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, or condylomas.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 on the skin.It 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 characterized by high resistance to the action of antiseptics, not to mention soap, so it can be picked up even by handling!
Important! There are several ways HPV is transmitted.You can get infected with this virus not only through unprotected sex, but also at home.
Ways of transmission of HPV:
- Sexually.This includes all types of sexual contact - vaginal, oral, anal.
- Contact.The virus can be contracted through scratches, scrapes, cuts and microcracks in the skin - by shaking hands, kissing 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 chronic infection.
Important! Condom use does not guarantee protection against HPV.The virus can be transmitted even by minor 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 know about the disease.Even if you've had HPV tests and they've all come back negative, there's still a chance you've gotten infected and cleared the virus between tests.
Is it possible to get infected with HPV again?
Unfortunately, yes.After exposure to the virus, permanent immunity does not develop, and infection from new sexual partners is very likely.In addition, if you have been infected with one type of virus, you do not develop immunity against 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 (safest),
- HPV of average oncogenic risk,
- HPV of high oncogenic risk (the most dangerous).
HPV of 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 about 70% of all cancers.The others are much less frequently associated with cancer.
Important! If you are infected with one of the "dangerous" viruses, it 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 remembered 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 simple 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 formation 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.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 that case, HPV can sooner or later cause cell changes: dysplasia (precancerous condition), and then cervical cancer.
Important! If HPV is detected, don't panic!It may disappear until the next review.Having a virus does not mean you are sick.If HPV persists in the body, come for checkups 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 (infection leads to cell transformation in less than 1% of infected persons), 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 leading to cancer.The probability of developing cancer increases with age.On average, 10-20 years pass 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 illness, but it is contagious to others.HPV is very often not manifested 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 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 domed or spiral to mushroom and plaque-like with a smooth or bumpy surface.Some genital warts grow extensively, giving them some 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 not dangerous, but in many people they create complexes, cause increased anxiety and reduce the quality of sexual life.
In women, condylomas can form on the mucous membrane of the cervix.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 injured, they can bleed.
Diagnostics
The effectiveness of treatment and prevention of the development of cancer largely depends on the timely detection of high oncogenic risk HPV.It is considered 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 do not have any symptoms or complaints, you must 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 notice suspicious growths on your body.The choice of specialist will depend on the location of warts or new birthmarks.If you are concerned about the area of the genitals 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 smear is usually performed, and at the same time an analysis is performed for the presence/absence of high oncogenic risk HPV (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 even the smallest changes in the cells.To make it 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 save a larger number of cells for study.
The HPV test is a vaginal swab.It is necessary 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.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 the scheduled examinations are done at least once a year.
Treatment begins only if cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Should I look for HPV if I have genital warts?
If you have condylomas, you do not need an examination.The appearance of warts in itself indicates a virus infection.An analysis of the cervix or vagina will not be necessary, 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 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 screening.
The vaccine is not recommended for pregnant women.Research suggests 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 her pregnancy is over.
The risk of passing HPV to your baby during delivery is very low.Even if newborns 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 diagnosed with human papillomavirus should simply monitor the infection.In that case, a PAP test (cytological smear) should be done once a year.This 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), treatment is resorted to only if there are unpleasant symptoms - itching, bleeding, burning or pain.Usually, for each patient, the doctor selects an 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 drugs or catechins - creams or solutions that are applied pointwise to condylomas (some of them are contraindicated during pregnancy),
- interferon injections into 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 types of treatment.Condylomas should be removed if the doctor has reason to believe that they may cause cancer (for example, in combination with a precancerous skin condition).
It is useless to remove warts to protect your sexual partner from the virus, because 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 condylomas, there is always a chance that they will reappear.
Local preparations
Among the local drugs that can be prescribed for the treatment of condyloma:
- Means for cauterization and keratolytics (salicylic, acetic, lactic acid),
- Cytotoxic and cytostatic antitumor drugs,
- Topical retinoids
- Catechins.
How HPV is NOT treated: immunomodulators and antiviral drugs
A positive test for HPV often becomes a reason to take various drugs, despite the fact that this infection has no cure.The following will not help you against HPV:
- immunomodulators and any means "to strengthen 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.Diagnosis of highly oncogenic types of HPV is not carried out for women under 25 years of age, because the virus is very often detected at a young age and just as often disappears with time.In old age, a positive test for HPV is a reason for regular visits to the gynecologist and additional examinations.Remember that a virus is not a disease.
Complications
Complications caused by 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, mental state.In addition, warts can:
- to bleed
- hurt, cause burning and itching,
- interfere with going to the toilet,
- interfere during 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 analyzing 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 leading causes 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 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 there is no cure for HPV, 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 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, a proper balanced diet and the use of vitamin complexes.Add variety to your diet by adding more vegetables and fruits.Not only are they rich in vitamins, but 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 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 of the world, HPV vaccination is an integral 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 the 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 viruses.
Boys also need vaccinations.Not only does it help reduce the spread of infection, it also protects against genital warts.
HPV vaccines protect against several types of viruses:
- bivalent vaccine - against the most dangerous viruses types 16 and 18,
- quadrivalent vaccine - against viruses types 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 the age of 15, it 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 the vaccine lasts at least 10 years.
Important! HPV vaccines are very safe and do not contain live viruses.Adverse effects after vaccination are: redness at the injection site, headache, dizziness, nausea.HPV vaccines do not affect fertility and do not cause infertility.
Conclusion
Infection caused by the human papillomavirus very often does not manifest itself in any way and can remain undetected for the rest of your life.Many patients find out 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.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.