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 pointed warts on the skin and mucous membranes.In medicine, such 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 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 picked up even by shaking hands!
Important! There are several ways of transmitting HPV.You can become infected with this virus not only through unprotected sex, but also at home.
Methods of transmission of HPV:
- 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 a handshake, kisses 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 the infection becoming chronic.
Important! Using a condom does not guarantee protection against HPV.The virus can be transmitted even through minor contact with skin or mucous membranes.
HPV is very common, with approximately 14 million people infected by 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 took HPV tests and all of them were negative, there is still a chance that you became 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 from new sexual partners is quite 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 depending on their ability to cause cancer.All types of the virus are divided into three groups:
- Conditional oncogenic HPV (the safest),
- HPV of average oncogenic risk,
- HPV of high oncogenic risk (the most dangerous).
HPV of high oncogenic risk includes only 15 types of virus (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 cancer most often: about 70% of all cases of cervical cancer - themwork.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 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 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, scrotum, perineal or anal area, 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 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 this case, HPV can sooner or later cause cell changes: dysplasia (precancerous condition), and then cervical cancer.
Important! If HPV is detected, do not panic!It may disappear by 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 people), but it poses a real danger.
The duration of development of the disease in this case is individual.In some patients, the initial stage can last for years without leading to cancer.The likelihood of developing cancer increases with age.On average, 10–20 years pass from infection to the appearance of dysplasia (precancerous condition) and cervical cancer.
Symptoms
At the initial stage, a person, as a rule, does not know about his disease, but is contagious to others.HPV very often 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.Their appearance may 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 turn out to be quite large.Condylomas can be either single or multiple, and have different shapes from dome-shaped or thread-like 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 it difficult to go to the toilet.Sometimes condylomas can hurt or itch, and when injured, they can bleed.
Diagnostics
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 years of age should be regularly diagnosed with HPV.
Which doctor should I contact?
If you are a woman and you do not have any 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 check.
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 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).
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 slightest changes in 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 selected.This method allows you to purify the sample and save a larger number of cells for study.
The HPV test is a vaginal smear.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 analysis can be either positive or negative.
If both tests are negative (no changes in cells, no HPV detected), the next scheduled examination can be carried out 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 scheduled examinations are carried out at least annually.
Treatment begins only if cervical dysplasia is diagnosed based on the results of a PAP test and biopsy.
Do I need to look for HPV if I have genital warts?
If you find yourself with condylomas, you do not need 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 take 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 cellular changes in the cervix.They can be detected through routine screening.
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 still needed.The expectant mother should not receive any doses of the HPV vaccine until after her pregnancy.
The risk of passing HPV to your baby during childbirth is very low.Even if infants 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 who are diagnosed with human papillomavirus should simply monitor the infection.In this case, you should take a PAP test (cytological smear) once a year.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 selects 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),
- injections of interferons into 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 can cause cancer (for example, they are combined with a precancerous skin condition).
It is useless to remove condylomas in order to protect your 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 appear again.
Local preparations
Among the local drugs that can be prescribed for the treatment of condylomas:
- Cauterizing agents and keratolytics (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 enhance immunity”,
- antiviral drugs.
HPV cannot be cured, you can only protect 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 for women under 25 years of age, since the virus is detected very often 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.Don't forget 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 discomfort to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.In addition, condylomas can:
- bleed,
- hurt, cause a burning sensation 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 developing it 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 analysis 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 leading cause of anal cancer.Cancer of the vulva, vagina or penis, on the contrary, 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 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
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 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.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 HPV prevention is being selective in choosing sexual partners.A healthy monogamous relationship excludes sexual transmission.The task of parents is to provide their children with sex education.The risk of the disease is reduced by using condoms and refusing sex with HPV carriers.
Vaccination
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 relevant for girls under 18 years of age who have not yet begun 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 the 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 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 6-12 months, for adults - three doses (schedule 0, 1-2, 6 months).Additional revaccinations are not 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 very often does not manifest itself in any way and may remain undetected for the rest of life.Many patients learn about 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 25 years of age, along with a Pap test.