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 yourself from infections.
What is HPV?
The human papillomavirus (HPV) is known to cause flat, 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 high resistance to the action of antiseptics, not to mention soap, so it can be detected even by shaking hands!
Important! There are several ways to transmit HPV.You can contract this virus not only through unprotected sexual intercourse, 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 a handshake, 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 diseases, regular stress, hypothermia, lack of sleep, alcohol consumption, smoking and general tiredness.All this increases the risk of infection and the infection becomes chronic.
Important! Using a condom does not guarantee protection against HPV.The virus can also be transmitted through light contact with the skin or mucous membranes.
HPV is very common and approximately 14 million people are infected with it each year.Over the course of their lives, almost every sexually active, unvaccinated person contracts it, but very few people know about the disease.Even if you have had HPV tests and they all came back negative, there is still a chance that you were infected and shed the virus between tests.
Is it possible to get HPV again?
Unfortunately yes.After exposure to the virus, lasting immunity does not develop and infection from new sexual partners is very likely.Also, if you have been infected with one type of virus, you will not develop immunity against other types.
Types of HPV
There are many types of HPV, more than 200. They are usually divided based on their ability to cause cancer.All types of viruses are divided into three groups:
- Conditional oncogenic HPV (the safest),
- HPV of medium oncogenic risk,
- HPV with high oncogenic risk (the most dangerous).
Oncogenic high-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 cause cancer most often: 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 often, our immune system defeats HPV in 1-2 years on average.Even if HPV persists in the body, you may never develop precancerous lesions or cancer.
It should be clear that different types of HPV affect different parts of the body.Not everyone is 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.Therefore, HPV types 6 and 11 are responsible for the appearance of genital warts in 90% of cases, but do not cause cervical cancer.
Stages of development of the disease
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 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, come for examinations regularly, at least once a year.A virus can only pose a threat if it goes unchecked.Dysplasia must be treated on time, otherwise cancer will not develop.
This development of the disease is rare (infection leads to cellular transformation in less than 1% of infected people), but represents a real danger.
The duration of the development of the disease in this case is individual.In some patients, the initial phase can last for years without leading to cancer.The chance of developing cancer increases with age.On average, 10-20 years pass from infection to the onset of dysplasia (precancerous condition) and cervical cancer.
Symptoms
At the initial stage, a person, as a rule, is not aware of his disease, but it is contagious to others.Most often HPV 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 cancers 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 are quite large.Warts can be single or multiple and have different shapes from domes or thread-like, mushroom-shaped, to plaques with a smooth or irregular surface.Some genital warts grow widely, giving them a certain resemblance to cauliflower.The color of warts 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, warts can form on the cervical mucosa.The growth of warts in the anus and urethra (or urethra) can make going to the bathroom difficult.Warts can sometimes hurt or itch, and if injured, they can bleed.
Diagnostics
The effectiveness of treatment and prevention of cancer development largely depends on timely detection of high oncogenic risk HPV.It is believed that all women over the age of 25 should be routinely diagnosed with HPV.
Which doctor should I contact?
If you are a woman and do not have any symptoms or complaints, you should still see a gynecologist once a year.Your doctor may order an HPV test as part of your overall health checkup.
You should also consult a doctor if you find any 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 do?
As part of women's health screening, the Pap test is usually carried out and at the same time the analysis is carried out for the presence/absence of high oncogenic risk HPV (co-testing).
The PAP smear (Pap smear) is familiar to most women.It is taken from the cervical canal, its external surface and the vaginal vaults.This cytological study allows you to see the slightest changes in the cells.To make it even more informative, they resort to HPV testing.
Important! When choosing 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 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 detected), the next scheduled test can be done after 3 years.If the PAP test is negative, but HPV is detected, the patient is at risk.You are prescribed a colposcopy (examination of the inside of the vagina and cervix), if necessary, a biopsy (taking a small fragment of biomaterial for further 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 the PAP smear and biopsy.
Should I look for HPV if I have genital warts?
If you end up with warts, you don't need tests.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 warts themselves can be performed.
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 cell changes in 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 expectant mother should not receive any doses of the HPV vaccine until after pregnancy.
