The human papilloma virus (HPV) is the most common viral infection of the genital trait.
General information
HPV is a group of extremely widespread viruses all over the world. There are more than 190 types of this virus, of which at least 13 lead to the development of cancer (they are known as types of high risk). The human papilloma virus is mainly transmitted with sexual contacts and most people are infected with them shortly after starting to lead sex. Two types of HPV (16 and 18) cause 70% of all cases of cervical carcinoma (RSHM) and precancerous pathological states of the cervix.
The probability of getting sick
The human papilloma virus is mainly transmitted with sexual contacts and most people are infected with them shortly after starting to lead sex. But penetrating sex is not necessary to transfer the virus. The genital contact of the belly is a well consolidated path of transmission of the papillomavirus infection. HPV infection risk groups are children and teenagers aged 15-18.
Cervical cancer develops following the acquired sexual means of infection with some types of HPV. Risk factors for the development of RSM: the first sexual intercourse at an early age; Numerous sexual partners; The suppression of immunity (for example, people with HIV infection undergo an increased risk of HPV infection and are infected with a wider range of VPV types).
Symptoms and nature of the course of the disease
Most HPV infections do not lead to the appearance of symptoms or diseases and move (about 90% pass within 2 years). However, a stable infection with some types of HPV (very often with the types of 16 and 18) can lead to the development of precancerous pathological conditions. Without treatment, these conditions can develop in cervical cancer. Today, cervical cancer is the most common disease associated with the human papilloma virus. Cervical cancer is the fourth of the most common types of cancer in women and the seventh in general: according to estimates, in 2012 528 were in 2012. 000 new cases in the world.
The symptoms of RSM usually appear only in the advanced phase of cancer and may include the following:
- Irregular, intermestrual (between menstruation) or pathological vaginal bleeding after sexual intercourse;
- Back pain, legs or in the pelvis;
- Fatigue, weight loss, loss of appetite;
- Unpleasant sensations in the vagina or download with an unpleasant smell;
- A swollen leg.
In the subsequent stages, more serious symptoms may appear.
The Papillomavirus infection is also involved in 20-90% of cases of cancer to flat cells of the anus, oropharynx, vulva, vagina and penis. According to estimates, up to 90% of all cases of anal cancer are due to HPV-16 and HPV-18 and 40% of cases of vulva cancer cases, which is mainly found in elderly women, are associated with the HPV-16.
HPV infection due to low -risk types cause anisk warts in men and women (pointed condition or sexual transmission warts). The average time between the infection with the types of HPV-6 or 11 and the development of sexual transmission warts is 11-12 months in men and 5-6 months in young women 16. Anogenital conditions are difficult to treat.
HPV-6 and HPV-11 can also cause a rare condition known as recurring respiratory papillomatosis (RRP), in which warts are formed in the larynx or other parts of the respiratory tract. RRP is mainly observed in children under the age of 5 (youth prp) or in the people of the third life (RRP for adults). In rare cases, women with genital HPV infection can transmit the virus to the child during childbirth. An absurd RRP can lead to a serious problem due to the obstruction of the respiratory tract.
Complications after illness
It has been established that the RSM in 100% of cases is due to ontogenic as types of human papilloma viruses (HPV). In women with a normal immune system, cervical cancer develops in 15-20 years. In women with an weakened immune system, for example, with HIV infection in the absence of treatment, its development can only take 5-10 years. Despite the limited data on Angenital, cancer, different from cervical cancer, an increasing number of effective data indicates the relationship of the human papillomavis with anus, vulva, vagina and penalty. And although these types of cancer are less common than RSHM, their connection with HPV makes them potentially capable of preventing the use of the same primary prevention strategies as cervical cancer.
The types of HPV that do not cause cancer (in particular types 6 and 11) can cause pointed condition and respiratory bow tie (a disease in which tumors grow in the respiratory tract that lead from nose and mouth to the lungs). And although these conditions are very rarely leading to death, they can often lead to a disease. Sharp widespread conditions are widespread and extremely contagious.
