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 and spiky 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 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, and can even be detected with a handshake!
Important! There are several ways HPV is transmitted.You can become infected with this virus not only through unprotected sex, but also at home.
HPV transmission methods:
- Sexual.This includes all types of sexual contact – vaginal, oral, anal.
- Contact.The virus can be infected through abrasions, scratches, cuts and microcracks in the skin - through handshakes, kisses and other close contact with a sick person.
- During childbirth from mother to child.
It is believed that the infection is often 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 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 all unvaccinated sexually active people contract the disease, but very few people learn about the disease.Even if you've had HPV tests and they all came back negative, there's still a chance you could have been infected and cleared 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 by new sexual partners is quite likely.Furthermore, if you are 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),
- Medium oncogenic risk HPV,
- High oncogenic risk HPV (the most dangerous).
High oncogenic risk HPV 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 cancer: about 70% of all cases of cervical cancer - they work.The rest are associated with cancer much less frequently.
Important! If you are infected with one of the “dangerous” viruses, this does not mean that there will definitely be cancer.Most of the time, 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 must 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.Furthermore, not all viruses that affect the skin and mucous membranes of the genital organs (penis, scrotum, perineal or anal region, vagina, vulva or cervical mucosa) can cause cancer.Thus, HPV types 6 and 11 are responsible for the occurrence 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 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 at the next exam.Having a virus does not mean you are sick.If HPV persists in the body, be tested 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 people), but it represents a real danger.
The duration of the development of the disease in this case is individual.In some patients, the early stage can last for years without causing cancer.The likelihood of developing cancer increases with age.On average, 10 to 20 years pass from infection to the onset of dysplasia (precancerous condition) and cervical cancer.
Symptoms
At the initial stage, the person, as a rule, does not know about his illness, but it is contagious to other people.HPV often doesn't even manifest itself, but certain types can cause the growth of flat or spiky 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 are quite large.Condylomas can be single or multiple and have different shapes, from dome-shaped or filamentous to mushroom-shaped and plaque-shaped with a smooth or bumpy surface.Some genital warts grow extensively, giving them some 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 increased 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 oncogenic risk HPV.It is believed that all women over 25 should be regularly diagnosed with HPV.
Which doctor should I contact?
If you are a woman and have no symptoms or complaints, you still need to see a gynecologist once a year.Your doctor may order an HPV test as part of your general health exam.
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 spots.If you are concerned about the genital area and anus, it is advisable to make an appointment with a venereologist, urologist or gynecologist.If not, 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 for the presence/absence of high oncogenic risk HPV (cotest) is carried out.
The PAP test (Pap 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 the cells.To make it even more informative, they use the HPV test.
Important! When it is possible to choose between “conventional” and “liquid-based” cytology, “liquid-based” should be selected.This method allows you to purify the sample and save a greater 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 changes in cells, no HPV detection), the next scheduled exam can be carried out after 3 years.If the PAP test is negative but HPV is detected, the patient is at risk.Colposcopy is prescribed (examination of the inside of the vagina and cervix), if necessary, biopsy (collection of a small fragment of biomaterial for further examination) and scheduled examinations are carried out at least once a year.
Treatment only begins if cervical dysplasia is diagnosed based on the results of a Pap smear and a biopsy.
Do I need to check for HPV if I have genital warts?
If you have condylomas, you don't need an exam.The appearance of warts alone indicates infection with a virus.An analysis of the cervix or vagina will be unnecessary, but if necessary, you can do an analysis of the condylomas themselves.
HPV and pregnancy
Experts recommend that women planning to become pregnant undergo a comprehensive examination to detect HPV infection.During pregnancy, a woman with HPV may develop genital warts or abnormal cellular changes on the cervix.They can be detected through routine exams.
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 expectant mother should not receive any dose 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 the human papillomavirus, their bodies usually eliminate the virus on their own.
Treatment
There is no effective treatment for HPV;only 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: remove or not?
Condylomas caused by HPV are usually monitored in a simple way (in about half of cases they disappear on their own), resorting to treatment only if there are unpleasant symptoms - itching, bleeding, burning or pain.Typically, for each patient, the doctor selects an individual therapy for condylomas, which takes into account his character and the patient's health characteristics.This therapy may include:
- the use of local antitumor drugs, cauterizers or catechins - creams or solutions that are applied pointwise to the 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).
Surgery is usually recommended if the warts have grown significantly, cause 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 they may cause cancer (for example, they are combined with a precancerous skin disease).
It is useless to remove condylomas to protect your sexual partner from the virus, as the virus can remain in the body.Getting rid of warts also does not reduce the risk of developing cancer in the future.After condylomas are removed, there is always a chance that they will reappear.
Local preparations
Among the local medicines 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 often becomes a reason to take various 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 medications.
HPV has no cure, you can only protect yourself 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 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 test for HPV is a reason to regularly visit a gynecologist and undergo additional tests.Don't forget that having a virus is not an illness.
Complications
Complications caused by the human papillomavirus can be dangerous, but they can be avoided if the body is regularly checked 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
- hurt, cause burning and itching sensation,
- interfere with going to the bathroom,
- interfere 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 analyzing their 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.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 for which it is not the 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 pregnancy loss,
- HPV, which often causes cancer, is not transmitted during pregnancy and childbirth;natural birth is permitted 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 give them up or at least significantly reduce your alcohol and tobacco consumption.Girls should also avoid using oral contraceptives, which also predispose them to the disease.
Strengthening the immune system is facilitated by physical activity, adequate and 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 cleanse the body of internal toxins that weaken the immune system.
An important point in preventing HPV 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 the disease is reduced by using condoms and refusing to have sex with people with HPV.
Vaccination
The most effective protection against HPV is vaccination.Today, in most developed countries in the world, HPV vaccination is an integral part of the vaccination schedule.Firstly, it is relevant for girls under 18 who have not yet started sexual activity.Given that HPV infection often occurs during the 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 the vaccine if they plan to change sexual partners.Vaccination will help prevent infection with new types of viruses.
Boys 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 the virus:
- 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, there are two doses of the vaccine with an interval of 6 to 12 months, for adults - three doses (schedule 0, 1-2, 6 months).No additional revaccinations are required;the effect after the vaccine lasts for at least 10 years.
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.
Conclusion
An infection caused by the human papillomavirus often does not manifest itself in any way and can go unnoticed for the rest of your life.Many patients only become aware of the infection 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 25 years of age, along with a Pap smear test.