Human papillomavirus (HPV) is a very common sexually transmitted infection worldwide.
The peculiarity of this infection is that it may not be detected for many years, but eventually lead to the development of benign (papilloma) or malignant (cervical cancer) diseases of the genitals.
Types of human papillomavirus
More than 100 types of HPV are known. Types are a peculiar "subspecies" of a virus that differ from one another. Types are indicated by numbers assigned to them upon detection.
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 oncogenic risk types 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, vagina, perianal area, skin of the genitals. They almost never become malignant, but cause significant cosmetic defects of the genitals. Warts on other parts of the body (hands, feet, face) can also be caused by this type of virus, or can have different origins. In the following 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 become infected with HPV sooner or later: Up to 90% of sexually active women experience this infection in their lifetime.
But there is good news: the majority of those infected (about 90%) will be free of HPV within two years without any medical intervention.
This is a 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 such a situation HPV will not do any harm to the body.That is, if HPV was detected some time ago, but not now, it is absolutely normal!
We must remember that the immune system works in different people "at different speeds". In this regard, the speed of getting rid of HPV may be different for sexual partners. Therefore, a situation is possible where HPV is detected in one partner and not in the other.
Most people become infected with HPV soon after sexual activity and many will never know they have been infected with HPV. Permanent immunity is not established after infection, so it is possible to re-become infected with the same virus already encountered as well as other types of the virus.
"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 inflammation of the vaginal / cervical mucosa, menstrual irregularities or infertility.
HPV does not affect the ability to conceive or conceive.
The "high-risk" HPV baby does not pass during pregnancy and childbirth.
Diagnosis of human papillomavirus
Taking an HPV test with a high oncogenic risk before the age of 25 is practically pointless (except for women who start having sexual activity earlier (before the age of 18)), because at this time there is a high probability of detecting the virus, which will appear soon. Leave the body by itself.
After 25-30 years it makes sense to do the analysis:
- With cytological analysis (PAP - test). If there are changes in the PAP test and HPV is "high risk", then this situation requires special attention;
- Prolonged maintenance of "high-risk" HPV in the absence of cytological changes also deserves attention. Recently, the sensitivity of HPV testing in the prevention of cervical cancer is higher than the cytological sensitivity and therefore the definition of HPV alone (without cytology) has been approved as an independent study for the prevention of cervical cancer. In the United States. However, in our country an annual cytological examination is recommended, so the combination of these two studies seems reasonable;
- After treatment of dysplasia / precancerous / cervical cancer (absence of HPV in the analysis after treatment almost always indicates successful treatment).
For the examination it is necessary to take a smear from the cervical canal (it is possible to study the material from the vagina, although it is recommended to take the material from the cervix during the screening).
The analysis should be performed:
- Once a year (if "high-risk" HPV has been previously detected and tested in conjunction with a cytological examination);
- 1 time in 5 years if previous analysis was negative.
It is almost never necessary to perform a low-risk oncogenic HPV test. If there are no papillomas, then this analysis makes no sense in principle (the virus can be transmitted, there is no cure for the virus, so what to do about the result of the next analysis is unknown).
If there are papillomas, then:
- Most often they are caused by HPV;
- They should be deleted regardless of whether we find the 6/11 type;
- If we take the smear, then it is directly from the papillomas themselves and not from the vagina / uterus.
There are tests to detect different types of HPV. If you are periodically tested for HPV, pay attention to which specific types are included in the test. Some laboratories conduct research on only 16 and 18 types, some - all types together. It is also possible to perform a quantitative test to detect all 14 types of "high risk" viruses. Quantitative characteristics are important in predicting the likelihood of developing pre-cancerous and cervical cancer. These tests should be used in the context of cervical cancer prevention and not as an independent test for HPV. Analysis without cytology results (PAP test) most often does not allow to make any conclusions about the patient's state of health.
There is no test to determine if a virus will "leave" a particular patient.
Treatment of human papillomavirus
There is no medical treatment for HPV. There is treatment for conditions caused by HPV (papillomas, dysplasia, precancerous, cervical cancer).
This treatment should be performed using surgical methods (cryocoagulation, laser, radiotherapy).
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 tests to show their effectiveness and safety. None of the protocols / standards / recommendations are contained in these drugs.
The presence or absence of cervical "erosion" does not affect the treatment tactics of HPV. ".
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 re-take 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 does not necessarily lead to cervical cancer, but control is necessary.
Treatment of sexual partners is not necessary (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 cancer cases, which is why protection from them is so important. Routine 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. By no means do I want to convey that I recommend for the mother to be inactive.