The Human Papillomavirus (HPV) is the most common sexually transmitted disease in sexually active people. It affects both men and women; it is estimated that more than 50% of sexually active women under the age of 30 are infected with the virus.
The disease usually leaves no sequelae. But there are some types of Human Papillomavirus (HPV) which can produce cellular alterations that can lead to the development of certain types of cancer. The following is everything you need to know about this disease and the importance of HPV vaccination.
What is Human Papillomavirus (HPV)?
The Human Papillomavirus (HPV) is a virus that has the ability to produce mutations in certain cells that can lead to changes in the genetic material that in the long term can lead to the risk of developing certain types of cancers.
However, more than 200 types of Human Papillomavirus (HPV) have been identified and only a few may be associated with cancer-predisposing mutations.
How does the transmission of Human Papillomavirus (HPV) occur?
The Human Papillomavirus (HPV) transmission is produced by vaginal, anal or oral sex or through skin-to-skin contact during sexual intercourse with an infected person, but not through body fluids.
Both men and women can contract the virus, and transmit it. Often a person does not know that they are infected with the virus, so they do not realise that they are passing it on to others. Almost everyone who has had sexual intercourse will get the virus at some point in their lives.
Symptoms of Human Papillomavirus (HPV)
In most cases, even in the case of infection with cancer-causing types, the infected person has no symptoms.
The main symptom that some people experience is the genital warts. Warts vary in appearance, depending on the type of Human Papilloma Virus (HPV) with which a person is infected. In most cases, however, the immune system eliminates the virus before it produces genital warts.
It is worth noting that the presence of these warts is reassuring about the cancer-causing potential of the HPV type. Moreover, not all warts have the same appearance or location:
Genital warts
This type of wart appears as a flat lesion, or as small cauliflower-shaped bumps or as small stalk-like bumps.
In women, these warts usually appear on the vulva, near the anus, on the cervix or in the vagina. In men, they appear on the penis, scrotum or around the anus. They rarely cause pain or discomfort, although they may be itchy or tender.
Common warts
These warts appear as rough, raised bumps. They appear on the hands and fingers. In most cases they are unsightly, and can be painful and susceptible to injury or bleeding.
Plantar warts
They are hard, granular lumps. They usually appear on the heels or on the front of the soles of the feet. They can cause discomfort.
Flat warts
They are flat, slightly raised lesions. These warts can appear anywhere on the body, but in children they usually appear on the face, in men on the beard and in women on the legs.
How is the diagnosis of Human Papillomavirus (HPV) performed?
The Human Papilloma Virus (HPV) diagnosis through the gynaecological examination.
External genital warts are usually diagnosed based on visual examination of their appearance. If they look strange, bleed, develop into open ulcers or become persistent after treatment, they are surgically removed.
Internal genital warts are diagnosed by examining the vagina with a speculum, sometimes requiring the use of a colposcope, which is a magnifying glass that allows the lesions produced by the virus to be seen under magnification. In the case of colposcopy, a dye is applied to facilitate the detection of these warts.
Once the presence of warts has been confirmed, the doctor takes a sample of the warts, which is analysed to determine whether it is Human Papilloma Virus (HPV), and if so, what type it is.
Screening is generally not recommended for people who have no symptoms, although the exception is women between 25 and 65 years of age who should be screened annually.
Importance of Human Papillomavirus (HPV) vaccination
There is a Human Papillomavirus vaccine (HPV) vaccine that can protect against HPV infections and their possible progression to cancer-causing lesions. This vaccine is most effective when the person is not yet sexually active, as they will not have had contact with any of the HPV types.
This vaccine is important because it is a method of prevention of Human Papillomavirus (HPV) disease. There are 3 types of HPV vaccine, but currently the most effective vaccine protects against 9 types of HPV (nonavalent) (types 6, 11, 16, 18, 31, 33, 45, 52 and 58). There are two other vaccines, quadrivalent, which protects against 4 HPV types (types 6, 11, 16 and 18) and bivalent, which protects against two HPV types (types 16 and 18).
Types 16 and 18 cause 70% of cervical cancer cases. Types 6 and 11 cause 90% of genital warts cases, and types 31, 33, 45, 52 and 58 cause 15% of cervical cancer cases.
The vaccine is administered by intramuscular injection in the upper arm and consists of 3 doses to be administered within a maximum period of one year, maintaining a minimum distance of 2 months between the first and second dose and 4 months between the second and third dose.
In many countries, vaccination of girls and boys has been implemented before the onset of sexual intercourse. However, the vaccine is also effective after the onset of sex, especially in patients who have had an HPV infection and whose immune system has been overcome, in order to prevent future infection with the most dangerous strains, as well as in patients who are infected with one of the high-risk strains, but who are not infected with any of the other strains contained in the nonavalent vaccine.
So don't hesitate to make a gynaecological control and ask about the possibility of screening for HPV infection and advice on whether or not vaccination makes sense in your case.
In Malaga in our Pérez-Bryan Gynaecology Clinic has a team of excellent and highly experienced gynaecologists in the field of gynaecology.