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 sharp warts on the skin and mucous membranes.In medicine, such neoplasms are called papilloma and condyloma, 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 common 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 its high resistance to the action of antiseptics, not to mention soap, so it can be caught even by shaking hands!
Important! There are several ways of transmission of HPV.You can be infected with this virus not only through unprotected sex, but also at home.
Ways of transmission of HPV:
- Sexual.This includes all types of sexual contact - vaginal, oral, anal.
- Get in touch.The virus can be infected through scratches, scrapes, cuts and microcracks on the skin - through shaking hands, kisses 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 this increases the risk of infection and the infection becomes chronic.
Important! Condom use does not guarantee protection against HPV.The virus can also be transmitted through small contact with the skin or mucous membranes.
HPV is very common, with approximately 14 million people infected with 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 been 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 exposure to the virus, stable immunity does not develop and infection from new sexual partners is quite possible.In addition, if you are infected with one type of virus, you are not immune 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 medium oncogenic risk,
- HPV with 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 cause the most frequent cancers.The rest is associated with cancer much less often.
Important! If you are infected with one of the "dangerous" viruses, this does not mean that there will definitely 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 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 mucosa of the genital organs (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 they do not cause 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 sooner or later can cause cellular changes: dysplasia (precancerous condition), and then cervical cancer.
Important! If HPV is detected, do not panic!It may disappear in the next examination.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 pose 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 (infection leads to cell transformation in less than 1% of infected persons), but it represents a real risk.
The duration of the development of the disease in this case is individual.In some patients, the initial stage can last for years without leading to cancer.The chance 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, as a rule, does not know about his disease, but it is contagious to others.HPV very often does not manifest itself 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 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 turns out to be quite large.Condylomas can be single or multiple and have different shapes from dome-shaped or filamentous to mushroom-shaped and plate-shaped with a smooth or bumpy surface.Some genital warts grow very large, giving them some resemblance to cauliflower.The color of condylomas is usually white or flesh-colored, rarely pink, red or brown.
Genital warts are benign formations, they are not dangerous, but in many people they form complexes, cause increased anxiety and reduce the quality of sexual life.
In women, warts can form on the cervical mucus.The growth of condylomas in the anus and urethra (or urethra) can make it difficult to go to the toilet.Sometimes warts can hurt or itch, and when they hurt, they can bleed.
Diagnosing
The effectiveness of treatment and prevention of the development of cancer mainly depends on the 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 contact?
If you are a woman and you have no symptoms or complaints, you should still go to the 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 suspicious growths on your body.The choice of specialist will depend on the location of the new warts or 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 do?
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 HPV with a high oncogenic risk (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 from the vaginal vaults.This cytological study allows you to see the smallest changes in the cells.To make it even more informative, they turn to HPV testing.
Important! When given a choice between "conventional" and "liquid-based" cytology, "liquid-based" should be chosen.This method allows you to clean the sample and save a larger number of cells for study.
The HPV test is a vaginal test.It is taken 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 test can be positive or negative.
If both tests are negative (no cell changes, HPV is not detected), the next scheduled examination can be performed 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 (taking samples of a small fragment of biomaterial for further examination) and planned 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.
Should I test 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 infection with a virus.An analysis from the cervix or vagina will be unnecessary, but if necessary, you can get an analysis from the condylomas themselves.
HPV and pregnancy
Experts recommend that women planning pregnancy undergo a comprehensive 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 routine examination.
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.The mother-to-be should not receive any dose of the HPV vaccine until after her pregnancy.
The risk of passing HPV to your baby during birth 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 who have been diagnosed with human papillomavirus should simply monitor the infection.In this case, once a year you should do a PAP test (cytological cleaning).It will help prevent the development of cervical cancer.
Condylomas: to remove or not?
Condylomas caused by HPV are usually simply monitored (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 individual therapy for condylomas, which takes into account their character and the patient's health characteristics.Such therapy may include:
- the use of local antitumor, cauterizing or catechin drugs - creams or solutions that are applied topically to condylomas (some of them are contraindicated during pregnancy),
- injections of interferons in 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 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 condition).
It is useless to remove warts to protect your sexual partner from the virus, as the virus can remain in the body.Removing warts also does not reduce the risk of developing cancer in the future.After removal of condylomas, there is always a possibility that they will appear again.
Local preparations
Among the local drugs that can be prescribed for the treatment of condylomas:
- Cauterizing and keratolytic agents (salicylic, acetic, 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 medications, despite the fact that this infection has no cure.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 against it through vaccination.
PREDICTION
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, since the virus is very often detected 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.Remember that having a virus is not a disease.
Complications
Complications due to 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 concern to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condylomas can:
- bloodshed
- injured, causes burning and itching sensations,
- interfere with going to the toilet,
- interfere 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 tests for 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 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 for which it is not the 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 lost 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 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 body protection.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.Add variety to your diet by adding more vegetables and fruits.Not only are they 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 the prevention of HPV is to be selective in the choice of sexual partners.A healthy monogamous relationship excludes sexual transmission.It is the duty of parents to provide their children with sex education.The risk of the disease is reduced by using condoms and refusing sex with HPV carriers.
vaccinations
The most effective protection against HPV is vaccination.Today, in most developed countries of the world, vaccination against HPV is an integral part of the vaccination schedule.First of all, it is important for girls under 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 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 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 type 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 the 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 (schedule 0, 1-2, 6 months).No additional revaccinations are required;the effect after vaccination lasts at least 10 years.
Important! HPV vaccines are very 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 in any way and can remain undetected for the rest of life.Many patients learn about the infection only if the characteristic warts appear on the skin or mucous membrane.The main risk of HPV is the risk of developing cancer, to which women are more susceptible than men.For all women over 25 years of age, regular screening for the presence of the virus in the body is recommended, along with the Pap test.