Birus human papillomas (HPV) is an extremely common in the world sexually transmitted infection.
The peculiarity of this infection is that for many years it may not manifest itself in any way, but ultimately lead to the development of benign (papillomas) or malignant (cervical cancer) genital diseases.
Types of human papilloma virus
More than 100 types of HPV are known. Types are the peculiar "subspecies" of the virus that differ among themselves. Types are indicated by numbers that were assigned to them as they open.
The group of high oncogenic risk is 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, the types of low Oncogenic risk (mainly 6 and 11) are known. They lead to the formation of Anogenital warts (pointed condille, papillomas). Papillomas are located on the mucosa of vulva, vagina, in the perianal region, on the skin of the genitals. They almost never become malignant, but 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 types of virus, and may have a different origin. In subsequent articles we will separately discuss the types of HPV "high risk" and "low risk".
Human papilloma infection of human papilloma
The virus is transmitted mainly in sexual intercourse. Sooner or later, HPV almost all women become infected: up to 90% of sexually active women will encounter this infection throughout life.
But there are good news: most infected (about 90%) will get rid of HPV without any medical interventions for two years.
This is a normal course of the infectious process caused by HPV 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 a HPV was discovered some time ago, but now it is not, it is absolutely normal!
It must be borne in mind that the immune system works for different people with "different speeds". In this regard, the speed of getting rid of HPV can be different in sexual partners. Therefore, a situation is possible when one of the partners found a HPV, and the other does not.
Most people become infected with HPV shortly after the start of sexual activity, and many of them will never know that HPVs have been infected. Persistent immunity after infection is not formed, so re -infection is possible both the same virus with which there was already a meeting, and other types of virus.
HPV "high risk" is dangerous in that it can lead to the development of cervical cancer and some other types of cancer. HPVs of high risk does not cause other problems. HPV does not lead to the development of inflammation on the vaginal mucosa/cervix, menstrual cycle disorders or infertility.
HPV does not affect the ability to conceive and bear pregnancy. The child’s HPV "High Risk" is not transmitted during pregnancy and during childbirth. Diagnosis of human papilloma virus
It is practically pointless to take an analysis for HPV HPV on a high oncogenic risk of up to 25 years (except for those women who start a sex life early (up to 18 years)), since at that time it is very likely to detect a virus, which will soon leave the body on its own.
After 25-30 years, it makes sense to take analysis:
- Together with an analysis of cytology (PAP - test). If there are changes in the Pap - test, and HPV "high risk", then this situation requires special attention;
- Long -term Persistence of HPV "high risk" in the absence of cytological changes also requires attention. Recently, it has been proved that the sensitivity of HPV testing in the prevention of cervical cancer is higher than the sensitivity of a cytological study, and therefore the definition of only HPV (without cytological research) is approved as an independent study for the prevention of cervical cancer in the USA. However, in Russia, an annual cytological study is recommended, therefore, a combination of these two studies is seen reasonable;
- After the treatment of dysplasia/precancer/cancer of the cervix (the absence of HPV in the analysis after treatment almost always indicates successful treatment). For research, it is necessary to obtain a smear from the cervical channel (it is possible to study and material from the vagina, however, it is recommended that the material is recommended from the cervix).
Analysis must be taken:
- Once a year (if HPV "high risk" was previously discovered, and the analysis is passed together with a cytological study);
- 1 time in 5 years, if the previous analysis was negative.
It is almost never necessary to take an analysis of the HPV low oncogenic risk. If there is no papillomas, then this analysis does not make sense in principle (the carriage of the virus is possible, there is no treatment of the virus, so it is not known what to do with the result of the analysis).
If there are papillomas, then:
- Most often they are caused by HPV;
- It is necessary to remove them regardless of whether we will find 6/11 types or not;
- If you take a smear, then directly with the papillomas themselves, and not from the vagina/cervix.
There are tests for identifying HPV different types. If you periodically take tests for HPV, pay attention to what specific types are included in the analysis. Some laboratories make a study only on the 16th and 18th type, others - for all types together. It is also possible to take an analysis that will identify all 14 types of "high risk" virus in quantitative format. Quantitative characteristics are important for predicting the likelihood of developing precancer and cervical cancer. These tests should be used in the context of the prevention of cervical cancer, and not as an independent test. Analysis for HPV without the results of cytology (RAR test) most often does not allow us to draw any conclusions about the patient's health status.
There is no such analysis that will determine whether the virus will "leave" in a particular patient or not.
Treatment of human papilloma virus
There is no drug treatment for HPV. There are methods of treating states caused by HPV (papillomas, dysplasia, forecasting, cervical cancer). This treatment should be carried out using surgical methods (Cryocoagulation, laser, radio knife).
No "immunostimulants" are related to the treatment of HPV and should not be applied. None of the widely known drugs passed adequate tests that would show their effectiveness and safety. No protocols/standards/recommendations are included in these drugs. The presence or absence of "erosion" of the cervix does not affect the tactics of the treatment of HPV.
If the patient has no complaints, and also does not papill/changes on the cervix during colposcopy and according to PAP - the test, no treatment procedures are needed.
It is only necessary to retake the analysis once a year and monitor the condition of the cervix (annually PAP - test, colposcopy). In most patients, the virus will "leave" the body on their own. If it does not leave, it is completely optional that it will lead to the development of cervical cancer, but control is necessary. Treatment of sexual partners is not required (with the exception of cases where both partners have genital papillomas).
Prevention of human papilloma virus
Vaccines have been developed that protect from 16 and 18 types of HPV (one of the vaccines also protects from 6 and 11 types). Types of HPV 16 and 18 "responsible" for 70% of cases of cervical cancer, and therefore protection against them is so important. Planned vaccination is used in 45 countries. Condom (does not provide 100% protection).