It is quite common that we hear about the Human Papilloma Virus. What's more, for some time, vaccination against Human Papillomavirus (HPV) has been included in the vaccination schedule.
Although there is enough information on the subject, sometimes we do not know how to deal with it and it is very common that either it becomes trivial or we worry excessively, assuming that after this infection our future is really uncertain or we will surely develop cancer. But does being a carrier of HPV really mean that we are going to develop cancer? Do we know everything there is to know about HPV? We will try to clarify your doubts.
What is HPV
There is not a single human papillomavirus. It is a group of more than 150 related viruses. Each of these HPV types is named by a number.
A Pair of 40 Types they are capable of causing diseases in humans.
This large group of viruses is called papilloma because several types of HPV cause warts or papillomas. Others, the most dangerous are capable of causing cancer. The most common cancer of the cervix.
HPV infection is considered the most common sexually transmitted disease. HPV is so common that almost the entire sexually active population contracts it at some point in their life.
Can it cause any cancer?
These viruses can only live in certain cells of our body. These are cells found in the skin and in moist areas, such as mucous.
- The vagina, anus, cervix, vulva (the area outside of the vagina)
- The inside of the foreskin and urethra of the penis
- The inside of the nose, mouth, and throat
- The trachea and bronchi
75% of HPV viruses are called cutaneous because they cause common warts on our skin. The arms, chest, hands or feet are common areas. These viruses are not transmitted sexually.
The rest are viruses that live in the mucous membranes. These are the ones that are transmitted sexually and cause genital warts or certain types of cancer.
Types of sexually transmitted viruses
inside this virus group we can distinguish between two others
- Low-risk HPV. These viruses do not cause cancer but can cause warts (condylomata) on the genitals, anus, mouth, or throat.. Within this group are HPV types 6 and 11, which are responsible for 90% of all genital warts. And they can even cause these lesions in the respiratory tract.
- High-risk HPV. These viruses can cause cancer. About 18 high-risk HPV types have been identified. Among them HPV types 16 and 18 that are responsible for most cancers caused by HPV.
How it is transmitted
It is a virus that is transmitted sexually. The contagion is really simple and frequent. Anyone who is sexually active can contract a Human Papillomavirus. Most sexually active people are estimated to contract the virus shortly after sexual intercourse begins. The more sexual partners the person has, the greater the risk of infection.
Genital human papillomavirus is spread primarily through direct skin-to-skin contact during vaginal, oral, or anal sex. It does not spread through blood or body fluids.
Sexual contact, even without intercourse, with an infected person is enough to become infected. And it may even be that contact with the infected person occurs long before the diagnosis is made or the lesions appear.
Most people who carry the virus do not know it.
Are there risk factors?
It is considered that there are several Factors riesgo to acquire the infection.
- Having many sexual partners. According to a study of the Ministry of Health, Social Services and Equality (msssi) "While the prevalence of HPV in monogamous women is 8,9%, that of women who refer 10 or more sexual partners is 44,6%"
- Having a partner who has had many partners
- Be under 25 years of age
- Start having sex at an early age. Before the age of 16, especially in women.
- Smoke tobacco.
- People with a weakened immune system.
- In men, a protective factor that reduces contagion is circumcision. The contagion is greater with men who are not.
Can infection be avoided? How to prevent its spread
In sexually active people avoiding infection is truly complex. Decreasing the number of our own and our partner's sexual partners we decrease the risk of infection.
The age of initiation of sexual intercourse is also a factor to take into account, the lower the age of onset, the greater the risk of contracting the infection.
The habitual and regular use of the condom decreases, although it does not prevent contagion. Even using a condom, there are areas that would not be covered and could transmit the virus.
It is important to use a new condom for each act of sex. It should always be placed before any contact with the genital or anal area and maintained until the complete completion of sexual intercourse.
Vaccination Especially when this is done before the start of sexual intercourse.
Do you have treatment?
Human Papillomavirus infection, when there are no lesions, currently has no medical treatment. A follow-up is usually carried out to detect early the possible injuries that it may cause.
