The human papillomavirus (HPV) is an extremely widespread sexually transmitted infection.
Feature of this infection is that it can for many years does not manifest itself, but eventually lead to the development of benign (papilloma) or malignant (cervical cancer) diseases of the genital organs.
Types of human papillomavirus
There are more than 100 types of HPV. Types are a kind of "sub-species" of the virus, differing. Types are denoted by numbers, which are assigned to them as open.
A group of high oncogenic risk are 14 types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 (these types are related to cervical cancer).
In addition, known types of low oncogenic risk (mainly 6 and 11). They lead to the formation of anogenital warts (warts, papillomas). Papillomas located on the mucosa of the vulva, vagina, in the perianal region, on the skin of the genitals. They almost never become malignant, however, lead to significant cosmetic defects in the genital area. Warts on other parts of the body (arms, legs, face) can also be caused by these virus types, and may have a different origin. In subsequent articles we will separately discuss the types of HPV "high risk" and "low risk".
Infection with human papillomavirus
The virus is transmitted mainly through sexual contact. Sooner or later, become infected with HPV, nearly all women: up to 90% of sexually active women will face this infection in their lifetime.
But there is good news: most cases (about 90%) will get rid of HPV without any medical intervention within two years.
This is the normal course of infectious process caused by HPV in the human body. This time is enough to the human immune system is completely rid of the virus. In this situation, HPV will not bring any harm to the body. That is, if HPV was discovered some time ago, now it's gone, it's absolutely fine!
It is necessary to consider that the immune system works different people with "different speed". In this regard, the speed of getting rid of HPV will have different sexual partners. Therefore, it is possible that one of the partners discovered the HPV and the other not.
Most people become infected with HPV soon after becoming sexually active, and many of them will never know that have been infected with HPV. Persistent immunity after infection is not generated, so perhaps re-infection as the same virus, which has already been meeting, and other types of virus.
HPV "high risk" is dangerous because it can lead to the development of cervical cancer and some other cancers. Other problems with HPV "high-risk" causes. HPV leads to the development of inflammation of the mucous membrane of the vagina/cervix of the uterus, menstrual irregularities or infertility.
HPV does not affect fertility and pregnancy. Child HPV "high-risk" is not transmitted during pregnancy and childbirth. Diagnosis of human papillomavirus
To test for HPV of high oncogenic risk up to 25 years, almost pointless (except for those women who early begins sexual life (till 18 years)), as at this time is very likely to detect the virus, which soon self will leave the body.
After 25 – 30 years to be tested makes sense:
- together with the analysis for Cytology (PAP – test). If there are changes in the PAP test and HPV "high risk", such a situation requires specific attention.
- long persistence of HPV "high risk" in the absence of cytological changes also requires attention. Recently it is proved that the sensitivity of HPV testing in the prevention of cervical cancer is higher than the sensitivity of cytological examination in connection with determination of HPV (without Cytology) approved as an independent study for the prevention of cervical cancer in the United States. In Russia, however, recommended annual cytological study, therefore, seems a reasonable combination of these two studies;
- after treatment of dysplasia/pre-cancer/cancer of the cervix (no HPV in the analysis after the treatment is almost always indicative of successful treatment). For the study, you must obtain a swab from the cervical canal (it is possible to study material from the vagina, however, screening is recommended obtaining material from the cervix).
Analysis need to take:
- 1 time per year (if HPV "high-risk" had previously been detected, and analysis is dealt in conjunction with Cytology);
- 1 time in 5 years, if the previous analysis was negative.
To test for oncogenic HPV low risk there is no need almost never. If papillomas, this analysis does not make sense in principle (carrier of the virus is possible, treatment of the virus there, so what to do with the result of the analysis is unknown).
If the papilloma is, then:
- most often they are caused by HPV;
- to remove them you need regardless of, we find we 6/11 types or not;
- if we take the swab, directly from papillomas, and not from the vagina/cervix.
There are tests for HPV of different types. If you periodically tested for HPV, pay attention to what specifically the types included in the analysis. Some laboratories doing research just for the 16 and 18 type, others on all types together. It is also possible to take the test, which will identify the 14 types of HPV "high risk" in a quantitative format. Quantitative characteristics are important to predict the probability of development of precancer and cervical cancer. To apply these tests in the context of cervical cancer prevention and not as an independent test. Analysis of HPV without the results of Cytology (PAP test) often does not allow to draw any conclusions about the health status of the patient.
There is no such analysis, which will determine "go" or virus in a particular patient or not.
Treatment of human papillomavirus
There is no medicinal treatment for HPV. There are treatments for conditions caused by HPV (papilloma, dysplasia, precancer, cervical cancer). This treatment should be carried out with the use of surgical methods (cryocoagulation, laser, radio knife).
No "adjuvants" are not related to the treatment of HPV and should not be applied. None of the well-known drugs have not been adequate tests that would have shown their efficacy and safety. Any one of the protocols/standards/recommendations these drugs are not included. The presence or absence of "erosion" of the cervix does not affect the treatment of HPV.
If the patient has no complaints, and no papillomas/changes on the cervix during colposcopy, and according to the PAP — test, no treatment procedures are not necessary.
You only need to retake the test 1 time per year and to monitor the condition of the cervix (annually PAP — test, colposcopy). In most cases, the virus will go away from the body on their own. If not leave, it is not necessary that it will lead to the development of cervical cancer, but monitoring is required. Treatment of sexual partners is not required (with the exception of those cases when both partners have HPV genital organs).
Prevention of infection with human papillomavirus
Developed vaccines that protect against 16 and 18 types of HPV (one of the vaccines also protects against 6 and 11). Types of HPV 16 and 18 are "responsible" for 70% of cervical cancer cases, and therefore protection from them is so important. Routine vaccination is used in 45 countries around the world. A condom (it doesn't provide 100% protection).