity does not develop, and the probability of infection from new sexual partners is quite high.In addition, if you are 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 by their ability to cause cancer.All types of viruses are divided into three groups:
- Conditionally oncogenic HPV (the safest),
- HPV with medium oncogenic risk,
- HPV with high oncogenic risk (the most dangerous).
High oncogenic risk HPV includes only 15 types of viruses (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82), and types 16 and 18 cause the most cancers.The rest are less often associated with cancer.
It is important! If you are infected with one of the "dangerous" viruses, it does not necessarily mean that you will get cancer.Most of the time, our immune system defeats HPV within an average of 1-2 years.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, "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, testicles, perineal or anal region, vagina, vulva or cervical mucosa) can cause cancer.Thus, HPV types 6 and 11 cause genital warts in 90% of cases, but not cervical cancer.
Stages of disease development
In most cases, HPV causes no 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 cell changes: dysplasia (a precancerous condition), and then cervical cancer.
It is important! If HPV is detected, do not panic!It may disappear with the next examination.Having a virus does not mean you are sick.If HPV persists in the body, get regular checkups at least once a year.A virus can only be dangerous if left unchecked.Dysplasia must be treated in time, then cancer will not develop.
This development of the disease is rare (the infection causes cell transformation in less than 1% of infected people), but it poses a real threat.
In this case, the duration of the disease is individual.In some patients, the initial stage can last for years without leading to cancer.The probability of developing cancer increases with age.On average, it takes 10-20 years from infection to the appearance of dysplasia (a precancerous condition) and cervical cancer.
Symptoms
At the initial stage, a person, as a rule, does not know about his illness, it is contagious to others.HPV is often asymptomatic, 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 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 are quite large.Condylomas can be single or multiple and have a variety of shapes, such as dome or thread, mushroom-shaped and plate-shaped, with a smooth or bumpy surface.Some genital warts grow widely and look like 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 discomfort and reduce the quality of sexual life.
In women, condylomas can form on the cervical mucosa.The growth of condylomas in the anus and urethra (or urethra) can make it difficult to go to the toilet.Sometimes condylomas can cause pain or itching, and when injured, they can bleed.
Diagnostics
The effectiveness of treatment and prevention of cancer development mainly depends on timely detection of HPV with 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 should still see a gynecologist once a year.Your doctor may order an HPV test as part of your general health checkup.
If you find suspicious growths on your body, you should also consult a doctor.The choice of a 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 performed and at the same time an analysis is performed for the presence/absence of high oncogenic risk HPV (cotesting).
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 study allows you to see the smallest changes in cells.For more information, they refer to the HPV test.
It is important! When given a choice between "conventional" and "liquid-based" cytology, "liquid-based" should be chosen.This method allows to clean the sample and save a larger number of cells for research.
The HPV test is a vaginal smear.It is carried out 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 positive or negative.
If both tests are negative (no cell changes, no HPV detected), the next scheduled examination can be done after 3 years.If the PAP test is negative but HPV is detected, the patient is at risk.Colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (a sample of a small piece of biomaterial for further examination) is prescribed to him, and planned examinations are carried out at least once a year.
Treatment begins only when cervical dysplasia is diagnosed based on the results of the PAP test and biopsy.
Should I be tested for HPV if I have genital warts?
If you have condylomas, you do not need to be examined.The appearance of warts in itself indicates a viral infection.An 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 plan to become pregnant undergo a thorough examination to detect HPV infection.During pregnancy, a woman with HPV may develop genital warts or abnormal cell changes on the cervix.They can be detected through regular examination.
The vaccine is not recommended for pregnant women.Studies show that it does not cause problems in babies born to women who were vaccinated during pregnancy, but more research is needed.The mother-to-be should not receive any doses of the HPV vaccine after pregnancy.
The risk of passing HPV to the baby during childbirth 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 simply monitor the infection.In this case, you should have a PAP test (cytological smear) once a year.This will help prevent the development of cervical cancer.
Condylomas: should be removed or not?
Condylomas caused by HPV are usually just monitored (in about half of the cases they disappear on their own), they seek treatment only in case of unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor chooses an individual therapy for condylomas, taking into account their character and the patient's health characteristics.Such therapy may include:
- the use of local antitumor, cauterizing drugs or catechins - creams or solutions applied pointwise to condylomas (some of them are contraindicated during pregnancy),
- interferon injections for condylomas (cannot be used during pregnancy),
- surgical treatment - removal, freezing or cauterization (under local anesthesia).
If the warts have grown significantly, are uncomfortable, are in the vagina, urethra, or around the anus, and do not respond to other types of treatment, surgery is usually recommended.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 condition).
To protect your sexual partner from the virus, it is useless to remove warts, because the virus can remain in the body.Getting rid of warts 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 preparations
Among the local drugs that can be prescribed for the treatment of condylomas:
- Thickening agents and keratolytics (salicylic, vinegar, lactic acids),
- Cytotoxic and cytostatic antitumor drugs,
- Topical retinoids
- catechins.
How HPV is not treated: immunomodulators and antiviral drugs
A positive test for HPV is often a reason to take different drugs, even though there is no cure for this infection.The following will not help you against HPV:
- immunomodulators and any means "to increase immunity".
- antiviral drugs.
HPV cannot be cured, only vaccination can protect against it.
Forecast
Once HPV is detected, the prognosis is generally favorable.The diagnosis of highly oncogenic types of HPV is not carried out for women under 25 years of age, because the virus is detected very often at a young age and disappears over time.A positive test for HPV at an older age is a reason to regularly visit a gynecologist and undergo additional examinations.Remember that having a virus is not a disease.
Complications
Complications related to human papillomavirus can be dangerous, but they can be prevented if the body is regularly examined for tumors.
Condylomas
A small number of condylomas may not cause concern to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condylomas can be:
- to bleed
- causes pain, burning and itching,
- prevent going to the toilet,
- intervene during childbirth.
Cervical cancer
The most common complication of HPV infection is cervical cancer.The risk of its 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 less common than cervical cancer.HPV types 16 and 18 are the main 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 is not the cause of inflammatory diseases of the cervix and vagina,
- HPV does not disrupt the menstrual cycle,
- HPV cannot cause a miscarriage or a 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 cannot be overstated.
How not to get infected
First of all, it is necessary to increase the body's defense level.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 are prone to disease.
Strengthening the immune system is facilitated by physical activity, properly 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 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 to be selective in choosing a sexual partner.A healthy monogamous relationship excludes sexual transmission.The duty of parents is to educate their children sexually.The risk of the disease is reduced by using condoms and avoiding sexual contact with HPV carriers.
Vaccination
The most effective protection against HPV is vaccination.Today, HPV vaccination is part of the vaccination schedule in most developed countries around the world.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 intercourse, 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 will help prevent infection with new types of the virus.
Boys need vaccines too.This not only helps reduce the spread of infection but also protects against genital warts.
HPV vaccines protect against several types of the virus:
- bivalent vaccine - against the most dangerous viruses of types 16 and 18,
- quadrivalent vaccine - against viruses of types 6, 11, 16 and 18,
- nine-valent vaccine - against viruses of 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 (table 0, 1-2, 6 months).Additional revaccination is not required;after vaccination, the effect lasts for at least 10 years.
It is important! HPV vaccines are highly safe and do not contain live viruses.Undesirable 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.
The result
An infection caused by the human papillomavirus often does not manifest itself in any way and may not be detected for the rest of 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 developing cancer, to which women are more susceptible than men.In addition to the Pap test, all women over the age of 25 are recommended to undergo regular screening for the presence of the virus in the body.