HPV – human Papillomavirus infection.


What is HPV?

Genital HPV infection is a sexually transmitted infection (STI). The causative agent of human papillomavirus infection - the human papilloma virus (HPV). The human papilloma virus is a group of viruses, which includes about 100 different types. More than 30 types of HPV are transmitted sexually and infect the genitals and anus of men and women.

The majority of those infected are unaware of their disease do not have clinical manifestations and, moreover, can spontaneously recover.

Part of these viruses are called viruses "high carcinogenic risk", they can cause precancerous lesions of the genitalia. Recent studies have confirmed a major role of HPV in development of cervical cancer. High-risk HPV also play a role in cancer of the vulva, vagina in women and penile cancer in men. To viruses high risk include 16, 18, 31, 33, 35, 39, 45, 52, 53, 56, 58, 59, 68, 69 types – these types of HPV are responsible for 95-98% of cases of cervical cancer. They cause the growth of abnormal cells, which is usually flat and nearly invisible during normal inspection compared to benign warts, which are caused by the virus low risk – 6, 11 types. Benign anogenital warts appear after 2 – 6 months after infection. On the development of precancerous or cancerous changes associated with carriage of high-risk HPV takes years and often there is a spontaneous cure HPV.

The infection is most common in the ages of 15 and 40 and affects equally both women and men. 50 years of life, about 80 percent of women will acquire an HPV infection.

About 50-75% of sexually active people become infected with HPV during their lives, and in most cases, infection does not cause disease and spontaneous healing.

Approximately 90% of HIV-infected people also have HPV infection.

How is HPV

The human papillomaviruses that infect the genital area are transmitted through sexual contact. Most people infected have no visible symptoms of the disease and are therefore carriers of HPV are unaware of their infection and can infect their sexual partners. Sometimes an infected mother can infect newborn during delivery. This can lead to the so-called laryngeal papillomatosis newborns.

Manifestations of infection

Most infected people do not know about it. HPV often causes no manifestations on the skin and mucous membranes. Some people develop genital warts or precancerous changes occur in the cervix, vulva, anus or penis. Very rarely, these changes go directly to the cancer. From infection to development of severe dysplasia on average it takes 20 years. Most women recover spontaneously within 9 – 15 months from infection. The main manifestation of HPV infection – genital warts or genital warts (are caused by HPV 6 and 11 type) - soft warty education on a short thin stalk, resembling a cauliflower or cockscomb with a different location (the head of the penis, penis, small and large labia, vagina, cervix, the anus). Genital warts appear after 2 – 6 months after infection. Visible genital warts are found during the inspection.

Diagnosis of infection

Diagnosis of warts is based on the inspection. Diagnostics of high carcinogenic risk HPV and related changes, a more difficult task. In the basis of diagnostics of precancerous diseases of the cervix for many stood cytological smear (smear under a microscope). However, it has some significant shortcomings – complexity, low sensitivity and high frequency of indeterminate results. The American Committee of the FDA (Committee on medicine and food) have approved the study of HPV by polymerase chain reaction - PCR, which can detect 13 high-risk HPV types. PCR for HPV has high sensitivity, is simple to implement. Sharing of cytological and PCR tests can significantly improve the efficiency of diagnosis, the sensitivity increased to 99 – 100%. It is important that identification of high-risk HPV occurs long before the appearance of precancerous changes of the mucous.

PCR study of high-risk HPV recommended:

  • - As a primary method in addition to Cytology for women 30 years and older.
  • To resolve questionable Cytology.
  • - Patients undergoing treatment for dysplasia or cancer.
  • - In the first stage of diagnosis for countries where poorly organized survey on infection of HPV.
  • - For men survey.

Is it possible to cure this disease?

Diagnosis and treatment of STIs should be carried out in a specialized clinic – the clinic with all the necessary tools for fast and accurate diagnosis.

Specific medications against HPV today no. There are many methods for removing warts, but the disease can return because the virus stays in the human body. Relapses are possible in 25% of cases within 3 months after treatment. In the treatment of warts required inspection of sexual partners. However, the vast majority of sexual partners are infected with HPV and have no visible signs of the disease.

Treatment of precancerous lesions is to use the chemical, physical and other methods, with the aim to change the structure of the affected areas of the mucous membranes, as well as the use of drugs stimulating the immune system. In the future, need annual Cytology and HPV determination by polymerase chain reaction.

What is the connection between HPV and cervical cancer?

Just the facts:

  • The human papilloma virus, high risk are the main cause of cervical cancer.
  • In cases of severe dysplasia (pre-cancer) and cervical cancer HPV is detected in almost 100% of cases.
  • HPV is associated with a 250-fold increase risk of development of severe dysplasia.
  • Cervical cancer is the 1st leading cause of female mortality in developing countries.
  • Cervical cancer occupies the 2nd place after breast cancer among women in the world – 250 thousand deaths every year.
  • Annually in Russia 300 12 women is diagnosed with cervical cancer and more than 6 thousand patients die each year.
  • Over the past 10 years, the average age of cases decreased from 58 to 55 years.
  • In women up to 29 years the incidence has increased in 2 times.
  • High-risk HPV cause cervical cancer in 100% of cases, cancer of the anus – 90%, cancer of the vagina and vulva – 40% of penile cancer – 40% oropharyngeal cancer in 12% of cases.
  • The American Cancer Society predicted in 2004 that approximately 10 520 women will develop invasive cancer of the cervix and about 3 900 women will die of the disease. The majority of women with aggressive cervical cancer is not passed the correct examination to HPV infection.

Infection prevention

The surest way to prevent genital HPV infection is to refrain from any sexual contact with another individual.

Long-term sexual relations with their regular sexual partner does not give 100% guarantee against HPV infection. It is difficult to determine without special tests, if infected at present, sexual partner.

Male latex condoms, when used correctly reduce the risk of transmission.

Any symptoms such as pain or unpleasant sensations when urinating, an unusual rash, discharge is a signal to stop sexual contact and immediate examination in a specialized clinic. If the patient has discovered an STI, it needs to inform their sexual partners so that they also passed a full examination and appropriate treatment. It will reduce the risk of developing serious complications and prevent re-infection.