Mortality
There is high global mortality from cervix cancer (52%), whose cause is human papillomavirus. In 2012, about 270. 000 women died for RSM and over 85% of these deaths occurred in countries with a low and medium income.
Treatment
RSM screening is testing precancerous conditions and cancer among women who have no symptoms and feel completely healthy. If the screening reveals precancerous pathological conditions, they can be easily treated and therefore prevent cancer. Screening can also identify cancer in an initial phase with a high probability of care.
Given the fact that the precancerous conditions have been developing for many years, every woman aged between 30 and 49 is recommended to undergo screening at least once in a lifetime and better often. Screening is effective to reduce mortality from cervical cancer only in the case of a significant number of women.
There are currently 3 different types of screening:
- The usual papanicolau test (Pap) and liquid cytology (LBC);
- Visual verification by acetic acid;
- Test on high -risk HPV types.
In developed countries, there are programs that offer women screening opportunities, which allows you to identify the most precancerous conditions in the phases when they can be easily treated. The early treatment of the human papilloma virus allows to prevent up to 80% of RSM development cases in these countries.
In developing countries, limited access to effective screening means that the disease is often detected only in the subsequent stages, when the symptoms develop. In addition, the treatment of the disease in such subsequent stages is ineffective, which leads to high levels of mortality from the ASM to these countries.
Effectiveness of vaccination
The results of the clinical studies indicate that the two existing vaccines today are safe and very effective in the prevention of HPV 16 and 18 infection. Both vaccines are more effective if the vaccination is carried out before the human papillomavirus is exposed. Therefore, it is preferable to have vaccination before the first sexual contact. Vaccines do not treat HPV infection or the disease associated with HPV (such as cancer).
In some countries, boys vaccination is introduced against the human papilloma virus, taking into account the fact that it allows you to prevent genital cancer in men and women and one of the available vaccines also prevents the development of genital warts in men and women. In addition, children's vaccination serves to prevent the circulation of HPV in the population of teenagers and young adults. The WHO recommends the vaccination of girls aged between 9 and 13 years, since this is the most effective, in terms of costs, a measure of public health against cervical cancer.
HPV vaccination does not replace cervical cancer screening. In countries where the VPV vaccine is issued, it may also be necessary to develop screening programs. At the end of 2013, the vaccine against the human papilloma virus was introduced in 55 WHO countries.
Modern mathematical models show that the coverage of 12-13-year-old girls, a complete course of primary immunization (3 doses) with a vaccine against papillomavirus infection, it is possible to provide for the risks of the development of cervical cancer of 63%, skin races, skin races. at the age of age. 30 years - of 27%.
Vaccines
Currently, there are two vaccines that protect from 16 and 18 types of human papillomavirus, causing at least 70% of cervical cancer. These vaccines can also provide a certain crossed protection against other less common types of HPV that cause RSM. One of these vaccines also protects from the types of HPV 6 and 11, which cause anogenital condition.
The development and recording of vaccines against Papillomavirus infection have led to the possibility of the primary prevention of the Arsm.
The latest epidemics
Cervical cancer is the second most common type of cancer among women - according to estimates, 530. 000 new cases of disease are recorded every year, about 270. 000 patients are dying.
The incidence maintains the trend of growth.
The probability of the CRM disease of every woman on average during her life is 0, 53%.
Historical information and interesting facts
In the middle of the mid -twentieth century, the scientist Harold Tsur Housen discovered that women suffering from cervical cancer are invariably infected with human papillomavirus. In 1983, he discovered the DNA of the Papillomavirus in a biopsy of cervical cancer and this event can be considered the opening of the VPH-16 oncogenic virus. In 2008, the Nobel Committee awarded the Nobel Prize in the field of physiology and medicine Harald Zur Hausen for discovering that the papilloma virus can cause cervical cancer.