HPV: know everything about the common disease in women

There are a variety of sexually transmitted diseases that can be potentially dangerous. One of the most common is infection with HPV, a silent virus that affects thousands of people worldwide. It mainly affects the female sex and is the cause of cervical cancer, responsible for 265 thousand deaths of women per year. For not showing symptoms, many people are infected and will only discover years later, when they develop more serious problems. Come on?

HPV virus infection is the most common sexually transmitted disease (STD) worldwide. According to data from the World Health Organization, there are around 600 million people infected around the planet. In addition, about 75% and 80% of the population acquire one or more types of HPV at some point in their lives. STDs are among the top ten causes of demand for health services worldwide.

In today’s text we will talk about:

  • What is HPV
  • Types of HPV
  • Contagion
  • Risk factors
  • Symptoms
  • Diseases caused by HPV
  • Diagnosis
  • Treatment
  • Prevention
  • Vaccination
  • Take cover

What is HPV?

Human papillomavirus, also known as HPV, is a virus that settles on the skin or mucous membranes and affects both men and women. HPV was first described in 1935 by Dr. Francis Peyton Rous, who demonstrated the existence of a virus with oncogenic (capable of inducing the formation of tumors) that caused cancer in the skin of rabbits; and whose description coincided with the papillomavirus. Currently, HPV infection is the most frequent sexually transmitted disease (STD), that is, it is the main viral infection transmitted by sex.

Types of HPV

There are 150 different types of HPV and of that total 30 to 40 can affect the genital areas of both sexes, causing different diseases. They are divided into two major groups:

Low oncogenic risk HPV – Usually associated with benign lesions. The most common are types 6 and 11, which cause approximately 90% of genital warts – one of the most common health problems with increasing rates worldwide – and about 10% of low-grade cervical lesions.

High-risk oncogenic HPV – May cause cancer precursor lesions. There are 15 in this group, but the most common are types 16 and 18, which cause most cases of cervical cancer worldwide (about 70%). They are also responsible for up to 90% of cases of cancer of the anus, up to 60% of cancers of the vagina and up to 50% of cases of vulvar cancer.

Contagion

The HPV virus is highly contagious and a person can be infected in a single exposure. Contagion can occur through direct contact with infected skin. Transmission occurs through direct contact with infected skin and unlike other STDs, it can occur even without vaginal or anal penetration and without the exchange of body fluids. In more rare cases, the virus can also be transmitted through contact with hand, skin, objects, underwear and even the vessel. There may also be transmission during delivery.

ince many people with HPV do not show any signs or symptoms, they do not know they have the virus and end up infecting their partners.

Risk factors

Factors that increase the risk of becoming infected with HPV include:

  • Relations with different partners
  • Maintain sexual contact without protection or without using condoms
  • Immunosuppression (low immune system)
  • Early sexual life
  • Presence of other sexually transmitted diseases

In addition, some factors may be responsible for the development of cervical cancer, which is associated with HPV, among them:

  • Overweight
  • Prolonged use of birth control pills
  • Multiple pregnancies
  • Family history of cervical cancer
  • HIV infection and other sexually transmitted diseases (such as herpes and chlamydia)
  • Smoking

There are a variety of sexually transmitted diseases that can be potentially dangerous. One of the most common is infection with HPV, a silent virus that affects thousands of people worldwide. It mainly affects the female sex and is the cause of cervical cancer, responsible for 265 thousand deaths of women per year. For not showing symptoms, many people are infected and will only discover years later, when they develop more serious problems. Come on?

hpv

HPV virus infection is the most common sexually transmitted disease (STD) worldwide. According to data from the World Health Organization, there are around 600 million people infected around the planet. In addition, about 75% and 80% of the population acquire one or more types of HPV at some point in their lives. STDs are among the top ten causes of demand for health services worldwide.

In today’s text we will talk about:

  • What is HPV
  • Types of HPV
  • Contagion
  • Risk factors
  • Symptoms
  • Diseases caused by HPV
  • Diagnosis
  • Treatment
  • Prevention
  • Vaccination
  • Take cover

What is HPV?

Human papillomavirus, also known as HPV, is a virus that settles on the skin or mucous membranes and affects both men and women. HPV was first described in 1935 by Dr. Francis Peyton Rous, who demonstrated the existence of a virus with oncogenic (capable of inducing the formation of tumors) that caused cancer in the skin of rabbits; and whose description coincided with the papillomavirus. Currently, HPV infection is the most frequent sexually transmitted disease (STD), that is, it is the main viral infection transmitted by sex.

