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?
The human papillomavirus (HPV) is known to cause flat, pointed warts on the skin and mucous membranes.In medicine, these 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 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 detected even with a handshake.
Important! There are several ways to transmit HPV.You can become infected with this virus not only through unprotected sexual intercourse, but also at home.
Methods of HPV transmission:
- Sexual.This includes all types of sexual contact: vaginal, oral, anal.
- Contact.The virus can be infected through abrasions, scrapes, cuts and microcracks in the skin, through handshaking, kissing and other close contact with a sick person.
- During childbirth from mother to child.
It is believed that infection is usually preceded by a weakened immune system due to chronic illness, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking, and general fatigue.All of this increases the risk of infection and the infection becoming chronic.
Important! Using a condom 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 approximately 14 million people become infected each year.During their lifetime, almost all unvaccinated sexually active people get it, but very few people learn about the disease.Even if you had HPV tests and they were all negative, there is still a chance that you could become infected and shed the virus between tests.
Is it possible to get infected with HPV again?
Unfortunately, yes.After exposure to the virus, long-lasting immunity does not develop and infection is most likely to occur through new sexual partners.Additionally, 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 (the safest),
- HPV of medium oncogenic risk,
- High oncogenic risk HPV (the most dangerous).
Oncogenic high-risk HPV includes only 15 virus types (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 cancer - about 70% of all cases of neck cancer.uterine function.The rest are much less frequently associated with cancer.
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 to 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, "skin" viruses (types 1, 2, 3, 4, and 10) cause common or flat warts.Furthermore, 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 they do not cause cervical cancer.
Stages of disease development
In most cases, HPV does not cause any symptoms or problems and is eliminated by the immune system within a few months.However, in 10% to 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 (precancerous condition) and then cervical cancer.
Important! If HPV is detected, don't panic!It may disappear on the next exam.Having a virus does not mean you are sick.If HPV persists in the body, go for tests periodically, 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 (the infection causes cellular transformation in less than 1% of infected people), but it represents a real danger.
The duration of the development of the disease in this case is individual.In some patients, the initial stage can last for years without causing cancer.The likelihood of developing cancer increases with age.On average, it takes 10 to 20 years from infection to the development of dysplasia (precancerous condition) and cervical cancer.
Symptoms
At the initial stage, a person, as a rule, does not know about his disease, but infects others.Most often, HPV does not manifest itself at all, but certain types can cause the growth of flat or pointed warts (papillomas or condylomas) on the skin and mucous membranes.Its appearance may occur several weeks or even months after infection.
The number and nature of tumors caused by HPV vary.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 or thread to mushroom-shaped and plaque with a smooth or rough surface.Some genital warts grow very large, giving them a certain 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 form complexes, cause greater anxiety 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 going to the bathroom difficult.Condylomas can sometimes be painful or itchy, and when injured, they can bleed.
Diagnosis
The effectiveness of treatment and prevention of cancer development largely depends on the timely detection of high-risk oncogenic HPV.It is believed that all women over the age of 25 should be periodically diagnosed with HPV.
Which doctor should I contact?
If you are a woman and do not have any 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 check.
You should also see a doctor if you find 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 perform?
As part of women's health screening, a Pap test is usually performed and, at the same time, an analysis for the presence/absence of high oncogenic risk HPV (cotest) is performed.
The Pap test (Pap smear) is familiar to most women.It is extracted from the cervical canal, as well as from its outer surface and vaginal vaults.This cytological study allows you to see the slightest changes in the cells.To make it even more informative, they turn to the HPV test.
Important! When given the choice between “conventional” and “liquid-based” cytology, “liquid-based” should be selected.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 used 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 detected, 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.You are prescribed colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (sample of a small fragment of biomaterial for more detailed examination) and scheduled examinations are carried out at least once a year.
Treatment begins only if cervical dysplasia is diagnosed based on the results of a Pap smear and biopsy.
Do I need to test for HPV if I have genital warts?
If you find condylomas, you do not need an examination.The appearance of warts in itself indicates infection with a virus.An analysis of the cervix or vagina will not be necessary, but if necessary, an analysis of the condylomas themselves can be performed.
HPV and pregnancy
Experts recommend that women who plan to become pregnant undergo a thorough examination for 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 exams.
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 expectant mother 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 babies become infected with HPV, 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 simply need to monitor the infection.In this case, you will need to have a Pap smear (cytological smear) once a year.It will help prevent the development of cervical cancer.
Condylomas: remove or not?
Condylomas caused by HPV are usually simply monitored (in about half of cases they disappear on their own) and 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 its character and the patient's health characteristics.Such therapy may include:
- the use of local antitumor drugs, cauterizing medications or catechins: creams or solutions that are applied punctually 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, if they are combined with a precancerous skin condition).
There is no point in removing warts to protect the sexual partner from the virus, since 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 medications 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 medications
A positive test for HPV often becomes a reason to take various medications, even though this infection has no cure.The following will not help you against HPV:
- immunomodulators and any means "to enhance immunity",
- antiviral medications.
HPV cannot be cured, you can only protect against it through vaccination.
Forecast
Once HPV is detected, the prognosis is usually favorable.The diagnosis of highly oncogenic HPV types is not carried out in 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 HPV test 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 can be avoided if the body is periodically 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.Additionally, condylomas can:
- bleed
- hurts, causes burning and itching sensations,
- interfere with going to the bathroom,
- Interferes 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 that routine screening for women's health includes analysis of its presence in the body.
Additionally, 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.Vulvar, vaginal or penile cancer, on the other hand, is not always associated with HPV (as is oropharyngeal cancer).
HPV is often associated with problems that it is not the cause of:
- HPV does not cause infertility,
- HPV is not the cause of inflammatory diseases of the cervix and vagina,
- HPV does not alter the menstrual cycle,
- HPV cannot cause miscarriage or pregnancy loss,
- HPV, which often causes cancer, is not transmitted during pregnancy or childbirth;Natural childbirth is allowed if HPV is present.
Disease prevention
Considering that 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 the body's defenses.If you have bad habits, it is better to stop them or at least significantly reduce your alcohol and tobacco consumption.Girls should also avoid the use of oral contraceptives, which also predispose them to the disease.
Strengthening the immune system is facilitated by physical activity, proper and 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, but they also improve intestinal motility, which helps cleanse the body of internal toxins that weaken the immune system.
An important point in HPV prevention is to be selective in choosing sexual partners.A healthy monogamous relationship excludes sexual transmission.The task of parents is to provide sexual education to their children.The risk of contracting the disease is reduced by using condoms and refusing to have sexual relations 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 18 years of age who have not yet initiated sexual activity.Since HPV infection usually occurs during first sexual contact, the ideal age for girls to be vaccinated is between 12 and 14 years old.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.
Children also need vaccines.It not only helps reduce the spread of infection but 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 15 years of age, these are two doses of the vaccine with an interval of 6 to 12 months, for adults - three doses (scheme 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.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.
Conclusion
An infection caused by the human papillomavirus very often does not manifest itself in any way and can go unnoticed for the rest of 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.It is recommended that all women over 25 years of age undergo periodic examinations to detect the presence of the virus in the body, along with a Pap smear.