The risk of transmitting HPV to your baby during birth 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 manifestations of the disease can be treated.Women diagnosed with human papillomavirus should simply monitor the infection.In this case it is advisable to carry out a PAP test (cytological smear) once a year.It will help prevent the development of cervical cancer.
Warts: to remove or not?
Warts caused by HPV are usually simply monitored (in about half of cases they disappear on their own), resorting to treatment only if unpleasant symptoms appear: itching, bleeding, burning or pain.Usually, for each patient, the doctor selects an individual therapy for warts, which takes into account their character and the patient's health characteristics.Such therapy may include:
- the use of local, cauterized anticancer drugs or catechins - creams or solutions applied timely on warts (some of them are contraindicated during pregnancy),
- interferon injections in 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, are causing discomfort, are located in the vagina, urethra, or around the anus, and do not respond to other types of treatment.Warts should be removed if your doctor has reason to believe they may cause cancer (for example, if they are associated with a precancerous skin condition).
It is useless to remove warts to protect the sexual partner from the virus, since the virus can remain in the body.Furthermore, eliminating warts does not reduce the risk of developing cancer in the future.After the removal of warts there is always the possibility that they will return.
Local preparations
Among the local drugs that can be prescribed for the treatment of warts:
- Cautery and keratolytic agents (salicylic, acetic, lactic acids),
- Cytotoxic and cytostatic anticancer drugs,
- Topical retinoids
- Catechins.
How HPV is NOT treated: immunomodulators and antiviral drugs
A positive test for HPV often becomes a reason for taking various medications, despite the fact that there is no cure for this infection.The following will not help you against HPV:
- immunomodulators and any means “to improve immunity”,
- antiviral drugs.
HPV cannot be cured, you can only protect yourself with vaccination.
Forecast
Once HPV is detected, the prognosis is generally favorable.Diagnosis of highly oncogenic HPV types is not carried out for women under 25 years of age, since the virus is most 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 further examinations.Don't forget that having a virus is not a disease.
Complications
Complications from human papillomavirus can be dangerous, but can be avoided if the body is regularly examined for tumors.
Warts
A small number of warts may not cause discomfort to a person, but their growth in some cases significantly affects the quality of life: sexual activity, psychological state.Additionally, warts can:
- bleed
- hurts, causes a 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 that routine screening for women's health includes testing for 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 leading cause of anal cancer.Cancer of the vulva, vagina, or penis, in contrast, is not always associated with HPV (as is cancer of the oropharynx).
HPV is often associated with problems that 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 interrupt the menstrual cycle,
- HPV cannot cause miscarriage or missed pregnancy,
- HPV, which often causes cancer, is not transmitted during pregnancy and childbirth;natural birth is permitted if HPV is present.
Disease prevention
Considering that there is no cure for HPV, the importance of preventing the 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 abandon them or at least significantly reduce your alcohol and tobacco consumption.Girls should also avoid using oral contraceptives, which 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 fruits and vegetables.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 selectivity in choosing sexual partners.A healthy monogamous relationship excludes sexual transmission.The job of parents is to provide their children with sexual education.The risk of the disease is reduced by using condoms and refusing sexual intercourse 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 program.First of all, it is relevant 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 is logical for adult women to get vaccinated if they intend to change sexual partners.Vaccination will help prevent infection with new types of viruses.
Kids need vaccinations too.Not only does it help reduce the spread of the infection, but it also protects against genital warts.
HPV vaccines protect against several types of viruses:
- bivalent vaccine - against the most dangerous viruses of types 16 and 18,
- quadrivalent vaccine - against viruses types 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 age.For children and adolescents under 15 years old, this is two doses of the vaccine with an interval of 6-12 months, for adults - three doses (schedule 0, 1-2, 6 months).No further revaccinations are required;the effect after the vaccine lasts at least 10 years.
Important! HPV vaccines are highly safe and do not contain live viruses.Side 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 most often does not manifest itself in any way and can remain undetected for the rest of 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 vulnerable than men.Regular screening for the presence of the virus in the body, along with a Pap test, is recommended for all women over the age of 25.