The human papillomavirus (HPV) is an extremely common sexually transmitted infection worldwide.
The specificity of this infection is that it may not last for many years, but may eventually lead to the development of benign (papilloma) or malignant (cervical cancer) genital diseases.
Types of human papillomavirus
More than 100 types of HPV are known. The types are peculiar "subspecies" of the virus that differ from each other. Types are denoted by the numbers assigned to them when they were discovered.
There are 14 types of high oncogenic risk: 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, types of low oncogenic risk are known (mainly 6 and 11). They cause the formation of anogenital warts (genital warts, papillomas). Papillomas are located on the mucous membrane of the vulva, in the vaginal region, on the skin of the genitals. They almost never become malignant, but cause significant cosmetic defects in the genital area. Warts on other parts of the body (hands, feet, face) can also be caused by these types of viruses, or they can have other origins. In the following articles, we will discuss the "high risk" and "low risk" types of HPV separately.
Human papillomavirus infection
The virus is transmitted mainly through sexual contact. Almost all women become infected with HPV sooner or later: up to 90% of sexually active women experience this infection in their lifetime.
But the good news is that most people (about 90%) will get rid of HPV within two years without any medical intervention.
This is a normal course of the HPV infection in the human body. This time is enough for the human immune system to get rid of the virus completely. In this situation, HPV will not cause any harm to your body.That's if HPV was discovered some time ago, but now it's not, that's perfectly normal!
It should be borne in mind that the immune system works at different speeds for different people. In this regard, the rate of HPV release to sexual partners may vary. Therefore, there may be a situation where HPV is detected in one partner but not in the other.
Most people become infected with HPV shortly after they become sexually active, and many will never find out that they are infected with HPV. Persistent immunity does not develop after infection, so it is possible to re-infect both the same virus that has already been encountered and other types of the virus.
"High-risk" HPV is dangerous because it can lead to the development of cervical cancer and some other types of cancer. "High-risk" HPV does not cause other problems.
HPV does not cause inflammation of the vaginal / cervical mucosa, menstrual irregularities or infertility.
HPV does not affect your ability to conceive or conceive.
A "high-risk" HPV baby is not transmitted during pregnancy and childbirth.
Diagnosis of human papillomavirus
It is practically useless to test for HPV to detect a high risk of oncogenes up to the age of 25 (except for women who start sex early (up to 18 years)), as it is very possible to detect a virus that will soon leave the body alone.
After 25-30 years, it is useful to perform an analysis of:
- together with cytological analysis (PAP - test). If there is a change in the PAP test and the HPV is "high risk", this situation requires special attention;
- Long-term persistence of "high-risk" HPV in the absence of cytological changes is also noteworthy. Recently, the sensitivity of HPV tests for the prevention of cervical cancer has been shown to be higher than the sensitivity of cytology, and therefore the detection of HPV alone (without cytology) has been approved as a separate study for the prevention of cervical cancer. In the United States. However, an annual cytological examination is recommended in our country, so a combination of these two studies seems reasonable;
- after treatment of dysplasia / pre-cancerous / cervical cancer (absence of HPV in the post-treatment analysis almost always indicates successful treatment).
For the study it is necessary to obtain a smear from the cervical canal (the material can be examined from the vagina, however, it is recommended to obtain the material from the cervix during screening).
The analysis must be provided:
- Once a year (if "high risk" HPV has previously been detected and the analysis is performed in conjunction with a cytological examination);
- 1 time in 5 years if the previous analysis was negative.
Low-oncogenic HPV risk analysis is almost never required. In the absence of papillomas, this analysis does not make sense in principle (transmission of the virus is possible, there is no treatment for the virus, so it is not known what to do next with the result of the analysis).
If there are papillomas:
- they are most commonly caused by HPV;
- they must be deleted whether or not we find 6/11 types;
- if we take a smear, then directly from the papillomas themselves, not from the vagina / cervix.
There are tests to detect different types of HPV. If you periodically test for HPV, pay attention to which specific types are included in the test. Some laboratories perform studies only on types 16 and 18, others on all types together. It is also possible to perform a test that will quantify all 14 types of "high risk" viruses. Quantitative characteristics are important to predict the likelihood of developing pre-cancerous and cervical cancer. These tests should be used in the context of cervical cancer prevention and not as a stand-alone test. Non-cytological analysis of HPV (PAP test) most often does not allow conclusions to be drawn about the patient's state of health.
There is no analysis to determine whether or not the virus will "leave" a particular patient.
Treatment of human papillomavirus
There is no medical treatment for HPV. There is treatment for HPV-induced conditions (papillomas, dysplasia, precancerous lesions, cervical cancer).
This treatment should be performed using surgical techniques (cryocoagulation, laser, radionase).
No "immunostimulants" are associated with the treatment of HPV and should not be used. None of the well-known medicines in our country has passed the appropriate tests to prove their effectiveness and safety. None of the protocols / standards / recommendations cover this medicine.
The presence or absence of cervical "erosion" does not affect HPV treatment tactics. You can read more about the situations when it is necessary to treat erosion in the article "Erosion or not erosion? ".
If the patient has no complaints and no papillomas / changes in the cervix during colposcopy and according to the PAP test, no medical procedures are required.
It is only necessary to repeat the analysis and monitor the condition of the cervix once a year (annual PAP test, colposcopy). For most patients, the virus will "leave" the body on its own. If it does not go away, it is not at all necessary that it will lead to the development of cervical cancer, but control is needed.
Treatment of sexual partners is not required (unless both partners have genital papillomas).
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). HPV types 16 and 18 are responsible for 70% of cervical cancers, which is why protection against them is so important. Conventional vaccination is used in 45 countries around the world.
Condom (does not provide 100% protection).
The only method that provides 100% protection is to abstain from sexual intercourse. I am by no means campaigning for him, just giving food for thought.