Birus human papillomas (HPV) are extremely common in the world of sexually transmitted infection.
The peculiarity of this infection is that for many years it cannot be manifested in any way, but finally lead to the development of benign genital diseases (papillomas) or malignant (cervical cancer).
Human papillomavirus types
More than 100 types of HPV are known. The types are the peculiar "subspecies" of the virus that differ between them. The types are indicated by the numbers assigned as they open.
The Oncogenic High Risk Group 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 are known (mainly 6 and 11). They lead to the formation of anogenital warts (Puntiaguda Condille, Papillomas). Papillomas are found in the mucosa of the vulva, the vagina, in the perianal region, in the skin of the genitals. They almost never become malignant, but lead to significant cosmetic defects in the genital area. Warts in other parts of the body (arms, legs, face) can also be caused by this type of virus, and may have a different origin. In subsequent articles we will discuss the types of HPV "high risk" and "low risk" separately.
Human papilloma infection of human papilloma
The virus is transmitted mainly in sexual relations. Sooner or later, HPV almost all women are infected: up to 90% of sexually active women will find this infection throughout life.
But there is good news: most of the infected (around 90%) will eliminate HPV without any medical intervention 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 be completely undone of the virus. In such a situation, HPV will not do any damage to the body.That is, if a HPV was discovered some time ago, but now it is not, it is absolutely normal!
It should be taken into account that the immune system works for different people with "different speeds. "In this sense, 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 did not.
Most people infect HPV shortly after the beginning of sexual activity, and many of them will never know that HPVs have been infected. Persistent immunity after infection is not formed, so reinfection is possible both the same virus with which there was already a meeting and other types of viruses.
The "high risk" of HPV is dangerous, since it can lead to the development of cervical cancer and some other types of cancer. High risk HPVs do not cause other problems. HPV does not lead to the development of inflammation in the vaginal uterine mucosa/cervical, disorders of the menstrual cycle or infertility.
HPV does not affect the ability to conceive and support pregnancy. The "high -risk" HPV "is not transmitted during pregnancy and during childbirth. Diagnosis of human papillomavirus
It is practically useless to take an analysis for HPV VPV at a high oncogenic risk of up to 25 years (except those women who begin an early sexual life (up to 18 years)), since at that time it is very likely that you 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 and HPV test "high risk", then this situation requires special attention;
- The long -term persistence of the "high risk" of HPV in the absence of cytological changes also requires attention. Recently, it has been shown that the sensitivity of HPV tests in cervical cancer prevention is greater 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 United States. However, in Russia, an annual cytological study is recommended, therefore, a combination of these two studies is reasonable;
- After the treatment of dysplasia/precacence/cervical cancer (the absence of HPV in the analysis after treatment almost always indicates a successful treatment). For research, it is necessary to obtain a smear of the cervical channel (it is possible to study and material from the vagina, however, it is recommended that the material be recommended from the cervix).
The analysis must be taken:
- Once a year (if the "high risk" of HPV was previously discovered, and the analysis is passed along 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 oncogenic risk of HPV. If there are no papillomas, then this analysis makes no sense in principle (the transport of the virus is possible, there is no virus treatment, so it is not known what to do with the result of the analysis).
If there are papillomas, then:
- Most of the time they are caused by HPV;
- It is necessary to eliminate them regardless of whether we will find types 6/11 or not;
- If you take a stain, then directly with the papillomas themselves, and not of the vagina/cervix.
There are tests to identify different types of HPV. If you perform periodic tests for HPV, pay attention to what specific types are included in the analysis. Some laboratories carry out a study only in type 16 and 18, others, for all kinds together. It is also possible to take an analysis that identifies the 14 types of "high risk" virus in quantitative format. The quantitative characteristics are important to predict the probability of developing cancer of precanceros and cervical. These tests should be used in the context of cervical cancer prevention, and not as an independent test. The analysis for HPV without the results of cytology (RAR test) does not allow us to draw conclusions about the patient's health.
There is no such analysis that determines whether the virus "will go" in a particular patient or not.
Human papillomavirus treatment
There is no pharmacological treatment for HPV. There are states treatment methods caused by HPV (papillomas, dysplasia, prognosis, cervical cancer). This treatment should be carried out using surgical methods (cryoagulation, laser, radio knife).
"Immunosimulants" are not related to HPV treatment and should not be applied. None of the widely known medications passed proper tests that show their effectiveness and safety. Protocols/standards/recommendations are not included in these medications. The presence or absence of "erosion" of the cervix does not affect the tactics of HPV treatment.
If the patient has no complaints, and he also does not have a papill/changes in the cervix during colposcopy and, according to PAP, the test, no treatment procedures are needed.
It is only necessary to resume 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 its own. If it does not leave, it is completely optional that leads to the development of cervical cancer, but control is necessary. No treatment of sexual partners is required (with the exception of cases in which both couples have genital papillomas).
Human Papilloma Virus Prevention
Vaccines have been developed that protect from 16 and 18 types of HPV (one of the vaccines also protects 6 and 11 types). The types of HPV 16 and 18 "responsible" for 70% of cases of cervical cancer and, therefore, protection against them is very important. Planned vaccination is used in 45 countries. Condon (does not provide 100%protection).