Types of HPV

There are 150 different types of HPV and of that total 30 to 40 can affect the genital areas of both sexes, causing different diseases. They are divided into two major groups:

Low oncogenic risk HPV – Usually associated with benign lesions. The most common are types 6 and 11, which cause approximately 90% of genital warts – one of the most common health problems with increasing rates worldwide – and about 10% of low-grade cervical lesions.

High-risk oncogenic HPV – May cause cancer precursor lesions. There are 15 in this group, but the most common are types 16 and 18, which cause most cases of cervical cancer worldwide (about 70%). They are also responsible for up to 90% of cases of cancer of the anus, up to 60% of cancers of the vagina and up to 50% of cases of vulvar cancer.

Contagion

The HPV virus is highly contagious and a person can be infected in a single exposure. Contagion can occur through direct contact with infected skin. Transmission occurs through direct contact with infected skin and unlike other STDs, it can occur even without vaginal or anal penetration and without the exchange of body fluids. In more rare cases, the virus can also be transmitted through contact with hand, skin, objects, underwear and even the vessel. There may also be transmission during delivery.

Since many people with HPV do not show any signs or symptoms, they do not know they have the virus and end up infecting their partners.

Risk factors

Factors that increase the risk of becoming infected with HPV include:

  • Relations with different partners
  • Maintain sexual contact without protection or without using condoms
  • Immunosuppression (low immune system)
  • Early sexual life
  • Presence of other sexually transmitted diseases

In addition, some factors may be responsible for the development of cervical cancer, which is associated with HPV, among them:

  • Overweight
  • Prolonged use of birth control pills
  • Multiple pregnancies
  • Family history of cervical cancer
  • HIV infection and other sexually transmitted diseases (such as herpes and chlamydia)
  • Smoking
risk-factors-hpv-catia-damascene

Symptoms

In most cases, HPV has no symptoms and is spontaneously eliminated by the body. It is estimated that only about 5% of people infected with HPV will develop some form of manifestation. However, when the infection is not cured and, depending on the type of HPV involved, some signs may appear.

In women, papillomavirus can cause genital warts to appear, which can be of various sizes – flat or high – and which the doctor can observe with the naked eye. They can appear on the cervix, vagina, vulva, pubic, perineal, perianal and anus regions. In men, warts can appear on the penis (usually on the glans), scrotum, pubic, perianal and anus. These lesions can also appear in the mouth and throat, in both sexes. If no treatment is followed, over time, these warts may disappear, remain unchanged, or grow and multiply.

Diseases caused by HPV

Vaginal warts

They are rashes of the skin, white or reddish and usually appear on the external genitals or near the anus, in men and women. In rarer cases they may appear inside the vagina and anus or in the cervix. Often, these rashes cause symptoms such as burning, itching or discharge. They can appear weeks or months after sexual contact with an infected person.

Cervical cancer

It is a tumor that develops from changes in the cervix, which is located at the bottom of the vagina. These changes, called precursor lesions, are completely curable most of the time. However, if left untreated, after many years, they develop into cancer.

Cervical cancer manifests itself at any age in a woman’s life. About half of all women diagnosed with the disease are between 35 and 55 years old. Many were probably exposed to HPV in their teens or in their 20s.

Other diseases

HPV has been linked to other types of cancers. Among them are cancer of the vagina, cancer of the vulva (outside of the female genitals that surrounds the opening of the vagina) and oropharynx. HPV infection can also cause cancer of the anus in men and women, which can begin both internally and externally.

Diagnosis

Genital warts can be diagnosed by urological (penis), gynecological (vulva) and dermatological (skin) exams. However, many people show no sign or symptom when infected and can transmit the virus without knowing it, as it can remain on human skin in a latent state (without manifestations) for years. Therefore, routine examinations by gynecologists, urologists and proctologists are necessary. Here are a few:

Pap smear

Most women find that they have HPV through a Pap smear, the most common preventive test, which helps detect abnormal cells in the lining of the cervix. Considered the best method to detect cervical cancer, it identifies between 80% and 95% of the cases of the disease. It is recommended that women take the exam annually from the age of 25.

Colposcopy

Made with a device called a colposcope, which increases the doctor’s vision power by 10 to 40 times. This examination allows to identify lesions in the vulva, vagina, cervix and anal region. Indicated in cases of abnormal Pap smear results. After localization of regions with suspected disease, a tissue fragment (biopsy) is removed for diagnostic confirmation.

Molecular Detection

Hybrid capture: molecular biology test, which investigates the presence of a high-risk HPV set, by detecting its DNA.

PCR (polymerase chain reaction): this test detects, using highly sensitive molecular biology methods, the presence of the HPV genome in cells, tissues and body fluids.

