Human papillomavirus (HPV) is an extremely common sexually transmitted infection in the world.
A characteristic of this infection is that it may not appear for many years, but eventually leads to the development of benign (papilloma) or malignant (cervical cancer) disease of the reproductive organs.
Types of Human Papillomavirus
More than 100 types of HPV are known. Types are special "subspecies" of viruses that differ from each other. Types are specified by the numbers assigned to them when they are discovered.
The high cancer risk group consisted 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 carcinogenic risk types (mainly 6 and 11) are known. They cause the formation of anogenital warts (genital warts, papillomas). Papillomas are located on the mucous membranes of the skin of the vulva, vagina, perianus, and reproductive organs. They rarely become malignant, but can cause noticeable cosmetic defects in the genital area. Warts on other parts of the body (hands, feet, face) may also be caused by these types of viruses, or may have different origins. In a follow-up article, we will discuss the "high-risk" and "low-risk" types of HPV separately.
Human papillomavirus infection
The virus is mainly spread through sexual contact. Almost all women will get HPV sooner or later: up to 90% of sexually active women will experience this infection during their lifetime.
But there's good news: Most infected people (about 90 percent) will get rid of HPV within two years without any medical intervention.
This is the normal course of the infection process in the human body caused by HPV. This time is long enough for the body's immune system to completely clear the virus. In this case, HPV will not cause any harm to the body.That said, if HPV was detected some time ago and not now, that's absolutely normal!
It must be kept in mind that the immune system works in different people at "different speeds". In this regard, the speed at which sexual partners clear HPV may vary. Therefore, this is possible when HPV is detected in one of the partners but not the other.
Most people get HPV shortly after becoming sexually active, and many people will never know they have HPV. Permanent immunity does not develop after infection, so reinfection with the same virus and other types of viruses already encountered may be possible.
"High-risk" HPV is dangerous because it can lead to the development of cervical cancer and some other cancers. "High-risk" HPV does not cause other problems.
HPV does not cause vaginal/cervical mucosal inflammation, irregular periods, or infertility.
HPV does not affect the ability to conceive and become pregnant.
"High-risk" HPV babies are not spread during pregnancy and childbirth.
Diagnosis of Human Papillomavirus
It is practically pointless to test for high cancer risk HPV before age 25 (except for women who are sexually active early (before age 18)), because at this time it is likely to detect a virus that will soon appear to allow the body toOn their own.
After 25-30 years, it makes sense to analyze:
- Together with cytological analysis (PAP-test). If there is a change in the PAP-test and the HPV is "high risk", then this situation requires special attention;
- The long-term persistence of "high-risk" HPV in the absence of cytological changes is also of concern. Recently, the sensitivity of HPV testing in preventing cervical cancer has been shown to be higher than that of cytology, so testing for HPV alone (without cytology) was approved as an independent study in cervical cancer prevention in the United States. However, in our country, annual cytology is recommended, so it seems reasonable to combine the two studies;
- Dysplasia/precancer/cervical cancer post-treatment (absence of HPV in post-treatment analysis almost always indicates successful treatment).
For this study, it was necessary to obtain a smear from the cervical canal (material can be studied from the vagina, however, as part of screening, it is recommended to obtain material from the cervix).
Analysis must be given:
- Once a year (if "high-risk" HPV was previously detected and analyzed with cytology);
- 1 in 5 years if previous analysis was negative.
Analysis of HPV with low cancer risk is rarely necessary. If there is no papilloma, this analysis is in principle meaningless (viral carry is possible, there is no treatment for the virus, so it is unknown what to do next with the results of the analysis).
If there is a papilloma, then:
- In most cases, they are caused by HPV;
- Whether or not we find 6/11 types, they must be removed;
- If we do a smear, it's directly from the papilloma itself, not from the vagina/cervix.
There are tests that can detect different types of HPV. If you are regularly tested for HPV, pay attention to which specific types are included in the analysis. Some labs only study types 16 and 18, while others study all types. A test can also be performed to identify all 14 "high-risk" viruses in quantitative form. Quantitative features are important for predicting the likelihood of developing precancerous lesions and cervical cancer. These tests should be used in the context of cervical cancer prevention, not as stand-alone tests. An HPV analysis (PAP test) without cytology results usually cannot draw any conclusions about a patient's health.
There is no such analysis that can determine whether the virus in a particular patient "leaves".
human papillomavirus treatment
There is no drug treatment for HPV. There are treatments for diseases caused by HPV (papillomas, dysplasia, precancerous lesions, cervical cancer).
This treatment should be performed using surgical methods (cryocoagulation, laser, radiosurgery).
There are no "immunostimulators" associated with the treatment of HPV and should not be used. None of the drugs that are widely known in our country have been adequately tested to prove their efficacy and safety. None of the protocols/standards/recommendations include these drugs.
The presence or absence of cervical "erosion" does not affect the strategy of HPV treatment. You can learn more about situations where you need to deal with erosion in the "Erosion or not to erode? " article.
If the patient has no complaints and there are no papillomas/changes on the cervix during the colposcopy and according to the PAP test, no medical procedure is required.
Just repeat the analysis 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 doesn't go away, it's not necessary at all to cause cervical cancer to develop, but control is necessary.
Treatment of sexual partners is not required (unless both partners have genital papilloma).
Prevention of human papillomavirus infection
Vaccines have been developed to protect against HPV types 16 and 18 (one vaccine also protects against HPV types 6 and 11). HPV types 16 and 18 cause 70% of cervical cancer cases, which is why preventing them is so important. Routine vaccination is used in 45 countries worldwide.
Condoms (does not provide 100% protection).
The only way to provide 100% protection is abstinence. I'm in no way running for him, I'm just thinking.