Human papillomavirus (HPV) is the most common sexually transmitted infection in the world.
The peculiarity of this infection is that it does not manifest itself for many years and can eventually lead to genital warts (papilloma) or malignant diseases (cervical cancer).
Types of human papillomavirus
More than 100 types of HPV are known. Types are specific "subspecies" of a virus that differ from one another. Types are denoted by the numbers assigned to them when they are opened.
The high oncogenic risk group consists of 14 types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 (these types are associated with the development of cervical cancer).
In addition, low types of oncogenic risk are known (mainly 6 and 11). They lead to the formation of anogenital warts (genital warts, papillomas). Papillomas are located in the mucous membrane of the vulva, vagina, perianal area, on the skin of the genitals. They are almost never harmful, but lead to serious cosmetic defects in the genital area. Warts on other parts of the body (arms, legs, face) can also be caused by these types of viruses or can be caused by other factors. In the following articles, we will discuss the "high risk" and "low risk" types of HPV separately.
Human papillomavirus infection
The virus is mainly transmitted through sexual contact. Almost all women sooner or later become infected with HPV: up to 90% of sexually active women experience this infection throughout their lives.
But the good news is that most people (about 90%) become HPV within two years without any medical intervention.
This is the normal course of the HPV-induced infectious process in the human body. This time is enough for the human immune system to completely get rid of the virus. In this situation, HPV does not cause any harm to the body.In other words, if HPV was detected some time ago, it is not so now, it is completely normal!
It is important to remember that the immune system works at "different speeds" in different people. In this regard, the rate of HPV elimination may vary for sexual partners. Therefore, HPV may be present in one partner and not in the other.
Most people become infected with HPV shortly after sexual intercourse, and most of them never know they have HPV. After infection, there is no permanent immunity, so you can be re-infected with both the same virus you have encountered before and other types of viruses.
"High risk" HPV is dangerous because it can lead to cervical cancer and other types of cancer. "High risk" HPV does not cause other problems.
HPV does not cause inflammation of the mucous membranes of the vagina / cervix, menstrual irregularities or infertility.
HPV does not affect pregnancy and pregnancy.
A "high risk" HPV baby is not infected during pregnancy and childbirth.
Diagnosis of human papillomavirus
It is virtually pointless to take an HPV test for a high oncogenic risk before the age of 25 (except for women who have started sexual intercourse early (before the age of 18) because there is a high probability of early detection of the virus. leaving the body on its own.
After 25-30 years, it makes sense to conduct this analysis:
- together with cytological analysis (PAP - test). If there are changes in PAP - testing, and "high risk" of HPV, then this situation requires special attention;
- The long-term persistence of "high risk" HPV without cytological changes also requires attention. Recently, it has been shown that the sensitivity of HPV testing in the prevention of cervical cancer is higher than the sensitivity of cytology, so the only detection of HPV (without cytology) has been approved as a stand-alone study for the prevention of cervical cancer. In the United States. However, cytological examination is recommended every year in our country, so the combination of these two studies seems reasonable;
- after treatment of dysplasia / advanced cancer / cervical cancer (absence of HPV in post-treatment analysis almost always indicates successful treatment).
The test requires a swab from the cervical canal (this material can be examined from the vagina, but it is recommended to take the material from the cervix as part of the screening).
The analysis should be provided:
- once a year (if "high risk" HPV has been previously identified, and the analysis is provided in conjunction with a cytological examination);
- If the previous analysis is negative, once in 5 years.
Getting a low-risk oncogenic HPV test is almost never required. If there are no papillomas, then this test is not fundamental (the virus can be carried, there is no treatment for the virus, so the results of the test are unknown what to do next).
If you have papillomas:
- most often they are caused by HPV;
- Whether we find 6/11 species or not, they must be eliminated;
- if we smear, it is directly from the papillomas themselves, not from the vagina / cervix.
There are tests to detect different types of HPV. If you are tested for HPV from time to time, pay attention to which specific types are included in the test. Some laboratories conduct research only on species 16 and 18, others - on all species together. It is also possible to test all 14 types of "high risk" virus in digital format. Quantitative characteristics are important for predicting the likelihood of developing precancerous and cervical cancer. These tests should be used in the context of cervical cancer prevention, not as a stand-alone test. Cytologically ineffective HPV analysis (PAP test) often does not allow to draw any conclusions about the patient's state of health.
There is no such test to determine whether a particular patient has "gone" the virus.
Treatment of human papillomavirus
There is no medical treatment for HPV. There are treatments for conditions caused by HPV (papillomas, dysplasia, precancerous lesions, cervical cancer).
This treatment should be performed using surgical techniques (cryocoagulation, laser, radio knife).
No "immunostimulants" are involved in the treatment of HPV and should not be used. None of the well-known drugs in our country have been adequately tested to demonstrate their effectiveness and safety. None of the protocols / standards / recommendations include these drugs.
The presence or absence of "erosion" of the cervix does not affect the tactics of treatment with HPV. You can read more about the conditions that need to be treated for erosion in the article "Erosion or not? "
No medical procedures are required if the patient has no complaints, no papillomas / changes in the cervix during colposcopy and according to the PAP test.
Only repeat the test once a year and monitor the condition of the cervix (annual PAP test, colposcopy). In most patients, the virus leaves the body on its own. If it does not go away, it may not lead to the development of cervical cancer, but it needs to be controlled.
Treatment of sexual partners is not required (except in cases where both partners have genital papilloma).
Prevention of human papillomavirus infection
Vaccines have been developed to protect against HPV types 16 and 18 (one of the vaccines also protects against types 6 and 11). Types HPV 16 and 18 are responsible for 70% of cases of cervical cancer, so protection against them is very important. Daily vaccinations are used in 45 countries around the world.
Condoms (do not provide 100% protection).
The only way to provide 100% protection is to abstain from sex. By no means am I propagandizing it, I am just feeding the thought.