Human papillomavirus (HPV) is an extremely common sexually transmitted infection in the world.
The peculiarity of this infection is that it may not manifest itself for many years, but eventually leads to the development of benign (papiloma) or malignant (cervical cancer) diseases of the genital organs.
types of human papillomavirus
More than 100 types of HPV are known. Types are peculiar "subspecies" of a virus that differ from one another. Types are designated by the numbers that were assigned when they were discovered.
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 related to the development of cervical cancer). .
In addition, less oncogenic risk types are known (mainly 6 and 11). They lead to the formation of anogenital warts (genital warts, papillomas). Papilomas on the skin of the genital organs, mucosa in the vagina, vagina, perianal regionThey almost never become fatal, but cause significant cosmetic defects in the genital area. Warts on other parts of the body (arms, legs, face) can also be caused by this type of virus, orMay be of a different origin. In subsequent articles, we will discuss the types of HPV "high risk" and "low risk" 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 will experience this infection in their lifetime.
But there's good news: Most (about 90%) of those infected will get rid of HPV within two years without any medical intervention.
This is the normal sequence of the infectious process caused by HPV in the human body. This time is sufficient for the human immune system to completely get rid of the virus. In this case, HPV will not cause any harm to the body.That is, if HPV was detected some time ago, and now it is not, then this is absolutely normal!
It should be borne in mind that the immune system works "at different speeds" in different people. In this regard, the speed of getting rid of HPV for sexual partners may differ. Therefore, such a situation is possibleWhen HPV is detected in one partner and not the other.
Most people become infected with HPV soon after becoming sexually active, and many people will never know they have been infected with HPV. Permanent immunity is not formed after infection, therefore, with the same virus. And it is possible to re-infect both with other types of 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 mucous membranes of the vagina/cervix, development of menstrual irregularities or infertility.
HPV does not affect the ability to conceive and conceive.
A "high risk" HPV baby is not transmitted during pregnancy and delivery.
Human papillomavirus diagnosis
It is practically pointless to test HPV for high oncogenic risk before the age of 25 (except in women who begin sexual activity early (before age 18)), because at this time it is very difficult to detect a virus. Chances are that will soon leave the body on its own.
After 25 - 30 years, it makes sense to analyze:
- a simultaneous cytology analysis (PAP - test). If there are changes in the PAP - test, and HPV "high risk", this condition requires special attention;
- The long-term persistence of "high-risk" HPV in the absence of cytological changes is also worth noting. Recently, the sensitivity of HPV testing in the prevention of cervical cancer has been shown to exceed the sensitivity of cytology, and therefore HPV alone. (without cytology) has been approved as a stand-alone study for the prevention of cervical cancer. In the United States. However, in our country, an annual cytological examination is recommended, so a combination of these two studies seems appropriate;
- After treatment for dysplasia/precancer/cervical cancer (absence of HPV in post-treatment analysis almost always indicates successful treatment).
For the study, it is necessary to obtain a smear from the cervical canal (it is possible to study material from the vagina, however, as part of the screening, it is recommended to obtain material from the cervix).
Analysis should be given:
- 1 time per year (if "high risk" HPV was previously detected, and the analysis is given with a cytological examination);
- 1 time in 5 years if the previous analysis was negative.
It is almost not necessary to conduct an analysis for HPV of low oncogenic risk. If there are no papillomas, this analysis does not make sense in principle (transport of the virus is possible, there is no cure for the virus, so the results of the analysis are notWhat to do next is unknown).
If there are papillomas, then:
- Often they are caused by HPV;
- Whether we find 6/11 types or not, they should be removed;
- If we take a smear, then directly from the papilloma and not from the vagina / cervix.
There are tests to detect different types of HPV. If you get tested for HPV from time to time, pay attention to which specific types are included in the analysis. Some laboratories only research types 16 and 18, Others - on all types at once. It is also possible to perform a test that will identify all 14 types of "high risk" viruses in a quantitative format. Quantitative features are important for predicting the likelihood of developing precancer and cervical cancer. The tests should be used in the context of cervical cancer prevention and not as a standalone test. Analysis for HPV without cytology results (PAP testing) often does not allow any conclusions to be drawn about the patient's health statusgives.
There is no analysis to determine whether the virus will "leave" in a particular patient.
human papillomavirus treatment
There is no medical treatment for HPV. There are treatments for conditions caused by HPV (papillomas, dysplasia, precancer, cervical cancer).
This treatment should be carried out using surgical methods (cryocoagulation, laser, radioknife).
No "immunostimulants" are related to the treatment of HPV and should not be used. None of the drugs widely known in our country have passed adequate testing that would demonstrate their effectiveness and safety. Any protocols/standards/Recommendations do not include these drugs.
The presence or absence of "erosion" of the cervix does not affect the strategy of HPV treatment. 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 there are no papillomas/changes on the cervix during the colposcopy and as per the PAP test, no medical procedure is required.
It is necessary to retake the analysis only once a year and monitor the condition of the cervix (annual PAP test, colposcopy). In most patients, the virus will "leave" the body on its own. If it does not go away, thenIt is not absolutely necessary that this will lead to the development of cervical cancer, but control is essential.
Treatment of sexual partners is not required (except in cases where both partners have genital papillomas).
Prevention of human papillomavirus infection
Vaccines have been developed that 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 cancer cases, so protection against themVery important. Routine vaccination is used in 45 countries around the world.
Condoms (does not provide 100% protection).
The only way to provide 100% protection is by abstaining from sexual intercourse. I am not campaigning for them in any way, I am just offering food for thought.