It takes a long time for the virus to cause a cancerous lesion, experts estimate between 10 and 20 years. In many cases our own body it is capable, over time, of eliminating the virus itself.
The tumors or warts produced by HPV do have treatment, which will be different depending on the lesion produced.
Types of cancer that can cause
- Cervical cancer. It is possibly the one that has the greatest relationship with HPV. Virtually all cervical cancers are caused by HPV.
- Vulvar cancer Much less frequent than the cervix.
- Vaginal cancer. It is estimated that 9 each 10 Vaginal cancers are caused by HPV
- Penile cancer More frequent in homosexual couples.
- Anal cancer Both men and women. Almost all cases of anal cancer are caused by HPV.
- Mouth and throat cancer. Most cancers of the back of the throat, including the base of the tongue and tonsils, are related to HPV. These are the most common HPV-linked cancers in men.
Do you have symptoms?
HPV infection has no symptoms unless it causes injury.
May appear warts in the genital, anal, or oral area.
If it causes any injury to the cervix at first, no symptoms may appear. If the injury to the cervix worsens, it may appear:
- Irregular breakthrough vaginal bleeding (between menstrual periods) or abnormal vaginal bleeding after you have had sex. These are the symptoms that can most guide us towards an injury to the cervix.
- back, leg, or pelvic pain
- tiredness, weight loss, loss of appetite
- vaginal discomfort or odorous vaginal discharge
How is it diagnosed?
There is only a validated cervical HPV screening test. In other words, there is no proven test to diagnose when a person is simply a carrier of the virus.
Cervical cytology is performed to screen for cervical cancer or triple feed (also called a Pap test).
The WHO recommends that all women between the ages of 30 and 49 have cytology performed.
In our country, the Ministry of Health, Social Services and Equality recommends carrying out the screening test (cervical cytology) to all women between 25 and 65 years, with a periodicity of between 3 and 5 years. Although each Autonomous Community can introduce certain changes.
There are vaccines
There are currently two HPV vaccines.
Gardasil® quadrivalent vaccine. Protects against HPV types 6/11/16 and 18. They are the causative types of most cases of genital warts and cancer.
Cervarix® bivalent vaccine. Protects against HPV types 16 and 18, causing most cancers.
Both vaccines make our body create immunity against these types of HPV, but there is also what is called "cross immunity". This type of immunity makes vaccinated people also protected against other types of HPV.
Both vaccines are authorized and have been included in the vaccination schedule. Vaccination is done to girls.
According to the Autonomous Community, vaccination is carried out with one or the other.
Gardasil® can also be applied to males.
WHO recommendations
WHO recommends vaccination for all girls from the age of 9. Ideally, vaccinate before the start of sexual intercourseIn this way, the girl has not been able to get it even by any type of HPV.
If you are vaccinated before the age of 15, two doses are sufficient. Ideally, the interval between the two doses should not exceed 12/15 years.
In immunosuppressed people and those over 15 years of age, the vaccine is also advisable. In this case, three doses are needed to be fully protected.
As an example I leave you the vaccination recommendations in the Region of Madrid:
Vaccination at 12 years. Two doses of vaccine, with an interval of 6 months.
Vaccination at 14 years of previously unvaccinated girls. The guideline is also two doses in six months.
Ideally, the two doses should be put in a maximum interval of one year
Does the vaccine have adverse effects?
Like all vaccines, it is not exempt from adverse reactions. All the studies In this regard, they have come to the conclusion of that adverse reactions are quite rare and insist that the benefits outweigh the risks. Hence the consensus of the scientific community to recommend vaccination.
The reactions more frequent are those that occur locally at the injection site. The most frequent is that it appears redness, pain and certain inflammation. They may also suffer from syncope or dizziness.
Can the vaccine be contraindicated?
Yes. When in the first dose a significant adverse reaction has occurred or the girl has an allergy to any of the components of the vaccine or suffers from a disease that contraindicates vaccination. In this case, the doctor should be informed before proceeding with the vaccination.