Treatment

The form of treatment depends on factors such as the patient’s age, the type, extent and location of the lesions. See below:

  • Warts – External genital warts can be removed by laser, cryotherapy (freezing) or surgery using local anesthetics. There are treatments with chemical substances, such as podofline and its derivatives and trichloroacetic acid. However, warts can come back several times in up to 50% of cases, requiring many applications, over weeks or months.
  • Cervical cancer – When the cancer is restricted to the lining of the cervix ( carcinoma in situ ), the doctor is usually able to remove it completely, removing part of the cervix. When it is in a more advanced stage, radical hysterectomy (surgery for the removal of the uterus and adjacent structures) and the removal of lymph nodes are necessary. If the cancer has not spread beyond the pelvic region, treatment can be done through radiation therapy.

Prevention

Prevention is the best way to reduce HPV cases, in addition to being more cost-effective. Here are some simple steps that can help prevent contagion:

  • Condom use (sex) during sexual intercourse
  • Avoid having too many sexual partners
  • Carry out personal hygiene
  • Get vaccinated against HPV
  • Conduct periodic examinations
  • Have healthy lifestyle habits.

Vaccination

The vaccine stimulates the production of antibodies specific to each type of HPV. Protection against infection will depend on the amount of antibodies produced by the vaccinee, the presence of these antibodies at the site of infection and their persistence over a long period.

According to the WHO, vaccination is the main form of prevention against HPV, since the use of condoms helps, but does not guarantee total protection against contagion. In Brazil, two types of vaccine have been approved.

  • Bivalent vaccine – protects against HPV types 16 and 18, and should be taken in three doses. It is indicated for girls and women over 9 years and without age limit, as it offers preventive coverage against approximately 70% of cancer and injuries
  • Quadrivalent vaccine – protects against HPV types 6, 11, 16 and 18, and should also be taken in three doses. It is the only one indicated for use in both sexes, in the age group of 9 to 26 years old and offers protection against cancers and precancerous lesions of the cervix, anus, vulva and vagina.

Warning: The vaccine is not a substitute for cervical cancer screening. Even women who are immunized should continue to have Pap smears on a routine basis. It is also good to remember that the vaccine is not therapeutic, that is, there is no effectiveness against infections or injuries that already exist.

Vaccination campaigns

With the objective of helping to prevent the appearance of cervical cancer, the fourth leading cause of death of women from cancer in the country, the Federal Government, the Ministry of Health and SUS carry out the HPV vaccination campaign annually.

Since 2014, when the HPV vaccine was included in the National Immunization Calendar, the Ministry of Health’s National Immunization Program has been carrying out actions aimed at achieving the goals of vaccination coverage (80%) in the target population. To this end, partnerships are being made with scientific societies and joint work with churches, non-governmental organizations and the media. The objective is to clarify about HPV as a public health problem in the country and the importance of vaccination, as a strategy to prevent cancers of the cervix, vulva, penis, anus and oropharynx.

Campaign extension

Until 2016, the target audience of the vaccination campaign were 9 to 15-year-old girls, but in 2017, it also included 11 to 15-year-old boys. They were also entitled to the vaccine, transplanted and cancer men and women in use. chemotherapy and radiotherapy. In addition, about 200 thousand children and young people, of both sexes, aged 9 to 26 years living with HIV / AIDS, also started to be vaccinated against HPV.

Low demand

Despite the expansion of the public, the demand for the vaccine remains low. One reason is the prejudice of some parents, who believe that vaccinating a child or adolescent against a sexually transmitted disease can encourage early sexual initiation. The Ministry of Health also faces other difficulties, such as the resistance of this age group to seek a health unit, especially to get vaccinated and the low knowledge about the importance of vaccination.

New changes and new target audience

In the second half of 2017, the Ministry of Health announced new changes: the expansion of HPV vaccination for men and women up to 26 years. The measure, of a temporary nature, will be carried out in municipalities with stocks available in the vaccination services and which have an expiration date until the month of September.

With the end of these stocks, the guidance of the Ministry of Health is that the vaccine continues to be administered only to the target audience (9 to 15 years).

Take cover

Dealing with a problem like infection like HPV is not easy. The diagnosis can cause frustration and anxiety, seriously impacting a person’s routine. In addition to the discomfort of undergoing prolonged and sometimes painful treatments. There are also psychological issues, such as shame and guilt. Therefore, it is best to be cautious and always use condoms, keep your vaccination up to date and undergo periodic examinations.

If you suspect you have HPV, see a doctor immediately to treat the problem and prevent it from developing into something more serious. Talk to your partner and explain your problem, so that both can take appropriate action. Remember: your health should always come first.

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