Human Papilloma Virus Infection
Human Papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) in the world.
Persistent HPV infection of the oncogenic type is the most important factor contributing to the development of cervical cancer which is the most common cause of cancer in women and in developing countries is the second most frequent cause of cancer death.
The mechanism of transmission of HPV unlike other STIs, is transmitted by friction with infected areas and not by secretions such as semen or blood.
Cervical cytology (Pap smear). The optimal age for initiating screening is unknown but clinical practice guidelines suggest it should be within three years after the first intercourse or until age 21, whichever occurs first. Cervical cytology will be performed annually until three technically satisfactory negative tests accumulated; Later, it is recommended every 2 or 3 years.
- Vaccination against HPV (it is recommended to apply the vaccine before starting the sexual life to be more effective, currently it has been established the age of 11-12 years.
- Protection during sexual intercourse (use of a condom, although it does not guarantee 100% protection, the only safe method is sexual abstinence)
- Reduce the number of sexual partners in order to lessen the risk of contagion.
HPV infection itself does not cause any symptoms, however it can be divided into two groups, those that infect the mucous membranes and those that infect the skin.
Condyloma acuminata or anogenital warts: These are newly-formed “tumors” at the expense of the first skin layer of the mucous and/or skin color, with a surface similar to a cauliflower, of variable size, appearing in the sexual organs, perianal region, urethra or oral cavity. They are characterized by being painless lesions, which may be single or multiple and of variable size. At the cervical neck and vagina level, visualization of the lesions is done through colposcopy.
- Women infected with HIV.
- Immunocompromised women (those who have received kidney transplants).
- Women who had exposure to diethylstilbestrol in utero.
- Women previously treated for CIN2, CIN3 or cancer.
The causative agent of this infection is the human papilloma virus; Which belongs to the family of papillomaviridae, of which more than 100 types have been recognized up to now.
They infect the skin and mucous membranes and can produce benign or malignant epithelial tumors. They vary in their tissue tropism, their association with different lesions and their oncogenic potential.
The most frequently associated (70% of cases) to intraepithelial neoplasia (cervical cancer, anus or penis) are 16 and 18, especially in people who are infected with HIV; and producers of condyloma acuminata in 90% are caused by 6 or 11, in addition to 1, 2, 3, 4. HPV types 16, 18, 31 and 35 are occasionally found in visible anogenital condylomas.
HPV infection is the cause of cervical cancer, which is the second cause of cancer in women in Mexico, followed by breast cancer.
However, having HPV infection does not mean that you have cervical cancer, in fact, most types of HPV infections do not cause cancer.
Women can protect themselves from cervical cancer by performing regular Pap tests and receiving early treatment for any problems that may lead to cancer.
Getting ready for your appointment with the specialist
You can go to the gynecologist for a preventive evaluation, for which there are no special precautions prior to the appointment, however if you have scheduled the completion of cervical cytology in the same consultation, it is important to go with the following specifications:
- Adequate personal cleanliness
- No sex 48 hours before the appointment.
- Not using tampons, vaginal foams, vaginal douches or vaginal medications in the previous days.
- Not being in the menstrual period.
Examinations and diagnostic studies
The diagnosis is made through biomolecular tests such as HPV DNA determination, visual inspection with acetic acid solution and the most used as screening in the country is cervical cytology (Pap test).
Medical treatment and medication
There is no treatment for genital human papillomavirus. However, most of the time, your body is in charge of fighting the virus by itself.
There are available treatments for health problems that can cause HPV, such as genital warts, cervical changes and cervical cancer.
The virus can remain in your body, even after you have been treated for genital warts. This means that you can still transmit HPV to your sexual partners.
Tips to stay healthy:
It is recommended to avoid risky sexual practices and perform the screening as mentioned above.
How to live better with HPV
Infection with the human papillomavirus is an asymptomatic infection, so there are no actions to be taken if you are in these conditions, but you must be in control if you have genital warts, to give specific treatment.
- Breviary for epidemiological surveillance of communicable diseases, 2014.
- Direction of medical benefits, IMSS.
- Prevention and timely detection of cervical cancer in the first level of care.
- Mexico: Mexican Social Security Institute, 2011
- Genital human papillomavirus. Center for the control and prevention of diseases.